Military Obstetrics & Gynecology
Pharmacy

Category:

• Miscellaneous

Description:

• Opiate antidote

Indications:

• Complete or partial reversal of narcotic depression, including respiratory depression

• Diagnosis of suspected acute opioid overdose

Precautions:

• Pregnancy category B

• Physical narcotic dependency

• Pre-existing cardiovascular disorders

Adverse Reactions (Side Effects):

• CNS: seizures, tremulousness

• CV: hypertension, hypotension, tachycardia, ventricular dysrhythmia

• GI: nausea, vomiting

• RESP: pulmonary edema

• SKIN: sweating

• MISC: reversal of anesthesia

Dosage:

Administered subcutaneously, intramuscularly, intravenously

• Adult:            

  • Narcotic overdose (known or suspected): 

    • SC/IM/IV 0.4-2mg initially, repeat at 2-3 minute intervals up to 10mg, if no response after 10mg reevaluate diagnosis

  • Postoperative narcotic depression (partial reversal): 

    • IV 0.1-0.2mg at 2-3 minute intervals to desired level of reversal; repeat doses may be required within 1-2 hour intervals

• Child:            

  • Narcotic overdose (known or suspected): 

    • SC/IM/IV 0.01 mg/kg initially, give subsequent doses of 0.01 mg/kg as needed at 2-3 minute intervals

  • Postoperative narcotic depression (partial reversal): 

    • IV 0.005-0.01mg every 2-3 minutes to desired degree of reversal

Consideration:

• Duration of action of some narcotics may exceed that of naloxone; repeat doses as needed