• Dr. Paul Dhillon MB BCh CCFP

Nar can be on the exam?


1. List the routes and corresponding doses for administration of Naloxone.

You know your Epinephrine doses but do you know your Narcan?

Naloxone (Narcan™) and deaths from opioid overdoses have been front page news across the country as our latest challenge against some of the harmful effects of opioids. Health Canada just approved a nasal version of the drug after an expedited review. It will be available over the counter.

DID YOU KNOW: Naloxone can be given IM, IV, SC, ETT(off-label), IO and now nasally. Onset is within 1-2 minutes IV, 2-5 min IM/SC, and 8-13 minutes after nasal use.


For IV, SC, and IM the dose is 0.4mg to 2mg per dose.

For nasal administration the dose is 4mg.

Keep in mind that the half-life of naloxone is short and you might need to repeat your dosing and change nostrils for the 2nd dose.

EXAM TIP – If you have someone who is at risk for overdose ensure you offer a Narcan Rx or recommend they or family members have access to it and know how to use it. Use with caution in pregnant patients as there is placental transfer and this could cause withdrawal symptoms in the fetus. If your patient is female remember to check that βHCG!

Reference List



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