Comparing methods of naloxone administration: A narrative review

Shawn E. Fellows, PharmD; Alexander J. Coppola, BS, EMT-B, PharmD; Mona A. Gandhi, PharmD

doi:10.5055/jom.2017.0393

Authors

Shawn E. Fellows, PharmD
Alexander J. Coppola, BS, EMT-B, PharmD
Mona A. Gandhi, PharmD

DOI:

https://doi.org/10.5055/jom.2017.0393

Keywords:

naloxone, administration, pharmacokinetics

Abstract

The effectiveness and safety of naloxone for the reversal of opioid toxicity are reviewed. A literature search was performed using PubMed, the Cochrane Library, CINAHL, and Medline. Clinical trials comparing either the clinical efficacy or pharmacokinetic/pharmacodynamic properties displayed by intravenous, intramuscular, intranasal, subcutaneous, and nebulized naloxone were included; however, trials with primary endpoints evaluating oral or endotracheal naloxone were excluded. Naloxone was shown to be clinically effective via all routes of administration, when compared to either baseline or control. The inconsistencies in data regarding the relative outcome comparisons between administration methods were likely due to differences in concentrations of naloxone preparations and method of administration for the same route of delivery between different studies. Choice of route depends on the environment in which the opioid toxicity occurs, individual patient characteristics, and provider preference.

Author Biographies

Shawn E. Fellows, PharmD

Assistant Professor, Pharmacy Practice and Administration, Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York

Alexander J. Coppola, BS, EMT-B, PharmD

Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York

Mona A. Gandhi, PharmD

Associate Professor, Pharmacy Practice and Administration, Wegmans School of Pharmacy, St. John Fisher College, Rochester, New York

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