Editing Naloxone (section)

=== Available forms ===

====Intravenous====
In hospital settings, naloxone is injected [[intravenously]], with an onset of 1–2 minutes and a duration of up to 45 minutes.<ref name="Lexicomp. 2013">{{cite book |title=Drug information handbook for advanced practice nursing: a comprehensive resource for nurse practitioners, nurse midwives, and clinical specialists, including selected disease management guidelines. |date=2013|publisher=Lexicomp|isbn=978-1591953234|oclc=827841946}}</ref>

====Intramuscular or subcutaneous====
Naloxone can also be administered via [[intramuscular]] or [[subcutaneous injection]]. The onset of naloxone provided through this route is 2 to 5 minutes with a duration of around 30–120min.<ref>{{cite web | title = Naloxone for Treatment of Opioid Overdose | date = October 2016 | url = https://www.fda.gov/media/100429/download | author = Advisory Committee | work = Insys Development Company, Inc. | publisher = U.S. Food and Drug Administration }}</ref> Naloxone administered intramuscularly are provided through pre-filled syringes, vials, and auto-injector. A hand-held auto-injector is pocket-sized and can be used in non-medical settings such as in the home.<ref name="special circum 2015"/> It is designed for use by laypersons, including family members and caregivers of opioid users at risk for an opioid emergency, such as an overdose.<ref name="FDA News Release">{{cite press release |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391465.htm|title=FDA approves new hand-held auto-injector to reverse opioid overdose |publisher = U.S. [[Food and Drug Administration]] (FDA) |archive-url= https://web.archive.org/web/20150716003000/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391465.htm|archive-date=16 July 2015|access-date=20 July 2015|url-status=dead}}</ref> According to the FDA's [[National Drug Code]] Directory, a generic version of the auto-injector began to be marketed at the end of 2019.<ref>{{cite web|url=https://ndclist.com/ndc/72853-051/package/72853-051-02|title=NDC 72853-051-02 Naloxone Hydrochloride Auto-injector|website=NDClist.com|access-date=21 March 2020|archive-date=21 March 2020|archive-url=https://web.archive.org/web/20200321212308/https://ndclist.com/ndc/72853-051/package/72853-051-02|url-status=dead}}</ref>

====Intranasal====
Narcan nasal spray was approved in the US in 2015 and is the first FDA-approved nasal spray for emergency treatment or suspected overdose.<ref name="FDA PR 20190419">{{cite press release|url=https://www.fda.gov/news-events/press-announcements/fda-approves-first-generic-naloxone-nasal-spray-treat-opioid-overdose|title=FDA approves first generic naloxone nasal spray to treat opioid overdose|date=11 September 2019|publisher=U.S. [[Food and Drug Administration]] (FDA)|access-date=23 October 2019|archive-date=14 September 2019|archive-url=https://web.archive.org/web/20190914122901/https://www.fda.gov/news-events/press-announcements/fda-approves-first-generic-naloxone-nasal-spray-treat-opioid-overdose|url-status=live}}</ref><ref>{{cite web |title = FDA Approves Narcan Nasal Spray|url = http://www.jems.com/articles/2015/11/fda-approves-narcan-nasal-spray.html|website = www.jems.com|access-date = 21 November 2015|url-status = live|archive-url = https://web.archive.org/web/20151120184918/http://www.jems.com/articles/2015/11/fda-approves-narcan-nasal-spray.html|archive-date = 20 November 2015}}</ref> It was developed in a partnership between LightLake Therapeutics and the [[National Institute on Drug Abuse]].<ref>{{cite web |url=https://www.drugabuse.gov/about-nida/noras-blog/2015/11/narcan-nasal-spray-life-saving-science-nida|title=Narcan Nasal Spray: Life Saving Science at NIDA| vauthors = Volkow N |date=18 November 2015|website=[[National Institute on Drug Abuse]] (NIDA) |url-status=live|archive-url=https://web.archive.org/web/20170226133910/https://www.drugabuse.gov/about-nida/noras-blog/2015/11/narcan-nasal-spray-life-saving-science-nida|archive-date=26 February 2017}}</ref> The approval process was fast-tracked.<ref>{{cite news|url=https://www.washingtonpost.com/national/health-science/fda-approves-device-to-combat-opiod-drug-overdose/2014/04/03/35b69cac-bb3e-11e3-96ae-f2c36d2b1245_story.html|title=FDA approves device to combat opioid drug overdose| vauthors = Dennis B |date=3 April 2014|newspaper=[[The Washington Post]]|access-date=8 April 2014|url-status=live|archive-url=https://web.archive.org/web/20140407173215/http://www.washingtonpost.com/national/health-science/fda-approves-device-to-combat-opiod-drug-overdose/2014/04/03/35b69cac-bb3e-11e3-96ae-f2c36d2b1245_story.html|archive-date=7 April 2014}}</ref> A generic version of the nasal spray was approved in the United States in 2019, though did not come to market until 2021.<ref name="FDA PR 20190419" /><ref name="Teva Pharmaceuticals_2021" />

In 2021, the FDA approved Kloxxado, an 8{{nbsp}}mg dose of intranasal naloxone developed by [[Hikma Pharmaceuticals]].<ref>{{cite press release |date=11 May 2021 |title=FDA Approves Higher Dosage of Naloxone Nasal Spray to Treat Opioid Overdose |url=https://www.fda.gov/news-events/press-announcements/fda-approves-higher-dosage-naloxone-nasal-spray-treat-opioid-overdose |access-date=21 September 2022 |publisher=U.S. [[Food and Drug Administration]] (FDA) |archive-date=1 September 2022 |archive-url=https://web.archive.org/web/20220901084121/https://www.fda.gov/news-events/press-announcements/fda-approves-higher-dosage-naloxone-nasal-spray-treat-opioid-overdose |url-status=live }}</ref> Citing the frequent need for multiple 4{{nbsp}}mg doses of Narcan to successfully reverse overdose, packs of Kloxxado Nasal Spray contain two pre-packaged nasal spray devices, each containing 8{{nbsp}}mg of naloxone.<ref>{{cite journal | vauthors = Abdelal R, Raja Banerjee A, Carlberg-Racich S, Darwaza N, Ito D, Shoaff J, Epstein J | title = Real-world study of multiple naloxone administration for opioid overdose reversal among bystanders | journal = Harm Reduction Journal | volume = 19 | issue = 1 | pages = 49 | date = May 2022 | pmid = 35596213 | pmc = 9122081 | doi = 10.1186/s12954-022-00627-3 | doi-access = free }}</ref><ref name="Kloxxado FDA label">{{cite web | title=Kloxxado- naloxone hcl spray | website=DailyMed | date=10 May 2022 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ebf0f833-c1c0-487c-8f29-01fa8c61b6cb | access-date=7 January 2023 | archive-date=7 January 2023 | archive-url=https://web.archive.org/web/20230107044215/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ebf0f833-c1c0-487c-8f29-01fa8c61b6cb | url-status=live }}</ref>

However, a wedge device (nasal atomizer) can also be attached to a syringe that may also be used to create a mist to deliver the drug to the nasal{{nbsp}}[[mucosa]].<ref name="pmid15039670">{{cite journal | vauthors = Wolfe TR, Bernstone T | title = Intranasal drug delivery: an alternative to intravenous administration in selected emergency cases | journal = Journal of Emergency Nursing | volume = 30 | issue = 2 | pages = 141–147 | date = April 2004 | pmid = 15039670 | doi = 10.1016/j.jen.2004.01.006 }}</ref> This is useful near facilities where many overdoses occur that already stock injectors.<ref>{{cite web| vauthors = Fiore K |title=On-Label Nasal Naloxone in the Works|url=http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/52118|website=MedPage Today|access-date=20 July 2015|url-status=live|archive-url=https://web.archive.org/web/20150801184056/http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/52118|archive-date=1 August 2015|date=13 June 2015}}</ref>
[[File:NARCAN teardown.jpg|thumb|Internal components of a naloxone nasal spray. ]]