Naloxone - Revision history

Danbot: Switch SMW query from broadtable to table format for better layout with TOC

2026-03-20T21:55:22Z

Switch SMW query from broadtable to table format for better layout with TOC

2026-03-20T17:24:28Z

Fix SMW query: replace link=subject with mainlabel=- to fix broken subobject fragment links

2026-03-20T16:42:36Z

Add dynamic SMW Indications by Condition table (auto-populated from disease pages via MedicationDose template)

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 *For this reason many hospital algorithms call for ~3 hours of ED observation prior to discharge
 *Some small studies have called for decreasing this time frame to 1 hour but there are often adverse events in a significant proportion of these patients (one study showed that 15% of patients had adverse events such as need for supplemental oxygen after attempting discharge at 1 hour)<ref>Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study Clemency, B.M., et al, Acad Emerg Med 26(1):7, January 2019</ref>.
 ==See Also==

2025-09-30T23:19:33Z

Opioid toxicity: Added intranasal dosing

← Older revision		Revision as of 23:19, 30 September 2025
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	==Adult Dosing==		==Adult Dosing==
	===[[Opioid toxicity]]===		===[[Opioid toxicity]]===
	*Bolus (May repeat q3min up to max dose 10mg		*Bolus (May repeat q3min up to max dose 10mg)
	**Apneic or near-apneic - 2mg IV		**Apneic or near-apneic - 2mg IV
	**Opioid-naive with minimal respiratory depression - 0.4mg IV		**Opioid-naive with minimal respiratory depression - 0.4mg IV
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	**Step 1: Determine the "wake-up dose" or bolus required to wake the pt		**Step 1: Determine the "wake-up dose" or bolus required to wake the pt
	**Step 2: Give 2/3 of the "wake-up dose" per hr; mix in 1L D5W		**Step 2: Give 2/3 of the "wake-up dose" per hr; mix in 1L D5W
			*Intranasal
			**Pre-mixed nasal spray: 3,4, or 8 mg (1 spray) in one nostril. May repeat q 2-3 minutes if no response
			**IV solution: 2 mg (1 mg each nostril using atomizer)<ref>Naloxone. In: ''Lexi-Drugs''. UpToDate Inc; 2025. Accessed September 30, 2025. https://www.uptodate.com/contents/naloxone-drug-information</ref>

	==Pediatric Dosing==		==Pediatric Dosing==

2025-09-30T22:36:01Z

Special Populations: Added missing renal/hepatic info.

← Older revision		Revision as of 22:36, 30 September 2025
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	*[[Drug Ratings in Pregnancy\|Pregnancy Rating]]: C		*[[Drug Ratings in Pregnancy\|Pregnancy Rating]]: C
	*Lactation: insufficient data		*Lactation: insufficient data
	*Renal Dosing		*Renal Dosing: No dose adjustment
	**Adult		*Hepatic Dosing: No dose adjustment
	**Pediatric
	*Hepatic Dosing
	**Adult
	**Pediatric

	==Contraindications==		==Contraindications==

2025-09-30T22:28:34Z

Pediatric Dosing: clarify full reversal vs. correction of correction of therapeutic resp depression

← Older revision		Revision as of 22:28, 30 September 2025
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	==Pediatric Dosing==		==Pediatric Dosing==
	*IV: 0.005 to 0.01mg/kg IV every 2 to 3 minutes as needed to desired degree of reversal		*Full reversal (overdose or intoxication)
	*If IV route is not available, may administer in divided doses IM		**IV/IO: 0.1 mg/kg (max 2 mg). Repeat every 2 to 3 minutes as needed
			*Titrated correction of respiratory depression from therapeutic opioid
			**IV/IM/SUBQ: 0.005 to 0.01mg/kg IV every 2 to 3 minutes as needed to desired degree of reversal

	==Special Populations==		==Special Populations==

2025-09-30T21:34:26Z

Pharmacology: expand mechanism of action

← Older revision		Revision as of 21:34, 30 September 2025
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	*Metabolism: hepatic		*Metabolism: hepatic
	*Excretion: renal		*Excretion: renal
	*Mechanism of Action: opioid antagonist		*Mechanism of Action: opioid antagonist (competes for mu receptor binding sites, displacing opioid)
	*Onset of action - 1-2min		*Onset of action - 1-2min
	*Duration of action - 20-90min ('''may be less than that of the ingested opioid''')		*Duration of action - 20-90min ('''may be less than that of the ingested opioid''')

2020-08-16T11:00:30Z

Adverse Reactions

← Older revision		Revision as of 11:00, 16 August 2020
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	==Adverse Reactions==		==Adverse Reactions==
	*[[Opioid withdrawal]]		*[[Opioid withdrawal]]
			*Non-cardiogenic [[pulmonary edema]]<ref>Mechanism for Naloxone-Related Pulmonary Edema in Opiate or Opioid Overdose Reversal. August 2015. EBM Consult. https://www.ebmconsult.com/articles/mechanism-naloxone-related-pulmonary-edema-opiate-opioid-overdose-reversal.</ref>
	*Serious complications are rare		*Serious complications are rare

2020-02-20T18:23:08Z

Pharmacology

← Older revision		Revision as of 18:23, 20 February 2020
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	*Onset of action - 1-2min		*Onset of action - 1-2min
	*Duration of action - 20-90min ('''may be less than that of the ingested opioid''')		*Duration of action - 20-90min ('''may be less than that of the ingested opioid''')
			*For this reason many hospital algorithms call for ~3 hours of ED observation prior to discharge
			*Some small studies have called for decreasing this time frame to 1 hour but there are often adverse events in a significant proportion of these patients (one study showed that 15% of patients had adverse events such as need for supplemental oxygen after attempting discharge at 1 hour)<ref>Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study Clemency, B.M., et al, Acad Emerg Med 26(1):7, January 2019</ref>.

	==See Also==		==See Also==

2019-09-22T23:46:45Z

← Older revision		Revision as of 23:46, 22 September 2019
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	==General==		==General==
	*Type: [[Opioid]] antagonists		*Type: [[Opioid]] antagonists, [[antidote]]
	*Dosage Forms:		*Dosage Forms:
	*Common Trade Names: Narcan		*Common Trade Names: Narcan
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	[[Category:Pharmacology]]		[[Category:Pharmacology]]
			[[Category:Toxicology]]