Naloxone nasal spray
NARCAN
What it isNaloxone 4 mg nasal spray (NARCAN, 2015; OTC since 2023) is a mu-opioid antagonist for community reversal of opioid overdose.
Why this oneA ready-to-use, needle-free device lets bystanders restore breathing before emergency clinicians arrive.
What limits itIt precipitates abrupt withdrawal in opioid-dependent people, and its intranasal half-life ~2 h may be shorter than the opioid's; repeat dosing and emergency care remain essential.
FDA-approved for
- opioid overdose (community reversal) (2015)
- nonprescription (OTC) status (2023)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Emergency treatment of known or suspected opioid overdose | Adults and pediatric patients | 4 mg (1 spray) intranasally in one nostril | repeat every 2–3 minutes in alternating nostrils until response | No stated maximum — continue until patient responds or emergency help arrives |
Renal Undefined
Hepatic Undefined
Repeat every 2–3 minutes until the person responds or emergency help arrives
Instructions
- For nasal use only; do not test device before use
- Each device delivers one dose (single spray)
- Insert nozzle into either nostril and press plunger firmly
- Call 911 immediately after the first dose
- Repeat every 2–3 minutes with a new device in alternating nostrils if no response; keep giving until the person responds or help arrives
Cautions
- On waking, some people may experience opioid withdrawal symptoms such as shaking, sweating, nausea, or feeling angry (expected)
Adverse reactions
- Opioid withdrawal symptoms on waking (shaking, sweating, nausea, feeling angry)
Pregnancy Undefined
Lactation Undefined
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
- Risk from concomitant use with benzodiazepines
Classes and tags
Clinical profile
Mechanism of action: Naloxone nasal spray ballicule
Open Naloxone nasal spray in the interactive console ↗
Memory aids: mascots and interaction avatars
dilated pupils → opioid blocker
