Naloxone Nasal Spray

What conditions is Naloxone Nasal Spray used for?  What does it treat?  Does it have any side effects?  Contraindications? 

You may have come to this page wanting to learn more about this medication. Well, you have come to the right place for the answers that you are seeking.

This medication is an intranasal spray indicated to treat someone who has overdosed on opioid substance(s).  It is also used when there is someone who is suspected of overdosing  on opioid substance(s).  The brand name for Naloxone NS is the much more commonly known Narcan nasal spray name.  Most people in the US are familiar with the brand name "Narcan" as most have heard about it on the news as the Opioid epidemic sweeps across our United States and even many places throughout the world.  Opioid abuse and Opioid overdose (OD) is truly an international problem and it should be treated as such.


Naloxone Has Three Current Dosage Forms

This form of medication is only one of three dosage forms of Naloxone which is in existence in approved status from the United States Food and Drug Administration.  The other two dosage forms are Injectable (requires professional training in order to administer) and Auto-Injectable.

Here are some statistics about Opioid Misuse:

  • "About 80 percent of people who use heroin first misused prescription opioids.7
  • Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.6
  • Between 8 and 12 percent develop an opioid use disorder.6"  ("Opioid Overdose Crisis | National Institute on Drug Abuse", 2020).

Common Misconceptions about Narcan

A common misconception is that Narcan has a needle and that it needs to be injected in order to be effective.  This is not true in all cases.  There is no needle in the this particular (nasal) dosage form of this medication.

Another common misconception is that since it is a nasal spray, that it needs to be inhaled in order for the medication to counteract the potentially fatal effects of the opioid overdose.  This is also not true.  According to Narcan.com, "Inhalation [is] not required."  ("What is NARCAN® (naloxone) Nasal Spray", 2020).


Side Effects of Naloxone Nasal Spray

What are some of the side effects of this form Narcan?  The following is a non-exhaustive list of side effects of Naloxone Nasal Spray.  To reiterate, some of the potential side effects from being administered this medication can include:

  • "body aches
  • diarrhea
  • increased heart rate
  • fever
  • runny nose
  • sneezing
  • goose bumps
  • sweating
  • yawning
  • nausea or vomiting
  • nervousness
  • restlessness or irritability
  • shivering
  • stomach cramping
  • weakness
  • increased blood pressure"("What is NARCAN® (naloxone) Nasal Spray", 2020).
  • Severe Opioid Withdrawal Symptoms will likely be precipitated by the use of Narcan.    ("Narcan Nasal (Naloxone Hydrochloride Nasal Spray): Uses, Dosage, Side Effects, Interactions, Warning", 2020)

Contraindications for Naloxone Nasal Spray

The next questions I'd like to answer are 1) are there any contraindications for this Naloxone nasal spray, and 2) when should this nasal spray never be used?

"The duration of action of most opioids may exceed that of NARCAN Nasal Spray resulting in a return of respiratory and/or central nervous system depression after an initial improvement in symptoms. Therefore, it is necessary to seek emergency medical assistance immediately after administration of the first dose of NARCAN Nasal Spray and to keep the patient under continued surveillance. Administer additional doses of NARCAN Nasal Spray if the patient is not adequately responding or responds and then relapses back into respiratory depression, as necessary."  ("Narcan Nasal (Naloxone Hydrochloride Nasal Spray): Uses, Dosage, Side Effects, Interactions, Warning", 2020). 

Breathing can slow or stop for those who have overdosed on Opioids, so it is essential that the patient be observed for at least two hours after Naloxone Nasal Spray has been administered, in order to ensure that the patient does not return to respiratory depression or cessation of breathing.  Sometimes, depending upon the the amount of opioids in the patients body, it is possible for the effects of the Narcan to wear of and for the patient to return to depression of their central nervous system as well.

It should be noted that if someone is allergic to Naloxone, that they should not be treated with Naloxone.

Symptoms of an Opioid Overdose

What are the symptoms and signs of an opioid overdose?

  • Low Blood Pressure
  • Fast Heart Rate (Tachycardia)
  • Shallow Breathing, slow breathing, or the patient may not be breathing.
  • Extreme Sleepiness and an inability to rouse the patient from sleep via verbal or by rubbing their sternum firmly.  ("Narcan Nasal (Naloxone Hydrochloride Nasal Spray): Uses, Dosage, Side Effects, Interactions, Warning", 2020)

References

Opioid Overdose Crisis | National Institute on Drug Abuse. (2020). Retrieved 17 October 2020, from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

What is NARCAN® (naloxone) Nasal Spray. (2020). Retrieved 17 October 2020, from https://www.narcan.com/

Narcan Nasal (Naloxone Hydrochloride Nasal Spray): Uses, Dosage, Side Effects, Interactions, Warning. (2020). Retrieved 17 October 2020, from https://www.rxlist.com/narcan-nasal-drug.htm#warnings

Opioid Overdose Reversal with Naloxone (Narcan, Evzio) | National Institute on Drug Abuse. (2020). Retrieved 17 October 2020, from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-reversal-naloxone-narcan-evzio


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