Nalmefene

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Nalmefene Brand Name– Revex

What is Nalmefene

NOTE: As of July 9, 2008, Baxter has discontinued nalmefene (Revex®) production.

Nalmefene is a parenteral opiate receptor antagonist with structural similarities to both naloxone and naltrexone.

Prior to development of nalmefene, naloxone was the only parenteral opiate antagonist available on the market after nalorphine was discontinued.

Nalmefene distinguishes itself from naloxone by its significantly longer metabolic half-life which makes its duration of action as long as that of most opiate agonists.

Because of this, nalmefene may be preferred over naloxone in cases of methadone overdose although repeat doses of nalmefene may still be necessary.

Nalmefene is not a controlled substance and is currently approved for reversal of postoperative opiate depression and for management of opiate agonist overdose or toxicity.

Nalmefene was approved for use on April 17, 1995.

Indications

  • opiate agonist-induced respiratory depression
  • opioid overdose

For known or suspected opioid overdose

Side Effects

  1. dizziness
  2. fever
  3. hypertension
  4. nausea
  5. sinus tachycardia
  6. vomiting
  7. withdrawal

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • brain tumor
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • geriatric
  • head trauma
  • infants
  • neonates
  • pregnancy
  • renal impairment
  • seizure disorder
  • substance abuse

Interactions

  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Alvimopan
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Butorphanol
  • Flumazenil
  • Methylnaltrexone
  • Nalbuphine
  • Naldemedine
  • Naloxegol
  • Opiate Agonists-Antagonists
  • Pentazocine
  • Pentazocine; Naloxone
  • Tramadol

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