Narcan

WHAT IS NARCAN?

Narcan (naloxone) is an over-the-counter (OTC) drug that’s used to treat known or possible opioid overdose. Narcan comes as a nasal (nose) spray. Each container holds one dose of Narcan that’s sprayed into one nostril.

Narcan is used in people of all ages if opioid overdose happens or has possibly happened. (An opioid overdose occurs when someone accidentally or intentionally takes more opioid than their body can safely process.) Narcan is usually given by a caregiver or loved one if they think opioid overdose has occurred.

After Narcan has been given, 911 or your local emergency number should be called right away. Administering Narcan is not a substitute for emergency medical care for opioid overdose.

In March 2023, the Food and Drug Administration (FDA) approved Trusted Source Narcan for OTC use. This means Narcan is available without a prescription. And you can purchase it at many pharmacies.

WHAT IS NARCAN USED FOR?

If you or someone you know takes an opioid medication, your doctor may suggest that you have Narcan available. (Opioids are medications used for pain.)

Narcan is used in people of all ages if opioid overdose happens or has possibly happened. Narcan is usually given by a caregiver or loved one if they think opioid overdose has occurred.

Narcan treats opioid overdose by blocking certain receptors (attachment sites) in your body that opioids bind to. Blocking these receptors helps reverse symptoms of opioid overdose. Once the receptors are blocked, the symptoms may quickly ease.

Symptoms of opioid overdose may include:

unconsciousness (unable to be awakened, even if shaken or shouted at)
slow heart rate
low blood pressure
slow, shallow breathing or breathing that has stopped
smaller than usual pupils (the dark, center portion of your eye)

Your doctor may recommend that you have Narcan available if you take a drug that has an opioid in it. Many pain medications contain opioids, including:

fentanyl
methadone (Dolophine, Methadose)
oxycodone (Oxycontin)
hydrocodone (Vicodin)

Narcan is approved for use in both children and adults. The use of naloxone (the active drug in Narcan) has been studied in children of all ages, including newborns.

But for newborns, certain medications for opioid overdose may be safer than Narcan. If a newborn needs treatment for opioid overdose, their doctor will recommend the best medication for them.

WHAT IS NARCAN'S DOSAGE?

Below is information about Narcan’s recommended dosage. But be sure to follow dosage guidance from your doctor or healthcare professional.

If you’re experiencing opioid overdose, typically you’ll need someone else to treat you with Narcan. Make sure that a caregiver or someone you know understands how to give Narcan doses.

Form and Strength

Narcan comes as a nasal (nose) spray in a strength of 4 milligrams (mg). It comes in a box containing two nasal spray devices. Each nasal spray device contains one 4-mg dose.

Note: Narcan nasal spray used to come in a 2-mg strength as well. This strength has been discontinued and is no longer available.

Recommended Dosage

The recommended first dose of Narcan, for people of all ages, is one 4-mg spray into one nostril. (The pediatric dosage of Narcan is the same as the drug’s adult dosage.)

Whether to give more doses depends on whether the person affected is responsive and starts breathing like usual. If not, another dose should be given in the other nostril 2–3 minutes after the first dose.

Narcan doses should be given every 2–3 minutes until the affected person is responsive and starts breathing like usual or emergency personnel arrive. Each dose should be alternated between the right and left nostrils.

Do not reuse the Narcan nasal spray device after giving one dose. Use a new nasal spray device for each dose.

Call 911 (or your local emergency number) right away after giving a dose of Narcan.

There’s no initial dose or maximum dose of Narcan. You can’t give too much Narcan to someone.

HOW IS NARCAN GIVEN?

Narcan comes as a nasal (nose) spray. Each Narcan device holds one dose of medication that’s given as a spray into one nostril.

Narcan is given when opioid overdose happens or has possibly happened. For a list of possible symptoms of opioid overdose, see the “What is Narcan used for?” section below.

Keep in mind that each container of Narcan holds a single dose of the medication. If more than one dose is needed, a new container of Narcan must be used for each dose. And the doses should be alternated between the right and left nostrils.

It’s important that 911 or your local emergency number be called as soon as the first dose of Narcan is given. This is necessary, even if the affected person becomes responsive and starts breathing like usual after getting Narcan.

For step-by-step guidelines on how to administer Narcan, view the drug’s instructions for use. And to watch a video that explains how to use Narcan, visit the drug manufacturer’s website.

How fast does Narcan work?

Narcan begins working as soon as it’s been given. In fact, someone may become responsive 2–3 minutes after their first dose is given. But sometimes, repeated doses of Narcan are needed.

It’s important that Narcan continue to be given once every 2–3 minutes until the person affected becomes responsive and breathes like usual or until medical help arrives. Also, do not reuse a Narcan nasal spray device after giving one dose. Use a new nasal spray device for each dose.

What are Narcan’s side effects?

Like most drugs, Narcan may cause mild or serious side effects. The lists below describe some of the more common side effects that Narcan may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

your age
other health conditions you have
other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of Narcan. They can also suggest ways to help reduce side effects.

Mild Side Effects

Here’s a short list of some of the mild side effects that Narcan can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Narcan’s labeling information.

Mild side effects of Narcan that have been reported include:

constipation
toothache
muscle spasms
pain in your bones
headache
dry, stuffy nose, or pain and swelling in your nose

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious Side Effects

Serious side effects from Narcan can occur, but they aren’t common. If you have serious side effects from Narcan, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Narcan that have been reported, and are discussed below in the “Side effect focus” section, include:

opioid withdrawal symptoms
allergic reaction

OPIOID WITHDRAWAL SYMPTOMS

It’s possible to have symptoms of opioid withdrawal after you receive Narcan. (Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on. And dependence is when your body needs a drug to function like usual.) Keep in mind that Narcan, which is used for opioid overdose, blocks the effects of opioids in your body.

Symptoms of opioid withdrawal may include: