Narcan is a brand-name medication that’s FDA-approved to treat known or possible opioid overdose in people of all ages. (Opioids are very strong pain medications.) An opioid overdose occurs when someone takes more opioids than their body can safely process.

Overdose symptoms include respiratory depression (slow, weak breathing) and loss of consciousness. Opioid overdose is a medical emergency because it can sometimes be fatal.

Narcan contains the active drug naloxone. It belongs to a class of drugs called opioid antagonists. These drugs work by blocking the effects of opioids in your body. This action reverses the life threatening effects that happen when someone overdoses on opioids.

Narcan comes as a nasal spray. Each single-dose container of Narcan nasal spray holds 4 mg of naloxone. Narcan is given as a spray into one nostril. It’s meant to be given by caregivers or other people who may see someone who has overdosed or possibly overdosed on opioids.

It’s important to know that Narcan is not a substitute for medical treatment. After giving Narcan to someone, you should call 911 right away, even if the person wakes up after getting Narcan. Many opioids last longer in the body than Narcan lasts, so it’s possible that the person may return to an overdose condition after receiving Narcan. In any case, someone who receives Narcan should always be seen by a healthcare provider as soon as possible.

Do I need a prescription for Narcan?

No, you can get Narcan from your pharmacy without a prescription from your doctor. Every state in the United States has passed laws that allow both people who take opioids and their caregivers to purchase Narcan directly from a pharmacy.

However, Narcan isn’t available over the counter. You’ll need to speak with a pharmacist in order to purchase this medication. ADAPT Pharma, Inc., the manufacturer of Narcan, provides a prescription aid that you can print out or display on your smartphone. You can show this to your pharmacist when requesting Narcan.

Effectiveness

Narcan has been found effective in reversing opioid overdose. For more information about the effectiveness of Narcan, see the “Narcan uses” section below.

Good Samaritan laws

The chances of surviving an opioid overdose can depend on how quickly an affected person receives medical treatment.

Most states have policies, called Good Samaritan laws, in place to protect people who overdose on opioids and the people who seek medical help for those individuals. These policies vary by state and provide some protection against prosecution for possessing (having) illegal drugs.

If you witness someone who has overdosed or possibly overdosed on opioids, don’t hesitate to call 911. You can save a life by acting quickly to get medical help.

You should give Narcan according to your doctor or healthcare provider’s instructions. Narcan is given as a nasal spray to someone who has overdosed or possibly overdosed on opioids.

Before giving someone Narcan, you should lie the person on their back in a safe area. Then tilt their head back and support their neck with one of your hands. Remove Narcan nasal spray from its packaging and do the following:

  1. Hold the nasal spray in one hand, with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.
  2. Insert the tip of the nozzle gently into one of the person’s nostrils.
  3. Press the plunger firmly to give them the full dose of Narcan, and then remove the Narcan nasal spray device from their nostril.
  4. Call 911 immediately after giving the first dose of Narcan.

After calling 911, turn the person who has overdosed onto their side. Place them into a “recovery position.” In this position, they’ll have one of their hands under their head and one knee bent forward to stop them from rolling onto their stomach. Lying in this position will prevent them from choking in case they vomit.

Make sure to stay with the person after giving them the first dose of Narcan. If they haven’t started breathing normally within 2 to 3 minutes after receiving their first dose, give them a second dose of Narcan. (Because there is only one dose of Narcan in each device, you’ll need another device to give a second dose.)

Give the second dose of Narcan in the opposite nostril as the first dose was given. Continue monitoring the person’s breathing and give them additional doses of Narcan every 2 to 3 minutes, if needed. You should alternate their doses between their right and left nostrils. Repeat this process until medical staff arrives.

For instructions (with pictures) on how to give someone Narcan, visit the manufacturer’s website.

When to give

Narcan should be given to someone who has overdosed or possibly overdosed on opioids. Before giving Narcan, you should look for signs of an overdose, such as when a person:

  • will not wake up, even when you gently shake them back and forth and yell their name
  • has very slow, shallow breathing, or is not breathing at all
  • has smaller-than-normal pupils (the dark center of your eyes)

Some people may need more than one dose of Narcan. If a person hasn’t started breathing normally within 2 to 3 minutes after receiving their first dose of Narcan, give the person another dose. Continue this process as needed until emergency medical staff arrive.

Narcan is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of a brand-name medication.)

Narcan contains the active drug naloxone.

Other forms of naloxone

Other forms of naloxone, the active drug in Narcan, are available. These forms are typically used in a hospital or healthcare clinic. And they’re given as injections, either into your vein (intravenous), your muscle (intramuscular), or under your skin (subcutaneous).

Narcan nasal spray comes in single-use nasal spray devices that hold one dose of the drug. When receiving Narcan, some people need more than one dose of the medication. Because there is only one dose of Narcan in each device, you’ll need to use a new device for each dose of Narcan.

Talk with your doctor about your opioid overdose concerns. They can recommend the appropriate number of Narcan nasal spray devices for you to keep on hand.

Drug forms and strengths

Narcan comes as a nasal spray that contains the active drug naloxone. It’s available in single-dose containers that hold 4 mg of naloxone.

Narcan comes in a package containing two nasal spray devices (for a total of two doses).

Narcan was available in a 2-mg strength in the past, but that strength has been discontinued.

Dosage for opioid overdose

The standard (initial) dose of Narcan for adults is one spray into one of their nostrils. One spray delivers 4 mg of naloxone, the active drug in Narcan. Be sure to call 911 right after giving someone their first dose of Narcan. Then stay with the person until medical staff arrives.

If the person doesn’t begin breathing normally within 2 to 3 minutes after receiving their first dose, give them a second dose of Narcan. To do this, you’ll need to use a new nasal spray device. The second dose should be given in the opposite nostril as the first dose was given.

Continue to give Narcan doses every 2 to 3 minutes until the person begins breathing normally. You should alternate their doses between their right and left nostrils. Repeat this process until medical staff arrives.

There is no “low dose,” “high dose,” or “maximum dose” of Narcan. You should give the number of doses that are needed to help the person start breathing normally again.

Note: Some opioids, such as tramadol and buprenorphine, may require larger doses of Narcan to reverse an overdose.

Pediatric dosage

The standard dose of Narcan for children is the same as it is for adults: one spray into one of their nostrils. Each spray delivers 4 mg of naloxone, the active drug in Narcan.

Be sure to call 911 right after giving a child their first dose of Narcan. And stay with the child until medical staff arrives.

If the child doesn’t begin breathing normally within 2 to 3 minutes after receiving their first dose of Narcan, give them a second dose. The second dose should be given in the opposite nostril as the first dose was given. Continue giving doses of Narcan every 2 to 3 minutes until the child starts breathing normally again. You should alternate the doses between their right and left nostril. Keep repeating this process until medical staff arrives.

As with adults, there is no “low dose,” “high dose,” or “maximum dose” of Narcan for children. You should give the child the number of doses that are needed to help them start breathing normally again.

Note: Narcan may be processed differently in a child’s body than it is in an adult’s body. Because of this, children may have a greater risk of relapsing into an overdose state after they’ve been given Narcan. With relapse, even after Narcan treatment, children may start having overdose symptoms again. These symptoms can include having very little or no breathing. After a child has received Narcan, they should be monitored for at least 24 hours.

Newborn dosage

The standard dose of Narcan for newborns is typically the same as for adults and children. (See the sections “Dosage for opioid overdose” and “Pediatric dosage” above.) However, you should call the baby’s doctor to find out the appropriate dose of Narcan for your newborn.

For more information about using Narcan in newborns, see the section below called “Narcan uses.”

Is this drug meant to be used long term?

No, Narcan isn’t meant to be used as a long-term treatment. Narcan is meant to be used in emergency situations to reverse the effects of an opioid overdose.

How many times can Narcan be given?

There’s no limit or maximum number of Narcan doses that can be given to someone.

Narcan begins working within 2 to 3 minutes after it’s given. If the person who receives Narcan doesn’t start to breathe normally within that period of time, you should give them another dose of the drug.

Narcan should be given as many times as needed to help the person breathe normally, until emergency medical staff arrives. Giving more doses of Narcan than a person really needs will not harm the person.

Note: There is only one dose of Narcan in each nasal spray device. If you need to give more than one dose, you’ll need to use more than one device. Talk with your doctor or pharmacist about the appropriate number of devices you should keep on hand.

The Food and Drug Administration (FDA) approves prescription drugs such as Narcan to treat certain conditions. Narcan may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Narcan for opioid overdose

Narcan is FDA-approved to treat known or possible opioid overdose.

What is opioid overdose?

Opioids are very strong pain medications. Taking opioids at a higher dose or more often than your doctor recommends can lead to opioid overdose. This is because high amounts of opioids can overwhelm your body, and it may be unable to process the opioids.

Symptoms of an opioid overdose can include:

Opioid overdose is a medical emergency. If it’s not treated right away, it may be fatal.

Which drugs can cause opioid overdose?

All opioids can cause an opioid overdose. Examples of opioids include:

  • morphine (Kadian, MS Contin)
  • oxycodone (Oxycontin, Xtampza ER)
  • hydrocodone (Zohydro ER)
  • fentanyl (Abstral, Fentora, Subsys)
  • methadone (Dolophine, Methadose)
  • buprenorphine (Belbuca, Butrans, Buprenex)
  • hydromorphone (Dilaudid)
  • tramadol (ConZip, Ultram)
  • codeine

Heroin, which is an illicit (illegal) opioid, can also cause overdose. Overdose is also possible if you take opioids in combination with alcohol or certain other drugs. These other drugs include benzodiazepines (drugs used to treat anxiety) or certain medications that are used to help you sleep.

Many opioids come in combination medications, which contain more than one active drug. Opioid overdose can also occur after taking combination medications that contain an opioid.

Effectiveness for opioid overdose

Narcan has been found effective in reversing opioid overdose. The FDA approved Narcan nasal spray for this use based on clinical studies that compared Narcan nasal spray to injectable naloxone (the active drug in Narcan).

One study looked at how Narcan nasal spray acts inside the body compared to naloxone that’s injected into the muscle. In this clinical study, Narcan nasal spray reached higher levels in the body than did the injected naloxone. But Narcan nasal spray reached its maximum level in the body after about the same amount of time as did injectable naloxone. As well, Narcan nasal spray remained in the body longer than the injectable form of the drug did.

In another clinical study, some people who were considered at risk for an opioid overdose were prescribed intranasal naloxone. The medication was given to them as needed for known or possible opioid overdose. (In this study, people received a different intranasal naloxone product than Narcan, because the current Narcan device was not yet FDA-approved.) Other people in the study who were considered at risk for an opioid overdose did not receive a prescription for intranasal naloxone.

Over a period of 6 months, people who received the naloxone prescription had 47% fewer emergency department visits caused by opioid use than did people who didn’t receive the prescription. Over a period of 1 year, people who received a naloxone prescription had 63% fewer opioid-related emergency department visits than did people who didn’t have the prescription.

Narcan for other conditions

In addition to the use listed above, Narcan may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Narcan is used for certain other conditions.

Narcan for overdose caused by substances other than opioids

Narcan does not reverse the effects of an overdose caused by substances that aren’t opioids. This medication only reverses an overdose caused by opioids.

Narcan will NOT reverse an overdose that’s caused only by:

However, many opioid overdoses occur in people who’ve taken opioids with other prescription or illegal drugs. If someone has symptoms of an opioid overdose, but you’re not sure if they’ve taken opioids, you should still give them Narcan.

Narcan won’t hurt a person who has overdosed on something other than opioids, it just won’t treat their overdose unless it’s caused by opioids. After giving Narcan to someone, call 911 right away and stay with the person until emergency medical staff arrives.

Narcan for seizures (not an appropriate use)

Narcan isn’t FDA-approved to treat seizures. And it’s currently not used off-label for this purpose.

However, seizures can sometimes be a symptom of tramadol overdose. (Tramadol is a partial opioid, meaning that it acts like an opioid in your body at certain doses.) Tramadol overdose can be treated with Narcan. In this case, Narcan will reverse the opioid overdose effects, but it could also increase the number and length of seizures the person has.

If someone has overdosed or possibly overdosed on tramadol, you should give them Narcan. And make sure they lie down in a safe place in case they do have a seizure. Then, call 911 right away and stay with the person until emergency medical staff arrives.

Narcan and children

Narcan is FDA-approved to reverse opioid overdose in children of all ages, including newborns.

The effectiveness of Narcan in children has been determined based on studies of Narcan in adults. Narcan’s effectiveness in children is also based on the effectiveness of other products that contain naloxone (the active drug in Narcan) in adults.

It’s important to note that when it’s used in children, Narcan may reach unpredictable levels in their bodies. This is because Narcan may be absorbed into children’s bodies at different rates than it’s absorbed in adults’ bodies.

Because of this, children should be monitored for at least 24 hours after they’ve received Narcan. After giving Narcan to a child, call 911 right away, and stay with the child until emergency medical staff arrives.

Narcan and newborns

Narcan is FDA-approved to reverse opioid overdose in newborns.

Narcan has been found effective for reversing opioid overdose in newborns, based on studies of using this drug in adults. It’s also been found effective based on studies of other naloxone-containing products that were used in adults.

As with older children, the absorption of Narcan in newborns may be unpredictable. Sometimes giving Narcan to a newborn may also lead to severe, sudden opioid withdrawal symptoms. These symptoms, which include seizures, can be life threatening if they’re not treated by healthcare providers. See the “Narcan side effects” section below for more information about opioid withdrawal symptoms.

If a newborn may have possibly been exposed to or overdosed on opioids, call their doctor right away. Their doctor will recommend the right dosage of Narcan to reverse the opioid overdose for the newborn’s age and weight.

After giving Narcan to a newborn, call 911. Then stay with the infant until emergency medical staff arrives. If needed, they’ll treat the infant for any overdose or withdrawal symptoms.

Narcan is not used with other drugs when it’s given by nonmedical professionals to treat opioid overdose.

However, emergency medical staff may give other treatments with Narcan to someone who has overdosed on opioids. These treatments may include drugs that will help the person remain stable and breathe normally. If needed, medical staff may also give the person treatments for opioid withdrawal symptoms.

Recovery from an opioid overdose

If someone’s opioid overdose was caused by addiction or misuse of opioids, their doctor may recommend medication-assisted therapy for opioid use disorder. This therapy can include medications such as:

The medications listed above are used in combination with counseling and behavioral therapy to help reduce opioid cravings and behaviors that can lead to opioid overdose.

Resources that can help someone during the recovery process after an opioid overdose are available from the Department of Health and Human Services.

Narcan is used to reverse the effects of an opioid overdose.

What is opioid overdose?

Opioids are very strong pain relievers. Taking opioids at a higher dose or more often than your doctor recommends can lead to opioid overdose. Using opioids in these ways is called opioid misuse.

Overdose can also happen if you take opioids at a dose that you used to take in the past, but after you’ve stopped using opioids for a while. (This type of overdose is caused by a loss of tolerance to the opioids.)

Finally, it’s also possible to overdose on a prescribed dosage of opioids, but this isn’t a common way to overdose. However, this is more likely to happen if you take opioids in combination with alcohol or other drugs. These other drugs can include benzodiazepines (drugs used to treat anxiety disorders) or certain medications used to help you sleep.

In all of these cases, an overdose occurs when opioid levels in your body are too high, and they overwhelm your body. Opioid overdose can lead to possibly fatal symptoms, including:

  • respiratory depression (slow, weak breathing)
  • being unusually sleepy
  • loss of consciousness (unable to be woken up)
  • pinpoint pupils, which are smaller-than-normal pupils (the dark center part of your eyes)
  • severely low blood pressure
  • blue-colored lips and nails
  • cold and clammy skin

How opioid overdose can cause respiratory depression

One of the serious and possibly fatal symptoms of opioid overdose is respiratory depression.

This condition occurs when opioids attach to receptors (attachment sites) in the area of your brain that controls your breathing. When opioids bind to these receptors, they send a message to your lungs to breathe more slowly than usual. When opioid levels in your body are too high, your breathing can become dangerously slow or stop altogether.

How Narcan reverses opioid overdose

Narcan is an opioid antagonist (blocker). It works to reverse an opioid overdose by very quickly removing opioids from their receptors. This includes opioid receptors in the area of your brain that controls your breathing. This action “jump-starts” you to begin breathing again so that you can receive the oxygen that you need to survive.

Note: Even if someone wakes up after receiving Narcan, they may relapse back into an overdose condition. This can happen if they took very high doses of opioids or if they took opioids that last longer in their body than Narcan lasts. It’s possible that a person will need multiple doses of Narcan to avoid slipping back into respiratory depression.

How long does Narcan stay in your system and keep working?

Narcan stays in your body and continues to work for about 2 hours.

Some people may need additional doses of Narcan when the medication’s level gets too low in their body. This may be the case when people overdose on very high doses of opioids, very strong opioids, or long-acting opioids.

However, even though Narcan will work for a while, you should call 911 right away after giving someone their first dose of Narcan.

For many people, emergency medical staff will arrive before the person needs their second dose of Narcan. But you should stay with the person who overdosed until medical staff arrives. This will allow you to monitor the person’s breathing and give them additional doses of Narcan. They may need additional Narcan doses if they relapse to an overdose state or if their first dose isn’t effective enough.

How long does it take to work?

Narcan reverses an opioid overdose within 2 to 3 minutes after giving someone a dose. If the person doesn’t start breathing normally within that period of time, you should give them another dose of Narcan.

Narcan can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Narcan. These lists do not include all possible side effects.

For more information on the possible side effects of Narcan, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Narcan, you can do so through MedWatch.

More common side effects

The more common side effects of Narcan can include:

  • increased blood pressure
  • headache
  • muscle spasms
  • muscle pain
  • bone pain
  • constipation
  • toothache
  • dryness in your nose
  • stuffy nose
  • pain in your nose
  • dry skin
  • opioid withdrawal symptoms in people who are physically dependent on opioids (see the section below called “Side effect details” for more information about opioid withdrawal symptoms)

Most of these side effects may go away within a few days or a couple of weeks of using Narcan. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Narcan aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects, which are explained in more detail below in “Side effect details,” include:

  • severe allergic reaction
  • severe opioid withdrawal symptoms in people who are physically dependent on opioids

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on a few of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Narcan. It’s not known for sure how many people have had an allergic reaction to Narcan. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Narcan. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Withdrawal symptoms

You may have opioid withdrawal symptoms after receiving Narcan. This is because Narcan quickly blocks the activity of opioids in your body. This instantly reverses the effects of opioids in your system.

You’re at greater risk of having opioid withdrawal symptoms if you’re physically dependent on opioids when you receive Narcan. Being physically dependent on opioids means that your body needs the opioids in order for you to feel normal. Dependence is more likely to happen in people who’ve been taking opioids on a regular basis over a long period of time.

Opioid withdrawal symptoms can be mild or severe. Symptoms can include:

In some cases, severe opioid withdrawal in people using Narcan has caused serious health effects, including heart rhythm problems and heart attack. However, these effects typically occurred in people who already had cardiovascular problems.

After giving someone Narcan, you should call 911 right away. Once emergency medical staff arrives, they’ll help treat opioid withdrawal symptoms if needed.

Side effects in children

The side effects of Narcan in children are expected to be similar to those in adults. For more information on possible side effects in children, see the sections “More common side effects” and “Serious side effects” above.

Side effects in newborns

After receiving Narcan, newborns may be more likely to have severe opioid withdrawal symptoms that are life threatening than older children or adults are. These withdrawal symptoms can be life threatening if they’re not treated right away by healthcare providers.

Opioid withdrawal symptoms in newborns can include:

  • seizures
  • excessive crying (crying without stopping)
  • shakiness and twitching
  • breathing very quickly
  • vomiting
  • loose stools
  • poor feeding (may be caused by trouble sucking)
  • trouble gaining weight
  • trouble sleeping

If your newborn receives Narcan, call 911 right away. They will need to be treated by emergency medical staff right away to help ensure that they safely recover from treatment.

There is no maximum recommended dose for Narcan. And you can’t hurt someone by giving them more doses of Narcan than they actually need.

In fact, if someone has overdosed or possibly overdosed on opioids, you should give them Narcan every 2 to 3 minutes until they begin breathing normally again. After calling 911, you should continue to administer Narcan as needed until emergency medical staff arrives.

What to do if you think you’ve taken too much Narcan

If you think you or someone else has taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Narcan from the pharmacy, the pharmacist will add an expiration date to the label on the package. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Narcan nasal spray devices should be stored at room temperature (68°F to 77°F/20°C to 25°C) in their original packaging. Avoid storing this medication in areas where it could be exposed to very high or very low temperatures. Also, don’t freeze Narcan nasal spray, because it won’t spray out of its container if it’s frozen.

Disposal

If you no longer need to take Narcan and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

There aren’t any known interactions between Narcan and alcohol.

But keep in mind that Narcan will not reverse the effects of an alcohol overdose. If you or someone you know has overdosed on alcohol, call 911 right away.

There aren’t any studies that show specific medications, foods, or supplements that interact with Narcan. But it’s possible that Narcan may interact with certain substances.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Narcan and other medications, herbs, or supplements

There aren’t any medications, herbs, or supplements that are known to interact with Narcan.

However, when you receive Narcan from your pharmacy, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Other options besides Narcan are available to treat opioid overdose. Some may be a better fit for you than others. If you’re interested in finding an alternative to Narcan, talk with your doctor. They can tell you about other treatments that may work well for you.

Other forms of naloxone (the active drug in Narcan) may be used to reverse an opioid overdose. These include injectable forms of naloxone, which can be injected in one of these three ways:

Injectable forms of naloxone are mostly used in a healthcare facility, such as a hospital.

There is also a form of naloxone that comes as an autoinjector called Evzio autoinjector. This device is a prefilled auto-injector that can be used to inject the medication into your thigh. It can even be used to give the medication through clothing. The auto-injector has a voice recording that will describe step-by-step instructions for giving the drug.

You may wonder how Narcan compares to other medications that are prescribed for similar uses. Here we look at how Narcan and naltrexone are alike and different.

Ingredients

Narcan contains the active drug naloxone, while naltrexone is an active drug ingredient. Naltrexone is found in generic medications and in a brand-name medication called Vivitrol.

Uses

Narcan is used to treat opioid overdose in people of all ages.

Naltrexone is used as part of a complete treatment plan for opioid use disorder in adults. It’s used in combination with counseling and behavioral therapy. Naltrexone isn’t used in emergency situations to treat opioid overdose.

Naltrexone is also used to treat alcohol dependence.

Drug forms and administration

Narcan comes as a nasal spray. Each Narcan nasal spray device holds 4 mg of naloxone.

The standard dosage of Narcan for opioid overdose is one spray into one nostril. Repeated doses can be given every 2 to 3 minutes, if needed.

Naltrexone comes as 50-mg tablets that are taken by mouth once daily.

Naltrexone also comes as the brand-name medication Vivitrol. This medication is a liquid solution that’s given by intramuscular injection (an injection into your muscle). Each injection, which holds 380 mg of naltrexone, is given by a healthcare provider once every 4 weeks.

Side effects and risks

Narcan and naltrexone both contain drugs that block the effects of opioids, although they’re used for different purposes. Therefore, these medications can cause some similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Narcan, with naltrexone, or with both drugs (when taken individually).

  • Can occur with Narcan:
    • muscle spasms
    • bone pain
    • constipation
    • dryness in your nose
    • stuffy nose
    • pain in your nose
    • dry skin
  • Can occur with naltrexone:
    • trouble sleeping
    • anxiety
    • feeling nervous
    • belly pain and cramps
    • nausea
    • vomiting
    • fatigue (lack of energy)
    • joint pain
    • pain at your injection site (for Vivitrol injection only)
    • upper respiratory infection, such as the common cold
  • Can occur with both Narcan and naltrexone:
    • muscle pain
    • headache
    • toothache

Serious side effects

These lists contain examples of serious side effects that can occur with Narcan, with naltrexone, or with both drugs (when taken individually).

  • Can occur with Narcan:
    • no unique serious side effects
  • Can occur with naltrexone:
    • liver damage
    • feeling depressed or suicidal
    • a severe lung infection called eosinophilic pneumonia
  • Can occur with both Narcan and naltrexone:
    • severe allergic reaction

Effectiveness

Narcan and naltrexone have different FDA-approved uses. Narcan is used as needed to treat opioid overdose emergencies. Naltrexone is used on a consistent basis as part of a treatment plan for opioid use disorder.

Because these drugs have different approved uses, they haven’t been directly compared in clinical studies for reversing opioid overdoses.

However, the American Society of Addiction Medicine recommends Narcan as treatment for opioid overdose emergencies and naltrexone as a treatment option for opioid use disorder.

Costs

Narcan is a brand-name drug. There are currently no generic forms of Narcan available.

Naltrexone comes as a generic medication and a brand-name medication (Vivitrol). Brand-name medications usually cost more than generics cost.

Narcan and naltrexone are used for different purposes, so it’s difficult to compare costs. To find price estimates for either drug in your area, visit GoodRx.com. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Here are answers to some frequently asked questions about Narcan.

Will I feel sick if I’m given Narcan?

Yes, you may feel sick or have opioid withdrawal symptoms after receiving Narcan. This is more likely to happen if you’re physically dependent on opioids. (With dependence, your body needs a drug in order for you to feel normal.)

Symptoms of opioid withdrawal include:

But keep in mind that Narcan is used to reverse possibly fatal opioid overdoses. Any withdrawal symptoms that you may have from Narcan should not stop you from using the medication.

If you take opioids, it’s recommended that you have Narcan on hand, in case of an overdose emergency.

Can Narcan be used to treat constipation caused by opioids?

No, Narcan isn’t approved by the Food and Drug Administration (FDA) to treat constipation caused by opioid use.

Other forms of naloxone (the active drug in Narcan) have been used off-label to treat constipation caused by opioids. Off-label use is when a drug is FDA-approved for one purpose but is used for another purpose.

A pooled analysis of several clinical studies looked at treating constipation caused by opioids with either oral (taken by mouth) naloxone, a placebo (treatment with no active drug), or other standard constipation treatments.

The study found that oral naloxone was better than either the placebo or standard constipation treatments at increasing the number of bowel movements that people had. In some of these studies, naloxone was taken in combination with opioids, such as oxycodone.

If you have constipation caused by opioids, talk with your doctor. They can recommend over-the-counter or prescription treatments that can help treat your constipation.

Is Narcan the same as Romazicon?

No, Narcan isn’t the same medication as Romazicon is. Narcan contains the drug naloxone. It’s used to treat opioid overdoses. However, Romazicon, which contained the active drug flumazenil, was used to treat overdose of benzodiazepines. (Benzodiazepines are a class of drugs used to treat anxiety disorders.)

Romazicon (the brand-name form of flumazenil) is no longer available on the market. However, the generic drug flumazenil is available. But because this drug given by intravenous (into a vein) injection, it’s only given to people at a healthcare facility.

If you or someone you know has overdosed on opioids, flumazenil will not reverse their overdose. Also, Narcan will not reverse a benzodiazepine overdose.

If you’ve been prescribed a benzodiazepine, talk with your doctor about your risk of overdose. They can recommend ways to avoid an overdose and advise you on how to treat any possible overdoses.

Can you take Suboxone after you’ve been given Narcan?

It depends. Narcan will remain active in your body for at least 2 hours after you’ve received it. During this time, any opioids that you take will likely have very little to no effect in your body.

Once you receive Narcan to reverse an opioid overdose emergency, you should be treated by emergency medical staff right away. Then your doctor will discuss with you if and when you should start taking treatments (such as Suboxone) for opioid use disorder.

Does Narcan affect the results of drug tests?

Possibly. Naloxone, the active drug in Narcan, can be detected on certain drug tests. Drug screens that test for naloxone in urine are actually used to monitor treatment progress for some people with opioid use disorder.

If you’ve received Narcan, tell the medical staff who are giving you a drug test before you take the test. This will help them to accurately review your test results.

Does Narcan have any effect on a sober person?

No, Narcan won’t have any effect on a person who is sober from opioids. Narcan only works in your body if there are opioids present in your body.

It’s not known exactly how safe Narcan is when it’s used during pregnancy. Animal studies didn’t find any harm to fetuses when pregnant females were given naloxone (the active drug in Narcan). However, animal studies don’t always predict what will happen in humans.

The American College of Obstetrics and Gynecology recommends the use of Narcan to save the life of a pregnant woman who has overdosed on opioids. However, Narcan may also cause opioid withdrawal symptoms in her unborn child. These symptoms can be stressful on the unborn child. Any pregnant woman who receives Narcan should be seen by her doctor right away. This will allow the doctor to monitor the health of both the mother and her unborn baby.

If you have questions about using Narcan during pregnancy, talk with your doctor about the risks and benefits of treatment.

It’s not known if Narcan is safe to take during pregnancy. If you’re sexually active and you’re able to become pregnant, talk with your doctor about your birth control needs while you’re using Narcan.

It’s not known if Narcan passes into human breast milk or if Narcan can harm a child who is breastfed.

However, someone who has overdosed on opioids should still receive Narcan, even if they’re breastfeeding. Receiving Narcan for an opioid overdose can help save a mother’s life.

If you have questions about the safety of using Narcan while you’re breastfeeding, talk with your doctor. They can discuss the risks and benefits of treatment with you.

As with all medications, the cost of Narcan can vary. To find current prices for Narcan in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Narcan, help is available. Medicine Assistance Tool is website that lists programs that are available to help lower the cost of prescription drugs. To find financial assistance for Narcan, check out the program website.

Before taking Narcan, talk with your doctor about your health history. Narcan may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart problems. Narcan may increase the risk of heart problems, including heart attack, in people with heart disease or other heart issues. If you have heart problems, talk with your doctor about whether it’s safe for you to use Narcan.
  • Tramadol overdose. If you receive Narcan for a tramadol overdose, you may have a greater risk of seizures. If you’re using tramadol, talk with your doctor about any concerns you have for overdose.
  • Pregnancy. Narcan may cause opioid withdrawal symptoms in an unborn child if it’s used by a pregnant woman. For more information, please see the “Narcan and pregnancy” section above.
  • Breastfeeding. It’s not known if Narcan passes into human breast milk or if it affects children who are breastfed. For more information, please see the “Narcan and breastfeeding” section above.

Note: For more information about the potential negative effects of Narcan, see the “Narcan side effects” section above.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.