What is naloxone, also known by the brand name Narcan?

  • Naloxone, also known by the brand name Narcan®, is an opioid reversal medication. It can save someone’s life in the event of an opioid overdose.
  • What drugs does naloxone work on? Naloxone can only reverse the effects of opioid medications such as fentanyl, heroin, oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and methadone. 

Who should be carrying naloxone?

  1. It is most important that people who are currently using opioids have naloxone on hand when they take or use prescription and/or nonprescription opioids. 
  2. Secondly, it is important that friends, family, and those around people who routinely use opioids should carry naloxone.
  3. Lastly, if possible, everyone should be carrying naloxone in the event that you need to help a stranger with a suspected overdose. The Good Samaritan Act protects the public under law from being arrested, charged, or prosecuted for helping any and all people in the event an overdose emergency occurs. Always call 911 in the event of an overdose. Stay with the person, if you can, until emergency services arrive at the scene.

Why are there 2 naloxone devices in every box?

Opioid overdoses are very unpredictable, as you may not know how much drug was taken. One dose may not be enough to reverse the opioid effects, so 2 doses are in each box just in case. If the person who has overdosed has not responded within 2-3 minutes after 1 dose of naloxone, another dose should be given. 

How to administer naloxone in an emergency?

  1. Lay the person on their back with their chin tilted slightly upward
  2. Place your pointer and middle finger on either side of the spray device nozzle and your thumb on the device plunger. (Do not press the plunger yet)
  3. Gently insert the nozzle of the naloxone device into one nostril of the patient. 
  4. Now, press the plunger with your thumb to deliver the dose of naloxone. 
  5. Call 911 and let them know you have given naloxone.
  6. If the person is unresponsive after 2-3 minutes: Take a new naloxone device (do not reuse a device) and repeat the steps above to deliver another dose of naloxone.

How do I store naloxone?

  • While naloxone should be kept handy for any time someone may be using an opioid, it’s important to avoid keeping naloxone at extreme temperatures. For example, you do not want to keep naloxone in a car for long periods of time. Instead, you can carry naloxone in a purse, backpack, or bag that stays with you throughout the day. 
  • Generally, naloxone should be kept at room temperature in a dry place away from direct sunlight. Even if naloxone has been exposed to extreme cold or hot temperatures and you need to use naloxone, go ahead and use what you have in an emergency. 

What are the signs that someone is overdosing?

  • Unresponsiveness or unable to wake up
  • Trouble breathing, including slow, gasping breaths or no breathing at all
  • Purple, blue, or pale colored skin
  • Gurgling or sounds you can’t make out as words
  • How do I know if someone is overdosing on an opioid?
    • Unless you witnessed the person take the drug, you may not know what they took. Naloxone is very safe and will not cause harm if the person has overdosed on a drug other than an opioid. It is best to always administer naloxone and call 911 if you suspect any overdose. 

What to expect after giving naloxone?

The goal of naloxone is to prevent death, not to regain full consciousness. The person who overdosed may wake up slowly or quickly wake up agitated. It is important to explain to the person that they just overdosed, got naloxone, and are receiving help. If you do not feel that the scene is safe for you to stay because the person becomes violent, call and stay on the phone with 911 to keep them informed on where they can find the individual to provide follow-up care. 

Where to get naloxone?

Naloxone is now available without a prescription and can be found at most pharmacies over-the-counter. If you have a prescription for naloxone, your insurance may be able to cover the cost. 

When should naloxone be given?

Any time there is a suspected overdose, give naloxone! Naloxone has few side effects and is less harmful than any potential drug overdose. When in doubt, give naloxone.

 

References

  1. Centers for Disease Control and Prevention [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; [updated 2024 Apr 2; cited 2024 June 11]. Lifesaving naloxone. Available from: https://www.cdc.gov/stop-overdose/caring/naloxone.html
  2. Substance Abuse and Mental Health Services Administration [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration; [updated 2024 Mar 26; cited 2024 June 11]. Opioid overdose reversal medication (OORM) Available from: https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/opioid-overdose-reversal-medications 
  3. Good Samaritan Act: https://www.health.pa.gov/topics/Documents/Programs/PDMP/02b_PHMC_Good%20Samaritan%20Laws%20Fact%20Sheet.pdf 
  4. Narcan [Internet]. Gaithersburg (MD): Emergent Devices Inc; [updated 2023 July; cited 2024 Jun 11]. Opioid education. Available from: https://narcan.com/

 

Written by:

Maggie Jones

PharmD Candidate 2025

Philadelphia College of Pharmacy