Narcan

Authored by Claire Cheshire

Edited by Alexander Bentley

Reviewed by Dr Ruth Arenas

Narcan

 

Narcan is a medication given to individuals who have experienced an opioid overdose or may have experienced an opioid overdose. Your doctor may suggest Narcan be on hand if you are taking opioid pain medication. Narcan is given to patients of all ages. If there is worry that a person taking opioid pain relief medication has had an overdose, a caregiver will give Narcan to the individual.

 

Once Narcan is given to the individual, the caregiver should phone local emergency services right away. Although giving Narcan can save a person’s life, it does not replace medical care for opioid overdoses11.R. R. Lynn and J. Galinkin, Naloxone dosage for opioid reversal: current evidence and clinical implications – PMC, PubMed Central (PMC).; Retrieved September 28, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753997/.

 

What is Narcan?

 

Narcan contains the active drug naloxone. Naloxone is an opioid antagonist and works against opioids after a person overdoses. The spray is administered as a nasal spray or prefilled syringe. One dose of the opioid antagonist is contained in each spray bottle. A caregiver will spray the medication into one nostril.

 

Currently, there is no generic version of Narcan and it can only be bought under the brand name. A prescription is not needed to purchase the spray and it is available at most pharmacies. Due to the ongoing opioid drug problem in the United States, Narcan’s availability has grown.

 

Using Narcan

 

A pharmacist will explain to you how Narcan should be used. You will learn how to give the drug, how often, and how much to give the individual or yourself. You should follow their instructions to correctly give the medication.

 

One spray for one nostril is available in each Narcan container. After an individual has overdosed or possibly overdosed, Narcan should be given22.D. P. Wermeling, Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access – PMC, PubMed Central (PMC).; Retrieved September 28, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308412/. You may need more than one dose of Narcan to treat an individual. If this is the case, you will need more than one bottle of the opioid antagonist. When administering more than one dose, you should alternate the nostrils in which you gave it. Even if the person receiving the spray becomes responsive, you must call emergency services.

 

Narcan is such a powerful reversal agent that many individuals who have overdosed feel fine, and go on to use (and overdose) a second time.

What are the steps to administer Narcan?

*Download Full Instructions for Use

 

This information is not intended to replace the guidance you will receive on the Narcan label, in the Narcan pack, or when your Doctor or Pharmacist hands you the spray. The information relates to the Nasal Spray34.T. Knox, Browse journals by subject, Browse journals by subject.; Retrieved September 28, 2022, from https://www.tandfonline.com/doi/full/10.1080/10903127.2019.1597955. There are a few steps to follow to administer the spray.

 

The steps include:

 

  • Lay the victim flat on their back
  • Tilt the victim’s head back slightly
  • Confirm the opioid overdose by checking for a lowered heart rate, shallow breathing, and unresponsiveness
  • Place the nasal spray applicator into one nostril and squeeze
  • After giving the first dose, call the emergency medical services, and wait two to three minutes
  • If symptoms do not improve and they remain unresponsive, apply a second dose into the other nostril

 

The individual should respond within a few minutes. Narcan’s effects last 45 to 90 minutes. Emergency medical personnel will take over the treatment of the victim after they arrive. Narcan may save a person’s life while an ambulance is on route.

What is Narcan given for?

 

Narcan is used for people of all ages when an opioid overdose occurs or may have occurred. Narcan blocks certain receptors in the body that opioids bind to. By blocking the receptors, it helps to reverse an opioid overdose’s symptoms43.R. Abdelal, A. R. Banerjee, S. Carlberg-Racich, N. Darwaza, D. Ito, J. Shoaff and J. Epstein, Real-world study of multiple naloxone administration for opioid overdose reversal among bystanders – Harm Reduction Journal, BioMed Central.; Retrieved September 28, 2022, from https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-022-00627-3. Once Narcan blocks the receptors, the symptoms of an opioid overdose may improve quickly.

 

Opioid overdose symptoms may include:

 

  • Loss of consciousness
  • Slow heart rate
  • Low blood pressure
  • Slow, shallow breathing, or not breathing
  • Smaller than normal pupils of the eyes

 

Doctors may recommend for patients to have Narcan on hand in some cases. Many medications contain opioids.

 

If you take the following medication, you may need to have Narcan on hand:

 

  • Fentanyl
  • Methadone
  • Oxycodone
  • Hydrocodone

Spray dosage

 

The required dosage is one spray into the nostril. Children of all ages can take Narcan and the dosage for children is the same for adults. A dosage is given to the individual once every two to three minutes. Narcan should be given to the individual until they respond or emergency services arrive to take over.

 

The dosage can vary depending on the individual and overdose. One dose may be enough while more than one dose may be needed. There is no minimum or maximum dose requirement of Narcan. You cannot give someone too much nasal spray when it is administered.

 

Side effects of Narcan

 

There are a variety of side effects a person can experience after taking the spray. Side effects can range from mild to serious. The side effects depend on age, health conditions, and other medications that are being taken. When purchasing the nasal spray, speak to the pharmacist about the potential side effects. Pharmacists may even suggest ways to reduce side effects from occurring.

 

Mild side effects

 

  • increased blood pressure
  • Constipation
  • Toothache
  • muscle spasms
  • pain in the bones
  • headache
  • dry or stuffy nose
  • pain and swelling in the nose

 

However, if an individual is needing to receive the spray in an emergency situation then they won’t be worrying about a headache, stuffy nose or toothache.

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  • 1
    1.R. R. Lynn and J. Galinkin, Naloxone dosage for opioid reversal: current evidence and clinical implications – PMC, PubMed Central (PMC).; Retrieved September 28, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753997/
  • 2
    2.D. P. Wermeling, Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access – PMC, PubMed Central (PMC).; Retrieved September 28, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308412/
  • 3
    4.T. Knox, Browse journals by subject, Browse journals by subject.; Retrieved September 28, 2022, from https://www.tandfonline.com/doi/full/10.1080/10903127.2019.1597955
  • 4
    3.R. Abdelal, A. R. Banerjee, S. Carlberg-Racich, N. Darwaza, D. Ito, J. Shoaff and J. Epstein, Real-world study of multiple naloxone administration for opioid overdose reversal among bystanders – Harm Reduction Journal, BioMed Central.; Retrieved September 28, 2022, from https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-022-00627-3
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