Opioid receptor antagonist
Naloxone Trade names Narcan, Evzio, Nyxoid, others Other names EN-1530; N -Allylnoroxymorphone; 17-Allyl-4,5α-epoxy-3,14-dihydroxymorphinan-6-one, naloxone hydrochloride (USAN US ) AHFS /Drugs.com Monograph MedlinePlus a612022 License data
Pregnancy category Routes of administration Nasal , intravenous , intramuscular Drug class Opioid antagonist ATC code Legal status
Bioavailability 2% (by mouth , 90% absorption but high first-pass metabolism ) 43–54% (intranasally) 98% (intramuscular, subcutaneous)[ 12] [ 13] Metabolism Liver Onset of action 2 min (IV Tooltip intravenous injection ), 5 min (IM Tooltip intramuscular injection )[ 13] Elimination half-life 1–1.5 h Duration of action 30–60 min[ 13] Excretion Urine , bile
(4R ,4aS ,7aR ,12bS )-4a,9-dihydroxy-3-(prop-2-en-1-yl)-2,3,4,4a,5,6-hexahydro-1H -4,12-methano[1]benzofurano[3,2-e ]isoquinolin-7(7aH )-one
CAS Number PubChem CID IUPHAR/BPS DrugBank ChemSpider UNII KEGG ChEBI ChEMBL CompTox Dashboard (EPA ) ECHA InfoCard 100.006.697 Formula C 19 H 21 N O 4 Molar mass 327.380 g·mol−1 3D model (JSmol )
O=C1[C@@H]2OC3=C(O)C=CC4=C3[C@@]2([C@]5(CC1)O)CCN(CC=C)[C@@H]5C4
InChI=1S/C19H21NO4/c1-2-8-20-9-7-18-15-11-3-4-12(21)16(15)24-17(18)13(22)5-6-19(18,23)14(20)10-11/h2-4,14,17,21,23H,1,5-10H2/t14-,17+,18+,19-/m1/s1
Y Key:UZHSEJADLWPNLE-GRGSLBFTSA-N
Y
N Y (what is this?) (verify)
Naloxone is an opioid antagonist : a medication used to reverse or reduce the effects of opioids .[ 13] For example, it is used to restore breathing after an opioid overdose .[ 13] Effects begin within two minutes when given intravenously , five minutes when injected into a muscle ,[ 13] and ten minutes as a nasal spray .[ 14] Naloxone blocks the effects of opioids for 30 to 90 minutes.[ 15]
Administration to opioid-dependent individuals may cause symptoms of opioid withdrawal , including restlessness, agitation, nausea, vomiting, a fast heart rate , and sweating.[ 13] To prevent this, small doses every few minutes can be given until the desired effect is reached.[ 13] In those with previous heart disease or taking medications that negatively affect the heart, further heart problems have occurred.[ 13] It appears to be safe in pregnancy, after having been given to a limited number of women.[ 16] Naloxone is a non-selective and competitive opioid receptor antagonist .[ 6] [ 17] It works by reversing the depression of the central nervous system and respiratory system caused by opioids.[ 13]
Naloxone was patented in 1961 and approved for opioid overdose in the United States in 1971.[ 18] [ 19] It is on the World Health Organization's List of Essential Medicines .[ 20]
^ "Naloxone Use During Pregnancy" . Drugs.com . 2 September 2019. Archived from the original on 25 April 2020. Retrieved 13 May 2020 .
^ Lenton SR, Dietze PM, Jauncey M (March 2016). "Australia reschedules naloxone for opioid overdose" . The Medical Journal of Australia . 204 (4): 146–147. doi :10.5694/mja15.01181 . PMID 26937664 . S2CID 9320372 . Archived from the original on 19 July 2020. Retrieved 19 July 2020 .
^ Anvisa (31 March 2023). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 16 August 2023 .
^ "Frequently Asked Questions: Access to naloxone in Canada (including Narcan Nasal Spray)" . Health Canada . 6 July 2016. Archived from the original on 16 August 2021. Retrieved 16 August 2021 .
^ "Naloxone 400 micrograms/ml solution for Injection/Infusion – Summary of Product Characteristics (SmPC)" . (emc) . 6 February 2019. Archived from the original on 4 August 2020. Retrieved 13 May 2020 .
^ a b Cite error: The named reference Narcan FDA label
was invoked but never defined (see the help page ).
^ "Evzio- naloxone hydrochloride injection, solution" . DailyMed . 1 February 2018. Archived from the original on 8 October 2020. Retrieved 5 October 2020 .
^ "Zimhi- naloxone hydrochloride injection, solution" . DailyMed . 29 September 2022. Archived from the original on 7 January 2023. Retrieved 7 January 2023 .
^ Cite error: The named reference Kloxxado FDA label
was invoked but never defined (see the help page ).
^ "NDA 208411/S-006 Supplemental Approval letter" (PDF) . U.S. Food and Drug Administration (FDA). Archived (PDF) from the original on 25 June 2023. Retrieved 29 July 2023 .
^ "RiVive: Naloxone HCl Nasal Spray 3 mg Emergency Treatment of Opioid Overdose" (PDF) . Front Actuator (nasal spray device) Label . U.S. Food and Drug Administration. Archived (PDF) from the original on 2 August 2023. Retrieved 2 August 2023 .
^ Ryan SA, Dunne RB (May 2018). "Pharmacokinetic properties of intranasal and injectable formulations of naloxone for community use: a systematic review" . Pain Management . 8 (3): 231–245. doi :10.2217/pmt-2017-0060 . PMID 29683378 .
^ a b c d e f g h i j "Naloxone Hydrochloride" . The American Society of Health-System Pharmacists. Archived from the original on 2 January 2015. Retrieved 2 January 2015 .
^ McDonald R, Lorch U, Woodward J, Bosse B, Dooner H, Mundin G, et al. (March 2018). "Pharmacokinetics of concentrated naloxone nasal spray for opioid overdose reversal: Phase I healthy volunteer study" . Addiction . 113 (3): 484–493. doi :10.1111/add.14033 . PMC 5836974 . PMID 29143400 .
^ "Naloxone DrugFacts" . National Institute on Drug Abuse . 1 June 2021. Archived from the original on 6 January 2022. Retrieved 5 January 2022 .
^ "Prescribing medicines in pregnancy database" . Australian Government . 3 March 2014. Archived from the original on 8 April 2014. Retrieved 22 April 2014 .
^ Cite error: The named reference NHM-Naloxone pharmacology
was invoked but never defined (see the help page ).
^ Yardley W (14 December 2013). "Jack Fishman Dies at 83; Saved Many From Overdose" . The New York Times . Archived from the original on 15 December 2013. Retrieved 6 July 2015 .
^ US patent 3493657 , Jack Fishman & Mozes Juda Lewenstein, "Therapeutic compositions of n-allyl-14-hydroxy - dihydronormorphinane and morphine", published 1970-02-03, issued 1970-02-03, assigned to Mozes Juda Lewenstein Archived 7 December 2022 at the Wayback Machine
^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019 . Geneva: World Health Organization. hdl :10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.