Narcan

Narcan Nasal Spray is a prescription medication used to manage opioid overdose in adults and children.

Narcan belongs to a class of medications called opioid antagonists. They work by reversing and blocking the effects of other opioids to relieve dangerous symptoms, such as slowed or stopped breathing, caused by opioid overdose. Opioids include heroin and prescription pain medications.

This medication is available as a nasal spray and is administered into one nostril as an emergency treatment of known or suspected opioid overdose. 

Common side effects of Narcan include opioid withdrawal and low or high blood pressure.

Narcan Nasal Spray is a prescription medication used along with emergency medical treatment to reverse the life-threatening effects of a known or suspected opioid overdose. Signs and symptoms of an opioid overdose may include the following:

• extreme sleepiness - inability to awaken a patient verbally or with a firm sternal rub
• respiratory depression - this can range from slow or shallow breathing to no breathing
• miosis (constriction of eye pupil) - very small pupils
• slow heart beat and/or low blood pressure

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Narcan. See the “Narcan Precautions” section.

Common side effects of Narcan include the following:

• increased blood pressure
• muscle pain
• headache
• nasal dryness
• nasal edema (build up of fluid in the nose)
• stuffy nose
• nasal swelling

This is not a complete list of Narcan side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

No Narcan drug interactions have been studied by the manufacturer. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Serious side effects have been reported with Narcan Nasal Spray including the following: 

• Risk of recurrent respiratory and central nervous system (CNS) depression (impaired breathing and nervous sytem function). Narcan Nasal Spray effects do not last long; therefore, it is necessary to seek medical help right after the administration of the first dose of Narcan. Also, additional doses might be necessary to sustain its effects.
• Risk of limited efficacy with partial agonists or mixed agonist/antagonists. Narcan Nasal Spray may not be effective  for managing overdose from drugs like buprenorphine and pentazocine. Larger or repeat doses of Narcan Nasal Spray may be required. 
• Precipitation of severe opioid withdrawal (causing narcotic withdrawal symptoms). Use of Narcan Nasal Spray in patients who are opioid dependent may cause opioid withdrawal. Opioid withdrawal is characterized by the following signs and symptoms: body aches, diarrhea, fast heart beat, fever, runny nose, sneezing, sweating, yawning, nausea or vomiting, nervousness, irritability, shivering or trembling, abdominal cramps, weakness, and increased blood pressure. The doctor will monitor the patient for the development of the signs and symptoms of opioid withdrawal. In babies, opioid withdrawal may be life-threatening and may include the following signs and symptoms: convulsions, excessive crying, and jerking movements.
• Risk of cardiovascular (heart) event. Patients with heart problems should be closely observed by the doctor when treated with Narcan Nasal Spray due to an increased risk of convulsions, heart arrhythmias, fluid build up in the lungs, and sudden loss of heart function.

Do not use Narcan if you:

• are allergic to Narcan (naloxone) or to any of its ingredients

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Narcan, there are no specific foods that you must exclude from your diet when receiving this medication.

Before using Narcan Nasal Spray, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to Narcan (naloxone) or to any of its ingredients
• have or have had a heart condition
• have an addiction or dependence to any substance
• are pregnant or breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant.

In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Narcan crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Narcan nasal spray.

Use Narcan Nasal Spray exactly as prescribed.

This medication is available as a nasal spray and is administered into one nostril as an emergency treatment of known or suspected opioid overdose. 

Narcan Nasal Spray is not a substitute for emergency medical care. Seek emergency medical care immediately after use.

Administration instructions for family members or caregivers:

• Administer Narcan Nasal Spray as quickly as possible if a patient is unresponsive and an opioid overdose is suspected, even when in doubt, because prolonged respiratory depression may result in damage to the central nervous system or death.
• Lay the patient on their back and administer Narcan Nasal Spray into one nostril while providing support to the back of the neck to allow the head to tilt back.
• Use each nasal spray only one time.
• Turn patient on their side and call for emergency medical assistance immediately after administration of the first dose of Narcan Nasal Spray. 
• Monitor patients and re-administer Narcan Nasal Spray using a new Narcan Nasal Spray every 2 to 3 minutes, if the patient is not responding or responds and then relapses back into respiratory depression. Administer Narcan Nasal Spray in alternate nostrils with each dose.
• Replace Narcan Nasal Spray before its expiration date.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended dose of Narcan Nasal Spray is 1 spray (4mg) delivered into one nostril. If needed, additional doses may be given every 2 to 3 minutes until emergency medical assistance arrives. 

If you take too much Narcan, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If Narcan is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store Narcan Nasal Spray in the blister and cartons provided.
• Store at controlled room temperature 59°F to 77°F (15°C to 25°C).
• Do not freeze.
• Protect from light.