Administration

• IV Direct: May administer undiluted over 30 seconds; Maximum concentration: 1 mg/mL.

• Infusion:

  To prepare a standard concentration of 0.1 mg/ mL. 

  ·         add 5 mL of 0.4 mg/mL Naloxone to 15 mL of 0.9% NaCl. Total volume 20mL

   OR

  ·         add 2 mL of 1 mg/mL Naloxone to 18 mL of  0.9% NaCl. Total volume 20 mL

  Infusion device is required. 

Important Monitoring Information 

• Since the degree of opioid reversal is dependent on the dosage, route and type of opioid that is being reversed, monitoring parameters must be prescribed by the physician.
• Patients should be monitored for recurrence of symptoms for 4 to 6 hrs after last dose of naloxone or after infusion stopped.
• Infusions may be weaned in 50% decrements.  Patient should be monitored for recurrence of symptoms during weaning process.

Compatibility, Stability

• Compatible in dextrose 5% in water or sodium chloride 0.9%. Discard infusions after 24 hours.
• Protect from excessive light and store at room temperature.

Potential Hazards of Administration

• Severe withdrawal symptoms may be precipitated in opioid dependent patients.
• Hypersensitivity reactions.
• Nausea, vomiting or sweating.
• Use of larger than necessary doses in patients receiving opioids for analgesia may cause reversal of analgesic effects, prolonged blockade of opioid receptors and severe pain that is difficult to control.
• Possibility of elevated partial thromboplastin time.
• Hypertension, tachycardia, ventricular arrhythmias and pulmonary edema have been reported in postoperative patients, especially those with pre-existing cardiac disease.

Miscellaneous

• A pure opioid antagonist with little or no agonist activities.