Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/3533
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Narcan (Injection)
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NARCAN may be administered intravenously, intramuscularly, or
subcutaneously. The most rapid onset of action is achieved by
intravenous administration, which is recommended in emergency
situations. Since the duration of action of some opioids may exceed that of
NARCAN, the patient should be kept under continued surveillance.
Repeated doses of NARCAN should be administered, as
necessary.<br/>Intravenous Infusion: NARCAN may be diluted for intravenous infusion in normal
saline or 5% dextrose solutions. The addition of 2 mg of
NARCAN in 500 mL of either solution provides a concentration of
0.004 mg/mL. Mixtures should be used within 24 hours. After 24
hours, the remaining unused mixture must be discarded. The rate
of administration should be titrated in accordance with the
patient's response. NARCAN should not be mixed with preparations containing
bisulfite, metabisulfite, long-chain or high molecular weight
anions, or any solution having an alkaline pH. No drug or
chemical agent should be added to NARCAN unless its effect on
the chemical and physical stability of the solution has first
been established.<br/>General: Parenteral drug products should be inspected visually for
particulate matter and discoloration prior to administration
whenever solution and container permit.<br/>Usage in Adults:<br/>Opioid Overdose���Known or Suspected: An initial dose of 0.4 mg to 2 mg of NARCAN may
be administered intravenously. If the desired degree of
counteraction and improvement in respiratory functions
are not obtained, it may be repeated at two- to
three-minute intervals. If no response is observed after
10 mg of NARCAN have been administered, the diagnosis of
opioid-induced or partial opioid-induced toxicity should
be questioned. Intramuscular or subcutaneous
administration may be necessary if the intravenous route
is not available.<br/>Postoperative Opioid Depression: For the partial reversal of opioid depression
following the use of opioids during surgery, smaller
doses of NARCAN are usually sufficient. The dose of
NARCAN should be titrated according to the
patient's response. For the initial reversal
of respiratory depression, NARCAN should be injected in
increments of 0.1 to 0.2 mg intravenously at two- to
three-minute intervals to the desired degree of
reversal, i.e., adequate ventilation and alertness
without significant pain or discomfort. Larger than
necessary dosage of NARCAN may result in significant
reversal of analgesia and increase in blood pressure.
Similarly, too rapid reversal may induce nausea,
vomiting, sweating or circulatory stress. Repeat doses of NARCAN may be required within
one- to two-hour intervals depending upon the amount,
type (i.e., short or long acting) and time interval
since last administration of an opioid. Supplemental
intramuscular doses have been shown to produce a longer
lasting effect.<br/>Septic Shock: The optimal dosage of NARCAN or duration of
therapy for the treatment of hypotension in septic shock
patients has not been established .<br/>Usage in Children:<br/>Opioid Overdose���Known or Suspected: The usual initial dose in children is 0.01 mg/kg
body weight given I.V. If this dose does not result in
the desired degree of clinical improvement, a subsequent
dose of 0.1 mg/kg body weight may be administered. If an
I.V. route of administration is not available, NARCAN
may be administered I.M. or S.C. in divided doses. If
necessary, NARCAN can be diluted with sterile water for
injection.<br/>Postoperative Opioid Depression: Follow the recommendations and cautions underAdult Postoperative Depression. For the initial reversal of respiratory
depression, NARCAN should be injected in increments of
0.005 mg to 0.01 mg intravenously at two- to
three-minute intervals to the desired degree of
reversal.<br/>Usage in Neonates:<br/>Opioid-induced Depression: The usual initial dose is 0.01 mg/kg body weight
administered I.V., I.M. or S.C. This dose may be
repeated in accordance with adult administration
guidelines for postoperative opioid
depression.
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naloxone hydrochloride
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Narcan (Injection)
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NARCAN is indicated for the complete or partial reversal of
opioid depression, including respiratory depression, induced by natural
and synthetic opioids, including propoxyphene, methadone and certain
mixed agonist-antagonist analgesics: nalbuphine, pentazocine,
butorphanol, and cyclazocine. NARCAN is also indicated for diagnosis of
suspected or known acute opioid overdosage. NARCAN may be useful as an adjunctive agent to increase blood
pressure in the management of septic shock (see CLINICAL
PHARMACOLOGY; Adjunctive Use in Septic Shock).
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Narcan
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