NARCAN® Nasal Spray is a pure opioid antagonist indicated for emergency use to reverse known or suspected opioid overdose, as manifested by respiratory and/or severe central nervous system depression.
Always read the label and follow the directions for use.
For health care professionals:
For patients:
This product may not be right for you. Speak to your pharmacist.
What are opioids and who is at risk for an opioid overdose?
Opioids are a class of drugs that work by acting on specific receptors found in the brain and in the nervous system to reduce the amount of pain a person feels. Prescription opioids include codeine, morphine, oxycodone and hydromorphone.
Taking too many opioids can lead to an overdose, which can stop someone from breathing. The person may also experience other symptoms.
Anyone taking an opioid is at risk of a dangerous response, even if it is prescribed and taken properly. Recognizing this, the Canadian National Consensus Guidelines for Naloxone Prescribing by Pharmacists recommends that:
All patients receiving an opioid should proactively be dispensed take-home naloxone and counselled by a pharmacist.
WHAT IS
NARCAN® NASAL SPRAY and how does it work?
NARCAN® Nasal Spray is an intranasal form of naloxone. It is used to treat someone who has overdosed on opioids. NARCAN® Nasal Spray can be used by anyone to reverse the effects of the overdose until medical help arrives.
Opioid drugs work by acting on specific receptors found in the brain and nervous system. When these drugs attach to those receptors, they reduce the amount of pain felt. Taking too many opioids can lead to an overdose and that can stop someone from breathing. The person may also experience other symptoms. NARCAN® Nasal Spray stops the opioids from being attached to the receptors, and this reverses the effects and symptoms of the overdose.
WHAT IS
NARCAN® NASAL SPRAY USED FOR?
- Pale and clammy skin
- Extreme drowsiness or passing out
- Unable to be woken up by shouting, shaking of shoulders or touch, e.g. firmly rubbing middle of chest
- Breathing that is very slow, irregular or has stopped
- Slowed or no heartbeat
- Pinpoint pupils
- barbiturates
- benzodiazepines
- psychostimulants (for example: cocaine, amphetamines or methylphenidate)
- alcohol
- anesthetics
- sedatives
HOW DO YOU ADMINISTER
NARCAN® NASAL SPRAY?
Always read the label and follow the instructions for use before giving someone NARCAN® Nasal Spray.
For health care professionals:
For patients:
SUMMARY
If an opioid overdose is suspected, call 911 immediately and ask for emergency medical help. Do this before administering NARCAN® Nasal Spray — it is not intended to be a substitute for professional medical care.
As soon as the 911 call is made, lay the person on their back, and administer NARCAN® Nasal Spray as quickly as possible.
Remove device from packaging. Do not test the device. There is only one dose per device.
Tilt the person’s head back and provide support under their neck with your hand.
Hold the device with your thumb on the bottom of the plunger. Put your first and middle fingers on either side of the nozzle.
Gently insert the tip of the nozzle into one nostril. Your fingers should be right up against the nose. If giving to a child, make sure the nozzle seals the nostril.
Press the plunger firmly with your thumb to give the dose.
Remove the device from the nostril.
Move the person on their side (recovery position). Watch them closely.
Give a second dose after 2 to 3 minutes if the person has not woken up or their breathing is not improved. Alternate nostrils with each dose.
Note: Each NARCAN® Nasal Spray device contains only one dose; use a new device for each additional dose.
You can give a dose every 2 to 3 minutes, if more are available and are needed.
Perform artificial respiration or cardiac massage until emergency medical help arrives, if you know how and if it is needed.
You may need to help the person who received NARCAN® Nasal Spray. The patient may have a reaction such as becoming aggressive, shaking and/or vomiting.
You will need to pay special attention when giving NARCAN® Nasal Spray to a newborn who is less than four weeks old or a pregnant woman. Some of these reactions may cause preterm labour or can be life-threatening for a newborn or a fetus.
For a list of serious warnings, precautions and contraindications, refer to the product monograph.
WHAT ARE THE POSSIBLE SIDE EFFECTS OF
NARCAN® NASAL SPRAY?
Possible side effects include:
- Swelling, dryness, congestion in the nose
- Runny nose
- Yawning
- Nervousness
- Pain
- Aggressive behaviours, irritability, restlessness, agitation
- Increased blood pressure
- Increased heart rate
- Nausea, vomiting, diarrhea, abdominal cramps
- Fever, sweating, shivering, chills, tremors, trembling
- Weakness
- Seizures, shaking, muscle spasms
- Dizziness, headache
Please see the product monograph and patient information for a full list of possible side effects:
HOW CAN YOU GET
NARCAN® NASAL SPRAY?
Individuals, families, and caregivers:
NARCAN® Nasal Spray is available from pharmacies in Ontario and Quebec. NARCAN® Nasal Spray is also available for Veteran Affairs Canada clients, First Nations Health Authority (FNHA) clients in BC, and Non-Insured Health Benefits (NIHB) program clients. A prescription is not required.
If your pharmacy does not currently stock NARCAN® Nasal Spray, speak to your pharmacist. They can likely order it on your behalf. You may also be eligible to obtain NARCAN® Nasal Spray from public health offices in Ontario and Quebec.
- Ontario: April 27, 2018: UPDATED Notice from the Executive Officer: Funding of Naloxone Nasal Spray through the ONPP and Updates to the Existing Program
- Quebec: May 9, 2018: NARCAN® Nasal Spray covered under the free naloxone program (for pharmacies)
- NIHB: April 9, 2018: Naloxone Nasal Spray now available to First Nations and Inuit through Non-Insured Health Benefits program
Organizations wishing to order NARCAN® Nasal Spray:
Frequently asked questions about
NARCAN® NASAL SPRAY
For health care professionals:
For patients:
NARCAN® Nasal Spray can be used by anyone to reverse the effects of an opioid overdose until medical help arrives.
NARCAN® Nasal Spray comes ready-to-use. No device assembly or priming/testing of the device is required.
For directions on how to use NARCAN® Nasal Spray, please watch the video or download the instructions for use.
No, treatment of suspected opioid overdose must be performed by someone other than the affected person.
It may be possible that the signs of an opioid overdose do not subside after an initial dose of NARCAN® Nasal Spray. Alternatively, signs of an opioid overdose may return after a person has been given a dose of NARCAN® Nasal Spray. In either of these instances, you should:
- Lay the patient on their side to help them have a clear airway.
- Monitor them closely.
- Give a second dose after 2 to 3 minutes if the person has not woken up or their breathing is not improved. Alternate nostrils with each dose.
- Perform artificial respiration or cardiac massage until emergency medical help arrives, if you know how and if it is needed.
Always read the label and follow the directions for use before giving someone NARCAN® Nasal Spray.
For health care professionals:
For patients:
Medicinal ingredient: naloxone hydrochloride
Non-medicinal ingredients: benzalkonium chloride, disodium ethylenediaminetetraacetate, sodium chloride, hydrochloric acid and purified water.
NARCAN® Nasal Spray device with red plunger
- Store NARCAN® Nasal Spray in the blister and cartons provided.
- Store below 25°C. Can be stored up to 40°C only for short periods of time. Do not freeze or expose to excessive heat above 40°C.
- NARCAN® Nasal Spray freezes at temperatures below -15°C. If this happens, the device will not spray. If NARCAN® Nasal Spray is frozen and is needed in an emergency, do NOT wait for NARCAN® Nasal Spray to thaw. Get emergency medical help right away.
- You can thaw NARCAN® Nasal Spray by allowing it to sit at room temperature for 15 minutes. You can still use it if it has been thawed after being previously frozen.
- Replace NARCAN® Nasal Spray before the expiration date on the box.
- If only expired NARCAN® Nasal Spray is available, it should be used in an overdose situation.
- Keep out of reach and sight of children.
NARCAN® Nasal Spray should only be used in pregnant women when clearly needed.
Giving NARCAN® Nasal Spray to anyone who is physically dependent on opioids may induce an acute opioid withdrawal syndrome–causing a reaction such as becoming aggressive, shaking and/or vomiting. You will need to pay special attention when giving NARCAN® Nasal Spray to a pregnant woman because some of these reactions may cause preterm labour or can be life threatening to the fetus. Always call 911 for emergency medical assistance before administering NARCAN® Nasal Spray and as soon as an opioid overdose is suspected.
Please see the product monograph and patient information for a full list of warnings and precautions:
Can NARCAN® Nasal Spray be used on a child?
Yes, it can, but there are a few considerations:
Newborns:
You may need to help the person who received NARCAN® Nasal Spray. The patient may have a reaction such as becoming aggressive, shaking and/or vomiting. You will need to pay special attention when giving NARCAN® Nasal Spray to a newborn who is less than four weeks old or a pregnant woman. Some of these reactions can be life-threatening for a newborn or a fetus. Always call 911 for emergency medical assistance before administering NARCAN® Nasal Spray and as soon as an opioid overdose is suspected.
The pharmacist may recommend using an alternate form of naloxone in newborns or children under two years old. This is because smaller doses can be given with the injectable form of naloxone.
Children:
When administering NARCAN® Nasal Spray in young children, the nozzle of the device may not fit inside the child’s nostril. In this case, make sure that the device nozzle forms a seal with the nostril before giving NARCAN® Nasal Spray.
Please see the product and patient information for a full list of warnings and precautions:
Please see the product monograph and patient information for a full list of warnings and precautions: