Naloxone

Opioids and strong painkillers

Also known as Narcan

Naloxone rapidly knocks opioids off the receptors in the brain, which can restart someone's breathing within minutes during an overdose. It's a nasal spray you can buy over the counter at any pharmacy — no prescription, no questions. Here's the thing to remember: it does nothing to a person who doesn't have opioids in their system, so it can't hurt to use it. When in doubt, use it.

How to take it

When to use it

Use it at the first signs of overdose: very slow or stopped breathing, gurgling or snoring sounds, blue lips or fingertips, or someone who won't wake up even when you shout and rub your knuckles hard on their chest. Don't wait to be certain — every minute matters.

How to use it

Lay the person on their back. Insert the nozzle into one nostril and press the plunger firmly. If they don't respond in 2 to 3 minutes, give a second dose in the other nostril. If you're trained, start rescue breathing or CPR. Once they're breathing, roll them onto their side and stay with them.

Don't skip 911

Always call 911 — first if you can, or immediately after the first spray. Naloxone wears off in 30 to 90 minutes, often before the opioid does, so the person can slip back into overdose. Most states have Good Samaritan laws protecting people who call for help.

Storage

Keep it where the person taking opioids — and their family and friends — can find it fast, and make sure everyone knows where it is and how to use it. Check the expiration date now and then, and replace it after use. The FDA recommends it for everyone taking opioids.

Missed a dose?

Not applicable — naloxone isn't taken on a schedule. It's an emergency rescue medicine you keep on hand and use only during a suspected overdose.

Common side effects

In someone dependent on opioids, it triggers sudden withdrawal: shaking, sweating, nausea, vomiting, and agitation — miserable, but not life-threatening, and far better than the alternative
Headache
A runny or irritated nose from the spray
None at all if the person had no opioids in their system

Call a doctor if

Every suspected overdose is a 911 emergency — even if the person wakes up and says they're fine, they can stop breathing again as the naloxone wears off
The person is still not breathing normally after the first dose — give a second dose after 2 to 3 minutes, keep giving doses every few minutes if you have them, and continue rescue breathing or CPR until help arrives
The person wakes up but then gets drowsy or hard to rouse again — the overdose is returning; give another dose if you have one and make sure 911 is on the way
Gurgling sounds, blue lips, or limpness in anyone who has been around opioids — including a child who may have gotten into someone's medicine — use naloxone and call 911 immediately

Educational only. This summary is drawn from public FDA labeling and MedlinePlus and simplified for readability. Your prescription label and your pharmacist always come first — doses and instructions vary from person to person.