Naloxone (also known as the brand names Kloxxado™, Narcan®, RiViveTM, or Zimhi®) is a medicine that can save someone’s life if they are overdosing on opioids—whether it’s a prescription opioid, heroin, or an illicit drug containing fentanyl.
Naloxone quickly blocks and reverses the effects of an opioid overdose. You can tell it is working because it quickly helps a person breathe normally. It is not a treatment for opioid use disorder or opioid misuse.
Signs of an opioid overdose include:
Very slow or shallow breathing
Not responding when called, touched, or shaking
Blue or gray lips or nails
Carry naloxone with you every day. You can be a first responder. You can save a life.
Where can I get naloxone?
Naloxone is available over-the-counter in many pharmacies. There are also some naloxone products that need a prescription. Your local pharmacy staff can help you get naloxone and suggest ways to help save on the cost. You can also ask your healthcare providers to write a prescription for naloxone.
Kentucky Naloxone Copay Program
The Kentucky Naloxone Copay Program is one way to save on the cost of naloxone. Visit https://www.kphanet.org/copay or show the card to pharmacy staff for more information.
Can’t find a location near you that has naloxone? You might be able to order it through the mail from NEXT Naloxone (not available in MA).
Why should I carry naloxone?
If you or a loved one struggle with opioid use, you should have naloxone nearby. Ask your family and friends to carry it and let them know where your naloxone is, in case they need to use it.
People who previously used opioids and have stopped are at higher risk for an overdose. This includes people who have completed a detox program or have recently been released from jail, a residential treatment center, or the hospital. These people now have a lower tolerance for opioids and can overdose more easily.
Who can use naloxone?
Anyone—including you—can give naloxone to someone who is overdosing from a prescription opioid medicine, heroin, or a drug containing fentanyl. Naloxone nasal spray (Kloxxado™, RiVive™, Narcan®, or generics) is a ready-to-use, needle-free medicine that can be used without any special training. They require no assembly and are sprayed into one nostril while the person lies on their back. No priming is needed. The spray bottle (atomizer) is small and can fit in your pocket, purse, or glove compartment. Each box comes with two spray bottles in case a second dose is needed. An injectable naloxone product (Zimhi®) is also available with a prescription.
Carrying naloxone does not mean that you are encouraging people to misuse opioids or other drugs. It just means that you are ready to save a life if they overdose.
Naloxone is very safe and saves lives. It can be given to anyone showing signs of an opioid overdose, even if you are not sure if they have used opioids. Naloxone is not addictive and cannot be used to get high.
A Quick Start guide in the box gives instructions for each product and should be read in advance.
Naloxone has been proven to be extremely safe, with no negative effects on the body if the person has not used opioids. It can also be used on pregnant women and children in overdose situations.
People with physical dependence on opioids may have signs of withdrawal within minutes after they are given naloxone, but this is normal because it means that the naloxone is helping the person to breathe again. Normal withdrawal symptoms can include headaches, changes in blood pressure, anxiety, rapid heart rate, sweating, nausea, vomiting, and tremors. These symptoms are usually not life-threatening but can be uncomfortable. Always call 911 in an overdose emergency.
How do I administer naloxone?
To learn how to administer naloxone, check out the following resources:
Review the guide in the box with the naloxone product.
How long before I know naloxone is working?
Naloxone products for emergency bystander use begin working within minutes after they are given and should help the person wake up and breathe again. After administering a dose of naloxone (spray, injection, etc.), continue rescue breathing. If the person begins breathing or you need to leave them to get assistance, put the person in the recovery position, on their side with arms forward, and upper leg bent at the knee in front of the body, somewhat like a sleep position. Further instructions can be found in the box with the product, or online by searching for "recovery position."
If the person does not respond to the first dose of naloxone within two to three minutes, a second dose should be given, after putting the person on their back again. Additional doses can be given it the person does not begin breathing.
Important: If using a nasal spray, a second dose requires a second spray bottle (atomizers).
Naloxone works for 30 to 90 minutes, but because many opioids remain in the body longer than that, it is possible for a person to show signs of an overdose after naloxone wears off. Therefore, one of the most important steps is to call 911 so the person can receive medical attention to monitor their breathing and treat these possible effects. Wait for emergency personnel to arrive and be sure to tell them about the products and doses you gave the patient. Be sure to throw away all used spray bottles and naloxone products in the appropriate container.
Research reported in this website was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number UM1DA049406. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.