Naloxone
Opioid overdose reversal, Respiratory depression from opioids
Indications
- Opioid overdose reversal
- Respiratory depression from opioids
Adult dosing
- overdose: dose: 0.4; maxDose: 2; unit: mg; route: IV/IM/IN; interval: q2-3min; fixed: true; titrate: dose: 0.04; unit: mg; route: IV; interval: q2min titrate to RR>12; fixed: true; intranasal: dose: 4; unit: mg; route: IN; fixed: true
Pediatric dosing
- reversal: dose: 0.01; unit: mg/kg; maxDose: 2; maxDoseAbsolute: true; route: IV/IM; interval: q2-3min; weightBased: true; intranasal: dose: 0.1; unit: mg/kg; maxDose: 4; maxDoseAbsolute: true; route: IN; weightBased: true
Clinical pearls
- Start low (0.04mg IV) and titrate to respiratory drive in opioid-dependent patients
- Full dose (2mg) for apneic patients or unknown opioid dependence
- Duration shorter than most opioids — observe for re-sedation 2+ hours
- Intranasal: 4mg via atomizer in each nostril if no IV access
Source and review
- AHA ACLS Guidelines 2020; Goldfrank's Toxicologic Emergencies. Last reviewed: 2024-11-01