• competitive narc. antagonist used in management of known / suspected narc. OD
• antagonizes all actions of morphine
• preferred first line agent in suspected opioid OD

complete / partial reversal of CNS and resp. depression induced by opioids including: 

• narc. agonist
• narc. agonist / antagonist
• decreased level of consciousness
• coma (unknown origin)

• morphine sulfate
• heroin
• hydromorphone
• methadone
• meperidine
• paregoric
• fentanyl citrate
• oxycodone
• codeine
• propoxyphene

• hypersensitivity
• caution in narc. dependant - may experience withdrawal symptoms (including neonates of narc. dep. moms)

Onset : 2 min

Duration : 30-60 min

• tachycardia
• hypertension
• dysrythmias
• N + V
• diaphoresis
• blurred vision
• withdrawal (opiates)

• 0.4 mg / ml (1 ml, 10 ml)
• 1 mg / ml (2 ml) vials

Adult

0.4 - 2 mg IM / IV / SQ / ET diluted

may be repeated in 5 min intervals

max 10 mg over short period (<10 min)

Infusion: mix 8 mg in 1 L D₅W, infuse at 2/3 initial reversal dose, titrate

Dosage and Administration

Pediatric

0.04 - 0.16 mg/kg/hr IV/IO/SQ/ET diluted

Infusion:

< 5 y/o, < 20 kg: 0.1 mg/kg

> 5 y/o, > 20 kg: 2 mg, titrate

• Pregnancy category B
• seizures have been reported
• may not reverse hypotension
• caution in narc. addicts - may precipitate withdrawal w/ hypertension, tachycardia and violent behavior