Naloxone Hydrochloride (Narcan)

Narcotic Antagonist

Competitive inhibition at narcotic receptor sites, reverse respiratory depression secondary to depressant drugs, completely inhibits the effect of morphine.

Opiate overdose, coma; complete or partial reversal of CNS and respiratory depression induced by opioids; decreased level of consciousness; coma of unknown origin; narcotic agonist for the following: Morphine, Heroin, hydromorphone (Dilaudid), methadone, meperidine (Demerol), paregoric, fentanyl (Sublimase), oxycodone (Percodan), codeine, propoxyphene (Darvon); narcotic agonist and antagonist for the following: Butorphanol (Stadol), pentazocine (Talwin), nalbuphine (Nubain).

Use with caution in narcotic-dependent patients; use with caution in neonates of narcotic-addicted mothers.

Withdrawal symptoms in the addicted Pt., tachycardia, hypertension, arrhythmias, nausea, vomiting, diaphoresis.

Incompatible with bisulfite and alkaline solutions.

0.02 mg/mL (neonate); 0.4mg/mL, 1mg/mL; 2.0mg/5mL ampules; 2mg/5mL prefilled syringe.

• Adult: 0.4-2.0mg IV, IM, SC, or ET (diluted); minimum recommended dose, 2.0mg; repeat at 5 minute intervals to a maximum dose of 10mg (medical control may request higher amounts). Infusion: 2mg in 500mL of D₅W (4mcg/mL), infuse at 0.4mg/h (100mL/h).
• Pediatric: 0.1mg/kg/dose IV, IM, SC, ET (diluted); maximum dose of 0.8mg; if no response in 10 minutes, administer and additional 0.1mg/kg/dose.

• Onset: within 2 minutes.
• Peak effect: variable.
• Duration: 30-60 minutes.

Pregnancy safety: Category B. Seizures without causal relationship have been reported. May not reverse hypotension. Use caution when administering to narcotic addicts (potential violent behavior).