Reminder: patient safety alert – naloxone

Naloxone is a highly effective antidote for opioids and opiates.

It is licensed for use in complete or partial reversal of central nervous system depression and especially respiratory depression, caused by natural or synthetic opioids; and treatment of suspected acute opioid overdose or intoxication. 

Naloxone must be given with great caution to patients who have received longer-term opioid/opiate treatment for pain control or who are physically dependent on opioids/opiates. Use of naloxone in patients where it is not indicated, or in larger than recommended doses, can cause a rapid reversal of the physiological effects for pain control. This can lead to intense pain and distress, and an increase in sympathetic nervous stimulation and cytokine release, precipitating an acute withdrawal syndrome. 

Hypertension, cardiac arrhythmias, pulmonary oedema and cardiac arrest may result from inappropriate doses of naloxone being used for these types of patients. 

It is important to be aware of the correct usage of naloxone and the need for an adequate assessment of a patient’s history, including any previous long term drug use.

NHS England has published resources to help staff when dealing with naloxone and potential steps that can be taken to avoid the drug.

These and the full patient safety alert are available to download

Published 5th November, 2015