Naloxone

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Naloxone Brand Names- EVZIO | Narcan

What is Naloxone

Naloxone is a semisynthetic opioid-receptor antagonist, the n-allyl derivative of oxymorphone. Classically, it is used for complete or partial reversal of opioid-induced respiratory and central nervous system depression.

In emergent situations, naloxone should be administered as an adjunct to supportive or resuscitative measures.

The auto-injector and nasal spray formulations are specific for use in overdose outside of a medical setting; however, they are not substitutes for emergency medical care.

Besides treatment of opioid overdose, naloxone has been used to to address opioid-induced constipation and pruritus.

Naloxone was FDA-approved in 1971.

Indications

  1. coma
  2. hypotension
  3. irritable bowel syndrome
  4. nausea/vomiting
  5. opiate agonist dependence diagnosis
  6. opiate agonist-induced constipation
  7. opiate agonist-induced respiratory depression
  8. opioid overdose
  9. pruritus
  10. urinary retention

For the treatment of opiate agonist-induced respiratory depression

Side Effects

  1. agitation
  2. cardiac arrest
  3. confusion
  4. constipation
  5. dental pain
  6. dizziness
  7. dyspnea
  8. flushing
  9. hallucinations
  10. headache
  11. hot flashes
  12. hyperhidrosis
  13. hypertension
  14. hypotension
  15. hypoxia
  16. injection site reaction
  17. musculoskeletal pain
  18. nasal congestion
  19. nasal dryness
  20. nasal irritation
  21. nausea
  22. neonatal abstinence syndrome
  23. paresthesias
  24. pulmonary edema
  25. respiratory depression
  26. rhinalgia
  27. seizures
  28. sinus tachycardia
  29. tremor
  30. ventricular fibrillation
  31. ventricular tachycardia
  32. vomiting
  33. withdrawal

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • acute opioid withdrawal
  • breast-feeding
  • cardiac disease
  • infants
  • neonates
  • paraben hypersensitivity
  • pregnancy
  • substance abuse

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Alfentanil
  • Alvimopan
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir; Cobicistat
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Belladonna; Opium
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Butorphanol
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Fentanyl
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Levomethadyl
  • Levorphanol
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methylnaltrexone
  • Morphine
  • Morphine; Naltrexone
  • Nalbuphine
  • Naldemedine
  • Naloxegol
  • Opiate Agonists-Antagonists
  • Oxycodone
  • Oxymorphone
  • Pentazocine
  • Pentazocine; Naloxone
  • Propoxyphene
  • Remifentanil
  • Sufentanil
  • Tapentadol
  • Tramadol

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