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Narcan Nasal Spray

Generic name: naloxone (nasal) [ na-LOX-one ]
Drug class: Antidotes

Medically reviewed by Philip Thornton, DipPharm. Last updated on Aug 2, 2021.

What is Narcan?

Narcan nasal spray contains naloxone hydrochloride. Naloxone blocks or reverses the effects of opioid medication, including extreme drowsiness, slowed breathing, or loss of consciousness. An opioid is sometimes called a narcotic.

Narcan nasal spray is used in an emergency situation to treat a possible opioid overdose in an adult or child.

Narcan should not be used in place of emergency medical care for an overdose.

Warnings

Narcan is used to treat a possible opioid overdose. An opioid overdose can be fatal, and symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

A person caring for you can give the Narcan if you stop breathing or don't wake up. Make sure any person caring for you knows where you keep this medicine and how to use it.

You must get emergency help after giving Narcan spray. You may need to give another spray every 2 to 3 minutes until emergency help arrives.

Before taking this medicine

You should not be treated with Narcan if you are allergic to naloxone.

If possible before you receive Narcan, tell your doctor if:

  • you have heart problems; or

  • you are pregnant or breastfeeding.

If you use opioid medicine during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Using Narcan while you are pregnant may also cause opioid withdrawal effects in your unborn baby. However, having an opioid overdose can be fatal to both mother and baby. It is much more important to treat an overdose in the mother. You must get emergency medical help after using this medicine. Be sure all emergency medical caregivers know that you are pregnant.

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

In an emergency, you may not be able to tell caregivers if you are pregnant or breastfeeding. Make sure any doctor caring for your pregnancy or your baby knows you received Narcan.

How should I use Narcan nasal?

Use Narcan nasal spray exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

This medicine may be given by a healthcare provider, emergency medical provider, or a family member or caregiver who is trained to properly give Narcan nasal spray.

Narcan should be sprayed into the nose while the person is lying on his or her back.

If you are a caregiver or family member read all instructions when you first get this medicine. Ask your doctor or pharmacist if you have any questions.

Be sure you know how to recognize the signs of an opioid overdose in the person you are caring for. Overdose symptoms may include:

  • slowed breathing, or no breathing;

  • very small or pinpoint pupils in the eyes;

  • slow heartbeats; or

  • extreme drowsiness, especially if you are unable to wake the person from sleep.

Even if you are not sure an opioid overdose has occurred, if the person is not breathing or is unresponsive, give Narcan right away and then seek emergency medical care.

Do not assume that an overdose episode has ended if symptoms improve. You must get emergency help after giving Narcan nasal spray. You may need to perform CPR (cardiopulmonary resuscitation) on the person while you are waiting for emergency help to arrive.

After giving this medicine, stay with the person and watch for continued signs of overdose. You may need to give another dose every 2 to 3 minutes until emergency help arrives. Follow all medication instructions carefully.

Each nasal spray pump is for one use only. Throw away after one use, even if there is still some medicine left inside.

Store at room temperature away from moisture and heat. Keep each spray pump in the box until you are ready to give a dose. Do not use this medicine if the expiration date on the label has passed.

Dosing information

Usual Adult Dose for Opioid Overdose:

-Administer 1 spray intranasally into 1 nostril
-If desired response is not achieved after 2 or 3 minutes, give a second dose intranasally into alternate nostril; additional doses may be administered every 2 to 3 minutes in alternating nostrils until emergency medical assistance arrives.

Usual Pediatric Dose for Opioid Overdose:

Children:
-Administer 1 spray intranasally into 1 nostril
-If desired response is not achieved after 2 or 3 minutes, give a second dose intranasally into alternate nostril; additional doses may be administered every 2 to 3 minutes in alternating nostrils until emergency medical assistance arrives

Comments:
-IV route is recommended in emergency situations since it has the most rapid onset of action.
-The duration of action of some opioids exceed that of this drug, therefore, repeat doses may be needed; the need for repeat doses will depend on the amount, type, and route of administration of the opioid being antagonized.
-Patients should remain under continued surveillance; if a patients responds and relapses back into respiratory depression, additional doses should be given.
-Additional supportive and/or resuscitative measures may be helpful while awaiting emergency medical assistance.

What happens if I miss a dose?

Since Narcan nasal spray is used when needed, Narcan has no dosing schedule.

What happens if I overdose?

Since Narcan is supplied as the correct dose in a single-use spray pump, an overdose is unlikely to occur.

What should I avoid while taking Narcan nasal?

Avoid leaving a person alone after giving him or her a dose of Narcan nasal spray. An overdose of naloxone can impair a person's thinking or reactions.

Narcan nasal side effects

Get emergency medical help if you have signs of an allergic reaction to Narcan: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Because Narcan reverses opioid effects, its use may cause sudden withdrawal symptoms such as:

  • nausea, vomiting, diarrhea, stomach pain;

  • fever, sweating, body aches, weakness;

  • tremors or shivering, fast heart rate, pounding heartbeats, increased blood pressure;

  • goose bumps, shivering;

  • runny nose, yawning; or

  • feeling nervous, restless, or irritable.

Sudden withdrawal symptoms in a baby younger than 4 weeks old may be life-threatening if not treated the right way. Symptoms include crying, stiffness, overactive reflexes, and seizures. Call your doctor or get emergency medical help if you are not sure how to properly give this medicine to a baby.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Narcan nasal?

Other drugs may interact with naloxone, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Popular FAQ

Is naloxone an opioid antagonist?

Naloxone is a centrally acting opioid receptor antagonist. Naloxone binds with the highest affinity to the mu-opioid receptor subtype in the central nervous system (CNS). Naloxone works to reverse opioid overdose.

Is naloxone a controlled substance?

Naloxone is not a controlled substance, according to the US Drug Enforcement Administration (DEA). It is an opioid antagonist used to treat known or suspected opioid overdose.

Naloxone blocks opioid receptors from 30 to 120 minutes, but this can be variable and depends upon the dose and how it is given. Some patients may need repeat doses of naloxone. Continue reading

Naloxone works in an overdose by reversing serious or deadly central nervous system (CNS) depression due to opioids (narcotics), including depressed breathing, extreme drowsiness and loss of consciousness. This effect usually occurs in minutes. Naloxone is considered a pure opioid antagonist and it works by blocking opioid receptors in the body. Continue reading

More FAQ

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Narcan only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.