The rate of administration of the drug should be selected individually, depending on the patient's response to the use of naloxone and the previously administered single doses.
Naloxone is used intravenously, intramuscularly or subcutaneously.
In the case of infusion, a solution of naloxone is diluted in 0.9 % solution of sodium chloride or 5% dextrose solution as follows: 2000 μg (5_ ml solution containing 400 μg / ml naloxone) is added to 500 ml of infusion medium. The solution obtained after dilution contains 4 μg of naloxone in 1 ml. The solution is prepared immediately before use.
Dosing regimen
The dose of naloxone and the method of application depend on the patient's condition, type and amount of opioid taken.
In acute poisoning ('overdose') with narcotic analgesics.
Adults
The initial single dose is 400-2000 μg intravenously slowly (within 2-3 minutes). If necessary, the dose can be repeated after 2-3 minutes, until the restoration of consciousness and even breathing. If after the introduction of a total dose of naloxone 10 mg there was no recovery of consciousness and breathing, we should assume another (non-opioid) cause of poisoning.
Naloxone can also be administered intramuscularly or subcutaneously. In menacing states of life, an intravenous route of administration is preferred.
Children
The initial single dose is 10 μg / kg intravenously slowly (within 2-3 minutes). If necessary, after 2-3 minutes, an additional dose of 100 μg / kg can be administered.
If it is impossible to apply naloxone intravenously, injected intramuscularly or subcutaneously in divided doses at intervals of 2-3 minutes. With intramuscular injection, the effect of the drug manifests itself more slowly. A dose of about 200 μg (i.e., about 60 μg / kg) can be administered once, resulting in a longer duration of action.
Postoperative use: to accelerate the recovery from general anesthesia / if narcotic analgesics were used during the operation.
Adults
Intravenously, 100-200 μg (1.5-3 μg / kg) of naloxone solution every 2-3 minutes until adequate pulmonary ventilation and awakening of the patient occur, but without distinct pain and discomfort. A dose that exceeds the minimum required may cause the analgesia to stop and increase blood pressure, as well as other symptoms: nausea, vomiting, increased sweating, dyscirculatory crisis.
In some cases, especially after taking opioid analgesics with a long duration of action, intramuscular injection of an additional dose of naloxone is necessary within 1-2 hours.
The drug is also administered by intravenous infusion.
Children Intravenously 10 μg / kg naloxone solution. If necessary, an additional dose of 100 mcg / kg can be administered.
If it is impossible to apply naloxone intravenously, injected intramuscularly or subcutaneously in divided doses at intervals of 2-3 minutes. With intramuscular injection, the effect of the drug manifests itself more slowly. A dose of about 200 μg (i.e., about 60 μg / kg) can be administered once, resulting in a longer duration of action.
The drug is also administered by intravenous infusion.
Restoration of respiration in newborns after the introduction of opioid analgesics
Newborns
Before the introduction of the drug, it is necessary to check the patency of the airway of the newborn.
Intravenously, intramuscularly or subcutaneously, 10 μg / kg. If necessary, the dose can be repeated after 2-3 minutes.
After the birth of a child, one can administer 200 mg (ie, about 60 μg / kg) of naloxone for intramuscular injection.
As a diagnostic tool in patients with suspected drug (opioid) dependence
An intravenous dose of 0.5 mcg / kg allows us to decide whether respiratory depression or difficulty in urinating with opioids is caused. Then the dose of naloxone can be increased, avoiding too large doses. Large doses remove any action of the opioid, including pain medication, and also lead to the excitation of the systems of the sympathetic system and the circulatory system.