A Nasal Spray That Can Reverse Overdoses Is Available OTC (2023)

Here are some harrowing statistics for you: The most recent National Institutes of Health statistics researchreports that more than 106,000 people in the U.S. died from drug-involved overdoses in 2021, while opioid-involved overdose deaths clocked in at 80,411—about 90% of the total. And according to the Centers for Disease Control and Prevention, there has been a significant increase in overdose deaths in minors and teens since 2019.

The FDA recently approved naloxone (commonly referred to by its brand name, Narcan) for over-the-counter (OTC) use. If you ask experts in addiction and medicine, the approval was long overdue.

"While FDA approval of OTC naloxone is good news, there are challenges to the widespread adoption of the drug,"Dr. Hyong Un, MD, chief medical officer at Recovery Centers of America, tells Parade. "We must overcome barriers such as lack of awareness, cost and stigma. Additionally, although naloxone is lifesaving, follow-up treatment after use is imperative."

Here's everything parents need to know about over-the-counter Narcan (naloxone).

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What Is Narcan and How Does it Work?

"Narcan is the brand name for the medication naloxone hydrochloride. The FDA-approved version for selling over-the-counter is the intra-nasal version. It is an opioid antagonist, which means it binds to the same receptor which blocks the opioid from working. This blocking activity of Narcan reverses the respiratory depressing effect of the opioid and provides a life-saving benefit when a patient has overdosed on an opioid," Dr. Jonathan Watanabe, Ph.D,Associate Dean of Pharmacy Assessment and Quality at the University of California Irvine andmember of the White House Opioid Committee, tells Parade.

Dr. Eric Collins, MD, addiction psychiatrist and chief medical officer at RecoveryEducation.com, explained that naloxone works for a number of drugs, including fentanyl, oxycodone and morphine.

(Video) The FDA approved the first over-the-counter nasal spray that can reverse an opioid overdose

"When a person has overdosed on opioids and has consequently stopped breathing, Narcan can help them start breathing again by effectively taking the opioid medication off the receptors," Dr. Collins says.

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How Effective Is Narcan?

Narcan is popular because, thankfully, it works—usually within two to three minutes of the first dose, Dr. Watanabe says.

"There are case studies that show that additional Narcan doses may be needed depending on the amount of opioids or the strength or potency of the opioid," he advises. "Fentanyl, for example, is 100 times more potent than morphine. For this reason, the Narcan directions include that you can re-administer Narcan into the opposite nostril every two or three minutes if the patient does not respond."

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Will Having Narcan Encourage My Child's Drug Use?

Experts agree that the pros of having naloxone on hand far outweigh any risks—and this is especially true if parents have honest and conscientious discussions with their kids about drugs.

(Video) FDA approves overdose-reversing nasal spray Narcan

"Any substance in the home (alcohol, cigarettes, candy, an albuterol inhaler, an Epi-pen) presents an opportunity to have an age-appropriate conversation with our children and young adults about substances and the risks of their use,"Dr. Matthew Ruble, MD,Chief Medical Officer of Discovery Behavioral Health, tells Parade.

"We have so much evidence that age-appropriate discussions with kids lead to better outcomes. We know that discussions about sexual activity don't lead to sexual activity. We also know that discussions about suicide do not lead to or suggest suicide. Discussing how to save a person's life with Narcan should follow these same trends if discussed appropriately. Risk compensation, the balancing of the risks with the benefits of this education is very clearly in favor of education. People are much safer if they wear a seatbelt. The benefits of the seatbelt so greatly outweigh the risks."

"Naloxone has been likened to epinephrine auto-injectors (EpiPens), helping safeguard at-risk individuals from opioid overdose or anaphylaxis, respectively,"Dr. Christina Johns, MD, pediatric emergency doctor & Senior Medical Advisor at PM Pediatric Care, concurs. "Just like having an EpiPen at home does not encourage kids with peanut allergies to dive into a pool of Jiffy, having naloxone handy will not necessarily lead to children experimenting with opioid drugs."

A Nasal Spray That Can Reverse Overdoses Is Available OTC (2)

"About 2.7 million people in the United States report suffering from OUD, which we know is an underestimate," Dr. Watanabe says. "On average, we’re losing an American to an overdose every five minutes. So I would say that every person that is concerned they may at one point be a bystander should at the very least know where Narcan is present."

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How To Use Narcan

Dr. Johns says that because there are essentially no known negative effects of Narcan and naloxone, having it on hand is a good idea—and there are resources if you have questions on how to use or administer it.

(Video) FDA approves non-prescription sale of overdose reversal drug Narcan

"If you suspect your child may be misusing opioid drugs, don’t go it alone. Get support," she advises. "Check in with your pediatrician and local pharmacy for guidance on acquiring and using naloxone." You can also check to see if there are any local classes on using naloxone.

That said, the first step should be to shake the patient's shoulders and call their name. If they're unresponsive, check their breathing: Is it slow, uneven or stopped? Are they snoring, gasping or gurgling? Are their lips or fingernails purple or blue? If so, administer naloxone.

To administer naloxone:

  1. Use one spray in one nostril to start.
  2. Remove the nozzle from the person's nostril after spraying.
  3. After administering naloxone, position the patient on their side with their hands under their head and their upper leg bent forward. This will prevent them from rolling onto their stomach, which can be deadly for an overdosing person.
  4. If the overdosing individual doesn't respond within two to three minutes, you can spray another new dose of naloxone into the patient's other nostril.
  5. You can repeat, alternating nostrils, until the patient responds and breathes normally.

It's also incredibly important to get the patient emergency medical attention after the patient's first dose, even if they wake up and are responsive.

You can see a video demonstrating how to use Narcan below:

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What Are Narcan Side Effects?

Narcan can cause sudden and severe withdrawal symptoms in patients who've used opioids regularly. These can include aggressive behavior, body aches, diarrhea, fever, goosebumps, increased blood pressure, increased heart rate, irritability, nausea, nervousness, restlessness, runny nose, shivering, sneezing, stomach cramps, sweating, trembling, vomiting, weakness and yawning.

(Video) FDA approves overdose reversal drug for over-the-counter sale

How To Talk to Kids About Narcan

As with a lot of other things, the guidance on drug discussions with children varies by the child and their age, but it's an important conversation to have. Why? Because in 2019 alone, 1 in 7 high school seniors admitted to misusing opioids during their life already.

"Talking to children about naloxone should be tailored to their developmental level—the younger the child, the simpler the answer should be," Dr. Johns says. "It’s always a good idea to ask questions to understand what they know about the topic first; then you’ll have a better idea of how to address the subject."

One key: Don't act like an encyclopedia if you're not. "Be comfortable saying 'I don’t know' if you don’t know the answer to one of their questions," Dr. Johns notes, "and agree to find out the answer together."

Clinical psychologist and Hope for Depression Research Foundation adviserDr. Ernesto Lira de la Rosa, Ph.D.,says that these conversations should be ongoing as children grow up.

"For example, young children may benefit from a conversation around the importance of the safe use of medications and that medications should only be used as prescribed. As children get older, you may talk to them about the dangers of taking opioids or other drugs," Dr. de La Rosa explains. "You may also talk with them about what to do in situations when they feel pressured by peers to use drugs, including prescription medications."

Dr. Ruble also has another key tip: Encourage your teen to bring Narcan to parties and tell other parents you had the talk—because only one opioid use can be deadly.

Next,what is the BORG binge drinking trend on TikTok? Here's what parents should know.

(Video) Naloxone FDA approves over-the-counter Narcan nasal spray with Bobby Mukkamala, MD



What nasal spray reverses overdose? ›

Naloxone should be given to any person who shows signs of an opioid overdose or when an overdose is suspected. Naloxone can be given as a nasal spray or it can be injected into the muscle, under the skin, or into the veins.

Is Narcan nasal spray over-the-counter? ›

The nasal spray form of Narcan is the only form of naloxone that's been FDA-approved for over-the-counter use because it's been proven to be highly effective when an opioid overdose has occurred.

What nasal spray has Narcan? ›

Naloxone hydrochloride nasal spray is a prescription medicine used for the treatment of an opioid emergency such as an overdose or a possible opioid overdose with signs of breathing problems and severe sleepiness or not being able to respond.

What happens if you spray Narcan nasal spray? ›

Usually, it reverses the effects of opioid overdose in 2 to 3 minutes. This allows for emergency medical help to arrive. Get emergency medical help right after giving the first dose of NARCAN® Nasal Spray in any cases of known or suspected overdose. NARCAN® Nasal Spray is not a substitute for emergency medical care.

Is Narcan over-the-counter cost? ›

Over-the-counter Narcan to cost less than $50 for a two-pack, company says. The opioid overdose reversal drug will be available without a prescription later this year, but experts fear the price could be too high.

What is Narcan over-the-counter? ›

NARCAN®(naloxone HCl) Nasal Spray is an opioid antagonist indicated for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression.

When will naloxone OTC be available? ›

Washington, D.C.—Pharmacists can expect OTC Narcan nasal spray to be available by late summer, according to the manufacturer. Emergent BioSolutions, Inc.

What is equivalent to Narcan? ›

Zimhi is a medication that's used to treat opioid overdose. Zimhi belongs to a group of medications called opioid antagonists, also known as opioid blockers. These medications stop and rapidly reverse the effects caused by opioids during a suspected overdose. Zimhi is a 5 mg naloxone injection that comes in a syringe.

How much is Narcan at Walgreens? ›

Without insurance, Narcan typically costs about $130 for a kit with one or two doses, but the over-the-counter prices could be 25 percent lower depending on current price points and discounts for other pharmacies already carrying the drug, the company said in a news release.

What does Narcan nasal spray feel like? ›

Receiving Narcan may cause dryness or pain in the nose. It may also cause a stuffy nose. These side effects have been reported in people using the drug, although it isn't clear whether they're common or how often they happen.

Can you use Narcan spray on yourself? ›

Because you can't use naloxone on yourself, let others know you have it in case you experience an opioid overdose. Carrying naloxone is no different than carrying an epinephrine auto-injector (commonly known by the brand name EpiPen) for someone with allergies.

How many times can you use Narcan nasal spray? ›

How many times can Narcan be given? Narcan can be given every 2 to 3 minutes until the person wakes up and breathes normally. There is no maximum dose of Narcan, which means you can give as many doses as needed.

Why would a doctor prescribe Narcan nasal spray? ›

The drug naloxone, marketed under the brand name of Narcan or Evzio, is a drug that reverses the effect of an opioid and can prevent an opioid overdose death when given within a proper time frame.

What do you give after an overdose? ›

Naloxone is an emergency antidote to opiate overdose. It counteracts the effects of opioid drugs (such as heroin, methadone and fentanyl) and reverses the life-threatening effects of an overdose.

Can coconut water neutralize drugs? ›

No it doesn't. The coconut itself is like a first-aid drug. ..and it is useful for patients, as it allows the drugs to by absorbed easily. the only side effect (which is due to excessive consumption) is that it causes diarrhea to some people.

What happens if you take 4 pills at once? ›

The more meds you take, the higher the risk of harmful drug interactions. Having multiple meds in your system can cause them to work differently than they're supposed to—and may even make them less effective.

How much is Narcan nasal spray 4mg? ›

The cost for Narcan nasal spray (4 mg/0.1 mL) is around $141 for a supply of 2 spray, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.

Is there a generic version of Narcan? ›

Is Narcan available as a generic? Narcan is available as the generic drug naloxone. Like the brand-name version, it comes as a nasal spray.

How long is Narcan nasal spray good for? ›

NARCAN® Nasal Spray expiration will be changed from 2 years to 3 years on newly manufactured NARCAN® Nasal Spray units.

Is there a Narcan pill? ›

What Is Naloxone (Narcan)? Naloxone, known by the common brand name Narcan, is a medication designed to reverse the harmful effects of Opioid overdose. Opioids include Heroin, Hydrocodone, Morphine, Oxycodone and others. If not treated immediately, an Opioid overdose can be fatal.

How do I get a prescription for naltrexone? ›

Any licensed healthcare provider in the United States who is authorized to write a prescription can legally prescribe naltrexone. Naltrexone may be prescribed via a telehealth or virtual appointment with a clinician, or during an in-person office visit.

How do you use Narcan nasal spray? ›

Gently insert the tip of the nozzle into one nostril, until your fingers on either side of the nozzle are against the bottom of the person's nose. Press the plunger firmly to give the dose of Narcan® Nasal Spray. Remove the Narcan® Nasal Spray from the nostril after giving the dose.

How much does a naloxone kit cost? ›

Cost of naloxone: Depending on the specific form of naloxone used by the department, the cost of a single naloxone rescue kit ranges from approximately $22-$60 for intranasal kits.

Does Medicare pay for naloxone? ›

Naloxone is a drug Medicare covers that your doctor may prescribe as a safety measure to rapidly reverse the effects of an opioid overdose.

Can anyone use a naloxone kit? ›

Naloxone kits are available to anyone who is: currently using opioids or is a past opioid user who is at risk of returning to opioid use, or. a family member, friend or other person in a position to assist a person at risk of overdose from opioids.

Is Kloxxado better than Narcan? ›

Kloxxado® contains 8 mg of naloxone per spray, whereas Narcan® only contains 4 mg of naloxone per spray. Both products come with two devices per box, so with Kloxxado® you're getting twice as much naloxone per box. This is important because 34 percent of opioid overdose reversals involved at least 2 doses of naloxone.

Is Narcan similar to smelling salts? ›

Of the three types, nasal Narcan is the most common. It is the brand name, nasal inhaler version of naloxone. It works dramatically, like smelling salts. Or it used to, with most opioids, until fentanyl came along.

Is Kloxxado available? ›

Kloxxado Now Available for Emergency Treatment of Opioid Overdose. Kloxxado™ (naloxone hydrochloride) nasal spray is now available for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression, for adult and pediatric patients.

Can a normal person buy Narcan? ›

Do you need a prescription for Narcan? No. As of 2022, you can buy Narcan without a prescription from your healthcare provider in all 50 U.S. states. Washington D.C. and Puerto Rico also allow this.

Does Walgreens give you free Narcan? ›

You also could visit any major pharmacy and ask a pharmacist if Narcan is available for free. Some pharmacy chains — such as Walgreens, CVS and RiteAid — are involved in state programs that give out free Narcan. Your pharmacy also may have information about discounts or coupons.

Does Walmart give Narcan? ›

As an additional step, Walmart pharmacists provide Naloxone recommendations to patients who might be at risk for overdose in alignment with CDC guidelines. Ask your pharmacist about Naloxone when you pick up an opioid prescription for you or a loved one.

How fast does it take Narcan to work? ›

Wait about 3 minutes for naloxone to take effect. If the person has not responded after 3 minutes, give a second dose. Stay with the person until help arrives.

What are the side effects of nasal Narcan? ›

Incidence not known
  • Agitation.
  • body aches.
  • crying more than the usual (in babies)
  • fast, pounding, or irregular heartbeat or pulse.
  • goosebumps.
  • loss of consciousness.
  • nausea or vomiting.
  • ongoing trouble breathing.
Feb 1, 2023

What is the antidote for oxymetazoline? ›

There is no specific antidote for oxymetazoline, although its pharmacological effects may be reversed by an adrenergic antagonists such as phentolamine.

How do you give someone Narcan nasal spray? ›

Gently insert the tip of the nozzle into one nostril, until your fingers on either side of the nozzle are against the bottom of the person's nose. Press the plunger firmlyto give the dose of NARCAN Nasal Spray. Remove the NARCAN Nasal Spray from the nostril after giving the dose.

What is Narcan used for? ›

Naloxone, for example Narcan®, is a medicine that can help people who are overdosing on an opioid. Opioids include prescription medications, heroin, and fentanyl. Sometimes other drugs, including cocaine and methamphetamine, are mixed, or laced with fentanyl.

What is oxymetazoline 0.05 OTC? ›

Oxymetazoline (Afrin) is an over-the-counter (OTC) nasal spray commonly used to help relieve a stuffy nose from the common cold or allergies. It can be used in adults and children 6 years and older.

What kind of drug is oxymetazoline? ›

Oxymetazoline is in a class of medications called nasal decongestants. It works by narrowing the blood vessels in the nasal passages.

What is Afrin nasal spray used for? ›

This medication is used for temporary relief of congestion in the nose caused by various conditions including the common cold, sinusitis, hay fever, and allergies. It works by narrowing the blood vessels in the nose area, reducing swelling and congestion.

How do you ask for Narcan? ›

You can buy Narcan without a prescription at your local pharmacy. Pharmacies nationwide stock Narcan and are able to dispense it without a prescription. If your pharmacy doesn't have Narcan on hand, ask them if they can order it for you. You can also get Narcan through GoodRx.

How fast does intranasal Narcan work? ›

How long does naloxone take to work? Naloxone acts in two to three minutes. If the person does not wake up in three minutes, bystanders should give a second dose. (Rescue breathing should be done while you wait for the naloxone to take effect so that the person gets oxygen to his or her brain.)

When should I recommend Narcan? ›

Physicians and physician assistants: When initiating opioid treatment, “Naloxone shall be prescribed for any patient when risk factors of prior overdose, substance misuse, doses in excess of 120 MME/day, or concomitant benzodiazepine are present.”

How many times should you use Narcan? ›

How many times can Narcan be given? Narcan can be given every 2 to 3 minutes until the person wakes up and breathes normally. There is no maximum dose of Narcan, which means you can give as many doses as needed.


1. FDA approves first over-the-counter drug for opioid overdose reversal
(WGN News)
2. What is Narcan? And why FDA approved its selling over the counter. | USA TODAY
3. How to use Narcan to reverse an overdose
(CBS New York)
4. FDA approves Narcan over-the-counter | LX News
(LX News)
5. Narcan Nasal Spray: A Lifesaving Tool Against Opioid Overdoses
(Rush University System for Health)
6. FDA approves sale of life-saving drug Narcan without a prescription
(ABC7 News Bay Area)
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