Adult Dosing
Postoperative Opioid depression
naloxone HCL
- Give doses in increments of 0.1-0.2 mg IV, q2-3 min until the desired response. Repeat 1-2 hrs or 0.005 mg/kg IV repeated in 15 min
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Therapy is for intramuscular or subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
Opioid overdose (known or suspected)
naloxone HCL
- 0.4-2 mg IV. Repeat after 2-3 mins if required. (Max total: 10 mg)
- When IV is not available, IM or SC route may be used
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Use for intramuscular and subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
Emergency therapy in settings where opioids may be present
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Therapy is for intramuscular or subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
Pediatric Dosing
Opioid Overdose–Known or Suspected
naloxone HCL
- The usual initial dose in children is 0.01 mg/kg body weight given I.V. If this dose does not result in the desired degree of clinical improvement, a subsequent dose of 0.1 mg/kg body weight may be administered. If an I.V. route of administration is not available, naloxone may be administered I.M. or S.C. in divided doses.
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Therapy is for intramuscular or subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
- Caregiver should pinch the thigh muscle while administering the dose
Postoperative Opioid depression
naloxone HCL
- Give doses in increments of 0.005-0.01 mg IV q2-3 mins until the desired response
Neonatal Opioid-induced Depression
naloxone HCL
- The usual initial dose is 0.01 mg/kg body weight administered I.V., I.M. or S.C. This dose may be repeated in accordance with adult administration guidelines for postoperative opioid depression.
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Therapy is for intramuscular or subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
- Caregiver should pinch the thigh muscle while administering the dose
Emergency therapy in settings where opioids may be present
Evzio
- Upon actuation, Evzio automatically inserts the needle IM/SC 0.4 mg , and retracts the needle fully into its housing
Note:
- Therapy is for intramuscular or subcutaneous use only
- Administer drug into the anterolateral aspect of the thigh, through clothing if necessary
- Additional doses may be administered every 2-3 minutes until emergency medical assistance arrives
- Caregiver should pinch the thigh muscle while administering the dose
- The pain-relieving effects of narcotic medications are reversed with naloxone. Withdrawal symptoms could also occur, such as body aches, diarrhea, increased heart rate, fever, sweating, piloerection, nausea, vomiting, irritability, trembling, weakness, and increased blood pressure.
- Abrupt postoperative reversal of opioid depression has risk of seizures, ventricular tachycardia and fibrillation, pulmonary edema, cardiac arrest and potentially death
- Monitor patients with satisfactory response due to long duration of some narcotics; dose repetition may be necessary
- Naloxone hydrochloride injection may be diluted for intravenous infusion in sodium chloride 0.9% or Dextrose 5%.
- Naloxone is ineffective against respiratory depression due to non-opioid drugs. Reversal of buprenorphine-induced respiratory depression may be incomplete. Assist mechanically if an incomplete response occours
- Resuscitative measures such as maintenance of a free airway, artificial ventilation, cardiac massage, and vasopressor agents should be available
Cautions : Use cautiously in
- Cardiovascular disease or those receiving cardiotoxic drugs (serious adverse cardiovascular effects reported)
- Physical dependence on opioids (precipitates withdrawal)
- Pregnancy (may cause withdrawal in mother and fetus if mother is opioid dependent)
- Lactation (safety not established)
- Hepatic Impairment
- Renal Disease
Pregnancy Category:B
Breastfeeding: Safety unknown. Use with caution.
