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Naloxone
Aka: Naloxone, Narcan, Very Low Dose Naloxone Protocol
- See Also
- Nalmefene (Revex)
- Physiology
- Pure Narcotic antagonist
- Action in under 2 minutes
- Effect lasts 45 minutes
- Indication: Narcotic overdosage
- Respiratory depression
- Sedation
- Hypotension
- Hypoperfusion
-
Narcotic examples reversed by Naloxone
- Heroin
- Methadone
- Pentazocine
- Propoxyphene
-
Narcotics requiring increased Naloxone dosing
- Propoxyphene
- Pentazocine
- Buprenorphine
- Pharmacokinetics
- Onset: 1-2 minutes
- Duration: 1-2 hours
- Dosing: General
- Route:
- Reliable: IV, IO, and ET
- Erratic absorption: IM and SQ
- Single dose
- Child
- Under 5 years (under 20 kilograms): 0.1 mg/kg
- Over 5 years (over 20 kilograms): 2.0 mg
- Adult
- Dose: 0.4 to 2.0 mg IVP
- Start with 0.4 mg if suspecting severe withdrawal
- Repeat dosing
- May repeat at 2-3 minutes intervals
- Maximum total dose: 10 mg
- Infusion (for long acting Narcotic reversal)
- Dose: 0.04 to 0.16 mg/kg/h
- Dosing: Very Low Dose Naloxone Protocol
- Indications: Prevent severe rebound pain that would occur with complete Opioid reversal
- Cancer Pain
- Chronic Pain
- Prepare a 0.04 mg/ml Naloxone solution
- Start with one Naloxone ampule 0.04 mg/ml
- Add saline to make total dose of 10 ml
- Dosing protocol
- Administer 0.01 to 0.04 mg (or 1.5 mcg/kg) IV or IM
- Repeat dose every 3-5 minutes as needed
- Titrate dose to Respiratory Rate and mental status
- Precautions
- Recurrence of Narcotic intoxication
- Occurs if Narcotic half life is longer than Naloxone
- Infusion may be useful with longer acting Opioids
- Infants born to addicted mothers
- Naloxone may precipitate acute withdrawal or Seizures
- Restrain patient overdose prior to administration
- May precipitate withdrawal