Nasal vs Intramuscular Naloxone: A Comparison for Opioid Overdose Response
When administering naloxone for opioid overdose, choosing between nasal spray and intramuscular injection involves considerations such as ease of use, effectiveness in various conditions, and duration of action. Both methods have their advantages and may depend on individual circumstances. Nasal naloxone may offer a longer-lasting effect but could potentially lead to more severe withdrawal symptoms. Intramuscular injection provides a swift response but may require multiple doses for effectiveness. Understanding the differences can help in making informed decisions for opioid overdose management.
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Intranasal or intramuscular naloxone? Thanks to Fiona Raeburn, Specialist Pharmacist in Substance Misuse, NHS Grampian
WHERE ARE WE? 8,917 kits supplied in Edinburgh since 2011 1020 resupplies reported as used for overdose Almost1743 of these supplies were made in 1 year 2018-19 THAT S A POSSIBLE 1020 lives saved in Lothian that have been reported 4,685 people at risk have received a 1stsupply of estimated 9000 problem drug users
NASAL VS INTRAMUSCULAR NALOXONE PRENOXAD INTRAMUSCULAR INJECTION NYXOID NASAL SPRAY
NASAL VS INTRAMUSCULAR NALOXONE PRENOXAD INTRAMUSCULAR INJECTION NYXOID NASAL SPRAY Contains two nasal sprays Each spray contains one 1.8mg DOSE OF NALOXONE Do not prime or test when it s gone it s gone! Administer the contents of one spray into the nostril Switch the nostril for the next dose(s) if needed One pre-filled syringe with 5 x 0.4mg doses of naloxone + 2 needles Must be PRENOXAD brand of naloxone Others don t contain needles so useless in community settings Administer in thigh or upper arm muscle
NASAL VS INTRAMUSCULAR NALOXONE FOR BOTH PRODUCTS Administer one dose every 2 3 minutes until either The person responds recovery position and monitor OR The ambulance/police etc arrive and take over OR You have no naloxone left
NASAL VS INTRAMUSCULAR NALOXONE IN 2mg IN 2mg IM 0.4mg IM 0.4mg
NASAL VS INTRAMUSCULAR NALOXONE What will this mean in practise? Intranasal and intramuscular should have similar onset of action when using equivalent doses (0.4mg intramuscular vs 1.8mg intranasal). Intranasal may not be as effective if there is a lot of mucous etc in nasal passageway At these doses intranasal concentration is likely to continue to increase in the body for longer than intramuscular POTENTIAL TO LAST LONGER POTENTIAL TO RESULT IN MORE SEVERE SYMPTOMS OF WITHDRAWAL HOWEVER Comparisons done in laboratory conditions In practise many people will give variable number of doses using pre-filled syringe may be more than 0.4mg
NASAL VS INTRAMUSCULAR NALOXONE How to choose between the two products Prenoxad intramuscular injection For people who have used Prenoxad before and are happy with it give Prenoxad For people who have not used Prenoxad offer this as the first option
NASAL VS INTRAMUSCULAR NALOXONE How to choose between the two products Nyxoid nasal spray Nyxoid might be better for Younger people licensed from 14 years vs 16 years People who won t take the injectable product Don t like injections or the thought of using an injection Potentially people who use oral opioids e.g. opioid analgesics Family members Non-clinical service workers who might be less used to injecting medication People request replacement kits for other purposes e.g. used needles etc to inject drugs People who have refused naloxone in the past People who say they would prefer to try the nasal product
Naloxone preparation & administration - Nyxoid Watch Film Nyxoid Training video (Click Logo)
Naloxone preparation & administration - Prenoxad Click on Image 8 below for more detailed information Inject8 imagesCAULN3T1 Watch Film Administering Prenoxad Injection (Click Logo)
