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HelixTalk Episode #51 - Pharmacists to the rescue!

Date posted: October 25, 2016, 6:00 am

In this episode, we discuss two new naloxone devices (intramuscular Evzio and intranasal Narcan) and review new state laws that are expanding the role of pharmacists in dispensing these opioid reversal products.


Key Concepts

  1. Naloxone is currently available as a prescription in four dosage forms.  Two of the four formulations are “kits” that must be assembled and are being phased out in favor of pre-assembled products.
  2. Two new pre-assembled naloxone formulations include Evzio (an intramuscular autoinjector) and Narcan (an intranasal spray).  In both cases, the products come as a two pack (two doses) and a training demo device.
  3. In both Illinois and Wisconsin, pharmacists can dispense naloxone products using a standing order.  These pharmacists must undergo special training regarding the opioids, opioid overdose, and the naloxone products.  Pharmacists may dispense these products directly to patients or friends/family of patients who are at-risk for opioid overdose.
  4. Naloxone has a very short half-life and typically only last about an hour or less.  It is very important to activate the emergency response system (such as calling 911) because patients may require several doses or even a continuous naloxone infusion depending on the half-life and amount of opioid causing the overdose.

References and Additional Reading

  1. Summary review for regulatory action. Center for Drug Evaluation and Research. Online. 2015. Available: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/208411Orig1s000SumR.pdf. Accessed August 10, 2016.
  2. Medical review. Center for Drug Evaluation and Research. Online. 2015. Available: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/208411Orig1s000MedR.pdf. Accessed August 10, 2016.
  3. Strang J, McDonald R, Tas B, Day E. Clinical provision of improvised nasal naloxone without experimental testing and without regulatory approval: imaginative shortcut or dangerous bypass of essential safety procedures? Addiction. 2016; 111: 574-82.