Rextovy 4 mg/actuation nasal spray

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Medication name

Generic name:
Naloxone spray - nasal

Pronunciation
(nal-OX-one)

Brand name(s)
Narcan , RiVive

Uses

Naloxone is used for the emergency treatment of known or suspected opioid overdose. Serious opioid overdose symptoms may include unusual sleepiness, unusual difficulty waking up, or breathing problems (ranging from slow/shallow breathing to no breathing). Other symptoms of overdose may include very small "pinpoint" pupils, slow heartbeat, or low blood pressure. If someone has serious overdose symptoms but you are not sure if the symptoms are due to opioid overdose, give naloxone right away anyway, since lasting slow/shallow breathing may cause permanent damage to the brain or death. Since symptoms of opioid overdose may return after treatment, be sure to get medical help right away after giving the first dose of naloxone.

This medication belongs to a class of drugs known as opioid antagonists. It works by blocking the effects of the opioid in the brain.

How to use

If your doctor has prescribed this medication, read the Patient Information Leaflet and Instructions for Use provided by your pharmacist when you get this medication and each time you get a refill. If you are using the over-the-counter product, read and follow all directions on the product package before using this medication. Be sure to keep this medication handy in case it is needed. Learn ahead of time how to properly give this medication. If you have any questions, ask your doctor or pharmacist.

Close family and household members should know the symptoms of an opioid overdose and be instructed on how to give naloxone if needed. Opioid overdose should be treated right away to prevent serious effects (such as brain damage). See also Uses section.

Remove the naloxone spray from the package only when you are ready to use it. Lay the person on their back. Tilt the person's head back and support their neck with your hand. Use your other hand to gently insert the tip of the spray nozzle into one nostril, then firmly press the plunger to give the dose. Some brands may direct you to move the person onto their side after removing the spray nozzle from the nostril. Follow the directions for your brand carefully.

The effects of this medication are rapid but not long lasting. After giving naloxone, get medical help right away, even if the person wakes up. If symptoms return after giving the spray, give another dose in the other nostril every 2 to 3 minutes, changing nostrils with each dose. Each spray contains only one dose and cannot be reused. Continue to closely watch the person until emergency help comes. Tell the health care professional that you have given naloxone spray.

Side effects

Nasal dryness, swelling, or stuffy nose may occur. Muscle/joint pain or headache may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this product, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

In someone who has been using an opioid regularly, withdrawal symptoms can happen suddenly after receiving this medication. Withdrawal symptoms may include body aches, fever, sweating, watering eyes, runny nose, sneezing, goose bumps, yawning, weakness, shivering/trembling, nervousness, restlessness, diarrhea, nausea/vomiting, stomach cramps, increased blood pressure, fast heartbeat. In babies younger than 4 weeks who have been receiving an opioid regularly, sudden opioid withdrawal may be life threatening if not treated the right way. Symptoms in babies may include seizures, crying more than usual, and muscle twitching/spasms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using naloxone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • heart problems (such as irregular heartbeat, previous heart attack)

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Since untreated opioid overdose can harm both a pregnant woman and her unborn baby, this medication may be used during pregnancy. However, naloxone may cause opioid withdrawal in your unborn baby. Tell your doctor right away that you used this medication, so you and your unborn baby can be monitored. Ask your doctor for details.

It is unknown if this medication passes into breast milk. However, it is unlikely to harm a nursing infant. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Overdose

Naloxone overdose in somebody not regularly taking an opioid is highly unlikely. However, if someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Notes

Ask your doctor or pharmacist about ways to prevent opioid overdose. Teach your close family or household members the signs and symptoms of an opioid overdose and tell them where you keep this medication.

Missed dose

Not applicable.

Storage

Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.

From time to time, check the expiration date. Replace the spray before it expires.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this medication when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised May 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.