Some poison control centers recommend naloxone in the setting of clonidine overdose, including intravenous bolus doses of up to 10 mg naloxone. The mechanism for naloxone's proposed benefit in clonidine overdose is unclear, but it has been suggested that endogenous opioid receptors mediate the sympathetic nervous system in the brain and elsewhere in the body. As the doses used throughout the literature vary, it is difficult to form a conclusion regarding the benefit of naloxone in this setting. Case reports that used doses of 0.1 mg/kg (maximum of 2 mg/dose) repeated every 1-2 minutes (10 mg total dose) have shown inconsistent benefit. However, there is controversy regarding naloxone's efficacy in treating the symptoms of clonidine overdose, namely slow heart rate, low blood pressure, and confusion/somnolence. Clonidine overdoses are of special relevance for children, in whom even small doses can cause significant harm. Naloxone can also be used as an antidote in overdose of clonidine, a medication that lowers blood pressure. This approach to dealing with substance use disorder is to treat it as a medical problem and focusing efforts on reducing the harm produced directly (e.g., overdose) and indirectly (exposure to infectious disease). ĭistribution of naloxone to individuals likely to encounter people who overdose is part of the harm reduction initiatives that have spread throughout the US and the world. Prescribing naloxone should be accompanied by standard education that includes preventing, identifying, and responding to an overdose rescue breathing and calling emergency services. A prescription for naloxone is recommended if a person is on a high dose of opioid (>100 mg of morphine equivalence/day), is prescribed any dose of opioid accompanied by a benzodiazepine, or is suspected or known to use opioids nonmedically. This has been shown to reduce rates of deaths due to overdose. It is included as a part of emergency overdose response kits distributed to heroin and other opioid drug users, and to emergency responders. Whether it is useful in those in cardiac arrest due to an opioid overdose is unclear. Naloxone is useful in treating both acute opioid overdose and respiratory or mental depression due to opioids. Ī naloxone kit as distributed in British Columbia, Canada Food and Drug Administration (FDA) approved a higher dose naloxone hydrochloride nasal spray product ( Kloxxado) to treat opioid overdose. Naloxone is available as a generic medication. It is on the World Health Organization's List of Essential Medicines. Naloxone was patented in 1961 and approved for opioid overdose in the United States in 1971. It works by reversing the depression of the central nervous system and respiratory system caused by opioids. Naloxone is a non-selective and competitive opioid receptor antagonist. It appears to be safe in pregnancy, after having been given to a limited number of women. In those with previous heart disease or taking medications that negatively affect the heart, further heart problems have occurred. To prevent this, small doses every few minutes can be given until the desired effect is reached. Īdministration to opioid-dependent individuals may cause symptoms of opioid withdrawal, including restlessness, agitation, nausea, vomiting, a fast heart rate, and sweating. Multiple doses may be required, as the duration of action of most opioids is greater than that of naloxone. The effects of naloxone last from about 30 seconds to 24 hours. Another route it can be given is by spraying it into a person's nose. Effects begin within two minutes when given intravenously, and within five minutes when injected into a muscle. Naloxone may also be combined with an opioid (in the same pill), to decrease the risk of opioid misuse. It is commonly used to counter decreased breathing in opioid overdose. Oh, I walk by the store Where we sat on the floor And we ate like kids And someone said "Ay.Naloxone, sold under the brand name Narcan among others, is a medication used to block the effects of opioids. Without your lips on mine No, the sun doesn’t shine And no I can’t breathe I can't breathe Your words are a symphony Music that sings to me No I can’t breathe I can’t breathe I can’t breathe The roses you left me Slowly fading to gray Your coat on the chair And the scent of your hair I miss The clock on the wall It reminds me of all the better times When we walked in the park And we whispered in the dark And we laughed and criedĪnd I never knew along That wherever you are is home