{"id":4980,"date":"2019-07-15T09:00:33","date_gmt":"2019-07-15T13:00:33","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=4980"},"modified":"2020-07-15T19:11:38","modified_gmt":"2020-07-15T23:11:38","slug":"naloxone-formulation-guide","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/naloxone-formulation-guide\/","title":{"rendered":"Which naloxone formulation should you get?"},"content":{"rendered":"

It\u2019s a startling statistic: Each day, an average of 130 Americans die from an opioid overdose, according to the <\/span>Centers for Disease Control and Prevention<\/span><\/a> (CDC). To put that into perspective, you\u2019re now more likely to die from an opioid overdose than from a car crash.\u00a0<\/span><\/p>\n

What exactly are opioids? Opioids are a class of drugs that include both illegal substances such as heroin and prescription drugs like fentanyl and oxycodone. Misuse of these drugs has been on the rise since the late 1990s, with the <\/span>U.S. Department of Health and Human Services<\/span><\/a> recently declaring the opioid epidemic a \u201cpublic health emergency.\u201d<\/span><\/p>\n

One way in which medical professionals, community organizers, laypeople, and friends and family members of drug users are helping to combat these unnecessary deaths is by carrying and knowing how to administer naloxone. Often referred to as the \u201cLazarus drug,\u201d naloxone reverses the effects of an overdose in as little as 30 seconds.\u00a0<\/span><\/p>\n

How does naloxone work?<\/span><\/h2>\n

\u201cWhat it does is it goes into the brain and into the rest of the body and anywhere where there\u2019s an opioid sitting on an opioid receptor, it bumps it off of the receptor,\u201d explains Ginny Lovitt, executive director of <\/span>The Chris Atwood Foundation<\/span><\/a> and certified master revive trainer.\u00a0 \u201cThe number one cause of death in an opioid overdose is hypoxia, which is lack of oxygen. The most important thing that naloxone does is it restores normal breathing.\u201d The key, of course, is that someone nearby is carrying the drug.<\/span><\/p>\n

\u201cHow many people have a fire extinguisher in their home? Fires kill seven Americans every day. Drug overdose is now killing upwards of 150 people every day. If we have fire extinguishers why wouldn’t we have naloxone?\u201d says Lovitt.\u00a0<\/span><\/p>\n

The good news is that <\/span>naloxone<\/span><\/a> is readily available\u2014you can get it at a pharmacy without a prescription in most states thanks to a <\/span>standing order<\/span><\/a> (in much the same way as the flu vaccine, for instance), and it is covered by most insurance plans.\u00a0<\/span><\/p>\n

However, with four formulations of the drug available, it can be tricky to figure out which one will best fit your needs. Here\u2019s how to administer naloxone and what you need to know about each of its four forms:\u00a0\u00a0<\/span><\/p>\n

Injectable naloxone<\/span><\/h2>\n

Comprised of a needle, syringe, and a vial of the drug (typically 1mL or 10mL, for one and 10 doses, respectively), injectable naloxone is what Lovitt calls the \u201ctried-and-true method\u201d as its been around for decades and is the one used in medical settings.\u00a0<\/span><\/p>\n

Pros:<\/b> In her work as a revive trainer, Lovitt says she\u2019s received numerous anecdotal reports that injectable naloxone brings people back more quickly and in a gentler manner. \u201cWe\u2019ve heard from a lot of people that the intramuscular injection produces a bit less acute of a withdrawal,\u201d she says.\u00a0<\/span><\/p>\n

Cons:<\/b> For the needle-phobic, the injectable naloxone probably isn\u2019t the best option. Another downside is it isn\u2019t available at most pharmacies\u2014you\u2019ll have to get it through a community-based training program. (That said, injectable naloxone is given out for free by these organizations, so there shouldn\u2019t be any out-of-pocket cost to you.)\u00a0<\/span><\/p>\n

Naloxone autoinjector<\/span><\/h2>\n

Another intramuscular injection method, the autoinjector (brand name Enzio) takes some of the guesswork out of administering the drug, as it comes pre-measured and pre-packaged in an easy-to-use device.\u00a0<\/span><\/p>\n

Pros:<\/b> In addition to not having to fumble with a syringe during an emergency situation, the autoinjector comes equipped with audible instructions that walk you through each step. \u201cIt\u2019s really, really user-friendly,\u201d says Lovitt.<\/span><\/p>\n

Cons:<\/b> Without insurance, the autoinjector has quite a hefty price tag: around $4,000 for a two-dose pack. However, manufacturer <\/span>Kleo announced, in December 2018,<\/span><\/a> that it would authorize a generic version to be sold at a much more reasonable cost of $178 per kit. And while <\/span>research<\/span><\/a> has shown that Enzio can be used one year past its labeled expiration date, Lovitt warns that the battery operating the autoinjector may not last as long past the expiration date.\u00a0<\/span><\/p>\n

Naloxone with nasal atomizer<\/span><\/h2>\n

Nasal naloxone is comprised of a prefilled syringe, atomizer, and vial. It\u2019s largely fallen out of favor, however, with the introduction of the easier-to-use Narcan nasal spray (see below).<\/span><\/p>\n

Pros:<\/b> Though the syringe-and-vial system is similar to injectable naloxone, you won\u2019t have to deal with any needles since that\u2019s replaced here by a nasal atomizer that diffuses the drug into a spray.\u00a0<\/span><\/p>\n

Cons:<\/b> With its many components, nasal naloxone has historically been a difficult drug to dispense, says Lovitt. \u201cUnfortunately some of the pieces were sold separately, and so when you went to the pharmacy to get it you had to make sure that you were getting all three pieces,\u201d she explains. \u201cThere were cases where people were getting the medication but they weren\u2019t getting the nasal atomizer along with it.\u201d\u00a0 As a result, a number of pharmacies have stopped carrying this formulation altogether.<\/span><\/p>\n

Narcan nasal spray<\/span><\/h2>\n

In 2015, the FDA fast-tracked the approval of Narcan, the first nasal naloxone spray approved by the agency in its attempt to quash the growing opioid epidemic.<\/span><\/p>\n

Pros<\/b>: Narcan, with its pre-measured dose and pre-assembled packaging, is the easiest method to administer. \u201cIt\u2019s pretty hard to screw up using that product,\u201d says Lovitt. Along with the autoinjector, it\u2019s also the most discreet formulation to carry in a purse or backpack.\u00a0<\/span><\/p>\n

Cons:<\/b> Without insurance, <\/span>Narcan<\/span><\/a> is more expensive than its non-FDA-approved nasal naloxone counterpart (around $150 a dose compared to $50 a dose).\u00a0 <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s a startling statistic: Each day, an average of 130 Americans die from an opioid overdose, according to the Centers for Disease Control and Prevention (CDC). To put that into perspective, you\u2019re now more likely to die from an opioid overdose than from a car crash.\u00a0 What exactly are opioids? Opioids are a class of […]<\/p>\n","protected":false},"author":65,"featured_media":8057,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[],"coauthors":[8215],"class_list":["post-4980","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","wpautop"],"acf":[],"yoast_head":"\nNaloxone formulations: Pros and cons of nasal spray, injector, Narcan<\/title>\n<meta name=\"description\" content=\"About 130 Americans die daily from an opioid overdose. 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