Take-home naloxone treatment for opioid emergencies: a comparison of routes of administration and associated delivery systems.
Naloxone reversal of opioid-induced respiratory depression outside of medical facilities has become more prevalent because of the escalating opioid epidemic in the USA. Take-home naloxone for treatment of opioid emergencies is now being recommended by numerous federal, state, and professional organizations. Areas covered: The scope of the opioid overdose epidemic is reviewed along with practical, clinical, regulatory, and usability considerations for take-home naloxone routes of administration currently available and associated delivery systems. Specific opioid-related factors are discussed in detail with emphasis placed on life-threatening respiratory depression and naloxone antagonism. A clinical overview, including pharmacokinetic and FDA approval information for each take-home naloxone product is discussed in detail as well as the impact of take-home naloxone in the community. Finally, given these products are to be used in a panic-stricken, life-threatening opioid emergency, an analysis of available usability data is provided with proposed directions for further study. Expert opinion: Based on the available clinical evidence, auto-injectable naloxone should be the preferred administration route for take-home naloxone treatment until additional safety, efficacy, and comparative outcomes data are available for unconventional routes of administration that unequivocally provide equal or superior results.
a Medical Affairs , kaleo, Inc ., Richmond , VA , USA.
Mark J
MJ
Elzey
b Scientific and Clinical Affairs at Remitigate, LLC , Delmar , NY , USA.|c PGY2 Pharmacy Pain Management, Stratton VA Medical Center , Albany , NY , USA.|d Albany College of Pharmacy & Health Sciences , Albany , NY , USA.|e Western New England University College of Pharmacy , Springfield , MA , USA.
Jeffrey
J
Fudin
a Medical Affairs , kaleo, Inc ., Richmond , VA , USA.
Eric S
ES
Edwards
D000701:Analgesics, Opioid / Q000506:poisoning* / Q000627:therapeutic use; D004333:Drug Administration Routes; D017277:Drug Approval; D016503:Drug Delivery Systems; D062787:Drug Overdose / Q000188:drug therapy*; D004630:Emergencies; D006801:Humans; D009270:Naloxone / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000139:chemically induced; D014481:United States; D014486:United States Food and Drug Administration
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone
Auto-injector; intranasal kit; naloxone; nasal spray; opioid emergency; opioid overdose; opioid-induced respiratory depression