The New Nasal Spray That Can Reverse a Deadly Overdose Is Now Available Over the Counter (2023)

This may save your child's life.

Here are some harrowing statistics for you: The most recent National Institutes of Health statistics researchreports that more than 106,000 people in the U.S. died from drug-involved overdoses in 2021, while opioid-involved overdose deaths clocked in at 80,411—about 90% of the total. And according to the Centers for Disease Control and Prevention, there has been a significant increase in overdose deaths in minors and teens since 2019.

The FDA recently approved naloxone (commonly referred to by its brand name, Narcan) for over-the-counter (OTC) use. If you ask experts in addiction and medicine, the approval was long overdue.

"While FDA approval of OTC naloxone is good news, there are challenges to the widespread adoption of the drug,"Dr. Hyong Un, MD, chief medical officer at Recovery Centers of America, tells Parade. "We must overcome barriers such as lack of awareness, cost and stigma. Additionally, although naloxone is lifesaving, follow-up treatment after use is imperative."

Here's everything parents need to know about over-the-counter Narcan (naloxone).

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What Is Narcan and How Does it Work?

"Narcan is the brand name for the medication naloxone hydrochloride. The FDA-approved version for selling over-the-counter is the intra-nasal version. It is an opioid antagonist, which means it binds to the same receptor which blocks the opioid from working. This blocking activity of Narcan reverses the respiratory depressing effect of the opioid and provides a life-saving benefit when a patient has overdosed on an opioid," Dr. Jonathan Watanabe, Ph.D,Associate Dean of Pharmacy Assessment and Quality at the University of California Irvine andmember of the White House Opioid Committee, tells Parade.

Dr. Eric Collins, MD, addiction psychiatrist and chief medical officer at, explained that naloxone works for a number of drugs, including fentanyl, oxycodone and morphine.

"When a person has overdosed on opioids and has consequently stopped breathing, Narcan can help them start breathing again by effectively taking the opioid medication off the receptors," Dr. Collins says.

The New Nasal Spray That Can Reverse a Deadly Overdose Is Now Available Over the Counter (1)

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How Effective Is Narcan?

Narcan is popular because, thankfully, it works—usually within two to three minutes of the first dose, Dr. Watanabe says.

"There are case studies that show that additional Narcan doses may be needed depending on the amount of opioids or the strength or potency of the opioid," he advises. "Fentanyl, for example, is 100 times more potent than morphine. For this reason, the Narcan directions include that you can re-administer Narcan into the opposite nostril every two or three minutes if the patient does not respond."

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Will Having Narcan Encourage My Child's Drug Use?

Experts agree that the pros of having naloxone on hand far outweigh any risks—and this is especially true if parents have honest and conscientious discussions with their kids about drugs.

"Any substance in the home (alcohol, cigarettes, candy, an albuterol inhaler, an Epi-pen) presents an opportunity to have an age-appropriate conversation with our children and young adults about substances and the risks of their use,"Dr. Matthew Ruble, MD,Chief Medical Officer of Discovery Behavioral Health, tells Parade.

"We have so much evidence that age-appropriate discussions with kids lead to better outcomes. We know that discussions about sexual activity don't lead to sexual activity. We also know that discussions about suicide do not lead to or suggest suicide. Discussing how to save a person's life with Narcan should follow these same trends if discussed appropriately. Risk compensation, the balancing of the risks with the benefits of this education is very clearly in favor of education. People are much safer if they wear a seatbelt. The benefits of the seatbelt so greatly outweigh the risks."

"Naloxone has been likened to epinephrine auto-injectors (EpiPens), helping safeguard at-risk individuals from opioid overdose or anaphylaxis, respectively,"Dr. Christina Johns, MD, pediatric emergency doctor & Senior Medical Advisor at PM Pediatric Care, concurs. "Just like having an EpiPen at home does not encourage kids with peanut allergies to dive into a pool of Jiffy, having naloxone handy will not necessarily lead to children experimenting with opioid drugs."

The New Nasal Spray That Can Reverse a Deadly Overdose Is Now Available Over the Counter (2)

"About 2.7 million people in the United States report suffering from OUD, which we know is an underestimate," Dr. Watanabe says. "On average, we’re losing an American to an overdose every five minutes. So I would say that every person that is concerned they may at one point be a bystander should at the very least know where Narcan is present."

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How To Use Narcan

Dr. Johns says that because there are essentially no known negative effects of Narcan and naloxone, having it on hand is a good idea—and there are resources if you have questions on how to use or administer it.

"If you suspect your child may be misusing opioid drugs, don’t go it alone. Get support," she advises. "Check in with your pediatrician and local pharmacy for guidance on acquiring and using naloxone." You can also check to see if there are any local classes on using naloxone.

That said, the first step should be to shake the patient's shoulders and call their name. If they're unresponsive, check their breathing: Is it slow, uneven or stopped? Are they snoring, gasping or gurgling? Are their lips or fingernails purple or blue? If so, administer naloxone.

To administer naloxone:

  1. Use one spray in one nostril to start.
  2. Remove the nozzle from the person's nostril after spraying.
  3. After administering naloxone, position the patient on their side with their hands under their head and their upper leg bent forward. This will prevent them from rolling onto their stomach, which can be deadly for an overdosing person.
  4. If the overdosing individual doesn't respond within two to three minutes, you can spray another new dose of naloxone into the patient's other nostril.
  5. You can repeat, alternating nostrils, until the patient responds and breathes normally.

It's also incredibly important to get the patient emergency medical attention after the patient's first dose, even if they wake up and are responsive.

You can see a video demonstrating how to use Narcan below:

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What Are Narcan Side Effects?

Narcan can cause sudden and severe withdrawal symptoms in patients who've used opioids regularly. These can include aggressive behavior, body aches, diarrhea, fever, goosebumps, increased blood pressure, increased heart rate, irritability, nausea, nervousness, restlessness, runny nose, shivering, sneezing, stomach cramps, sweating, trembling, vomiting, weakness and yawning.

How To Talk to Kids About Narcan

As with a lot of other things, the guidance on drug discussions with children varies by the child and their age, but it's an important conversation to have. Why? Because in 2019 alone, 1 in 7 high school seniors admitted to misusing opioids during their life already.

"Talking to children about naloxone should be tailored to their developmental level—the younger the child, the simpler the answer should be," Dr. Johns says. "It’s always a good idea to ask questions to understand what they know about the topic first; then you’ll have a better idea of how to address the subject."

One key: Don't act like an encyclopedia if you're not. "Be comfortable saying 'I don’t know' if you don’t know the answer to one of their questions," Dr. Johns notes, "and agree to find out the answer together."

Clinical psychologist and Hope for Depression Research Foundation adviserDr. Ernesto Lira de la Rosa, Ph.D.,says that these conversations should be ongoing as children grow up.

"For example, young children may benefit from a conversation around the importance of the safe use of medications and that medications should only be used as prescribed. As children get older, you may talk to them about the dangers of taking opioids or other drugs," Dr. de La Rosa explains. "You may also talk with them about what to do in situations when they feel pressured by peers to use drugs, including prescription medications."

Dr. Ruble also has another key tip: Encourage your teen to bring Narcan to parties and tell other parents you had the talk—because only one opioid use can be deadly.

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The New Nasal Spray That Can Reverse a Deadly Overdose Is Now Available Over the Counter? ›

Today, the U.S. Food and Drug Administration approved Narcan, 4 milligram (mg) naloxone hydrochloride nasal spray for over-the-counter (OTC), nonprescription, use – the first naloxone product approved for use without a prescription.

When will naloxone OTC be available? ›

Washington, D.C.—Pharmacists can expect OTC Narcan nasal spray to be available by late summer, according to the manufacturer. Emergent BioSolutions, Inc.

Is Narcan approved for over-the-counter? ›

Narcan , the naloxone nasal spray used to reverse opioid overdose, was approved Wednesday for over-the-counter sale by the FDA . It's a major victory for harm reduction advocates and public health professionals—and a much needed step toward preventing thousands of overdose deaths each year.

What does Narcan nasal spray do? ›

Naloxone, the active ingredient in NARCAN® Nasal Spray, competes with opioids to bind with the same receptors in the brain. Usually, it reverses the effects of opioid overdose in 2 to 3 minutes. This allows for emergency medical help to arrive.

What states is naloxone OTC? ›

Do you need a prescription for Narcan? No. As of 2022, you can buy Narcan without a prescription from your healthcare provider in all 50 U.S. states. Washington D.C. and Puerto Rico also allow this.

How much is Narcan at Walgreens? ›

Without insurance, Narcan typically costs about $130 for a kit with one or two doses, but the over-the-counter prices could be 25 percent lower depending on current price points and discounts for other pharmacies already carrying the drug, the company said in a news release.

Can you just carry Narcan? ›

Anyone can carry naloxone, give it to someone having an overdose, and potentially save a life. Bystanders such as friends, family, non-health care providers, and persons who use drugs can reverse an opioid overdose with naloxone.

Can anyone use a Narcan kit? ›

Get a Naloxone Kit

Emergency naloxone kits, in both nasal spray and injection formats, are available to ANYONE who may need one at all of our Pharmacies and Clinics. Naloxone kits are available to anyone who is: currently using opioids or is a past opioid user who is at risk of returning to opioid use, or.

Can you use Narcan for any drug? ›

An overdose is life threatening. Give naloxone even if you do not know what kind of drugs a person took. Naloxone will only work on opioids, but there is no harm if they took a different kind of drug.

What is the nasal spray for overdose? ›

Naloxone should be given to any person who shows signs of an opioid overdose or when an overdose is suspected. Naloxone can be given as a nasal spray or it can be injected into the muscle, under the skin, or into the veins.

Is Kloxxado available? ›

Kloxxado Now Available for Emergency Treatment of Opioid Overdose. Kloxxado™ (naloxone hydrochloride) nasal spray is now available for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression, for adult and pediatric patients.

How much does Narcan cost? ›

The below-$50 price tag for Narcan announced by Emergent BioSolutions is less than the current list price for the medication, which is around $130 for a two-dose box, according to GoodRx, a group that tracks prescription drug prices.

Does CVS have naltrexone? ›

Naltrexone Hcl is a generic drug that is sold under the brand-name Revia.
Average 12 Month Prices for Naltrexone Hcl.
PharmacyNaltrexone Hcl Retail PriceNaltrexone Hcl SingleCare Price
CVS Pharmacy$108.90$45.33
4 more rows

Can doctors prescribe naloxone? ›

Patients often find the offer of a naloxone prescription acceptable. Prescribing naloxone with opioids does not increase liability risk. Naloxone is a prescription medicine that blocks the effects of opioids. It is used to treat opioid overdose by temporarily reversing the effects of opioid medicines and drugs.

How much is 4 mg of Narcan? ›

The cost for Narcan nasal spray (4 mg/0.1 mL) is around $141 for a supply of 2 spray, depending on the pharmacy you visit.

Does Walmart give Narcan? ›

As an additional step, Walmart pharmacists provide Naloxone recommendations to patients who might be at risk for overdose in alignment with CDC guidelines. Ask your pharmacist about Naloxone when you pick up an opioid prescription for you or a loved one.

How much does a Narcan vending machine cost? ›

Shaffer's prices range from $3,400 for a basic machine to $11,000 for a WiFi-enabled, temperature-controlled version.

Does Walgreen give out Narcan? ›

"Following the FDA's approval, Walgreens will offer over-the-counter naloxone later this year once commercially available, both in-store and online nationwide," the Deerfield-based retail pharmacy giant said in an emailed statement.

What to do when someone is overdosing? ›

The steps outlined in this section are recommended to reduce the number of deaths resulting from opioid overdoses.
  2. STEP 2: CALL 911 FOR HELP.

Is Narcan cost effective? ›

Naloxone is a highly cost-effective way to prevent overdose deaths,” said Coffin.

Can Narcan be used for heart attacks? ›

In a patient who has become so hypoxic from their opioid overdose that they have suffered a cardiac arrest, the treatment they need is active oxygenation/ventilation with an iGel or ETT. Narcan alone will not be enough to reverse this person's hypoxia and cardiac arrest, but active airway management will.

Where is the best place to administer Narcan? ›

Injecting into the muscle of the upper thigh or upper arm (see below) with a syringe is also a very common way to administer naloxone. Many naloxone kits come with a syringe and a vial (seen in photo below) or a pre-filled cartridge of naloxone.

What is in a take home naloxone kit? ›

Each injectable naloxone kit includes: 1 hard case (for example, a zippered hard black case with red “naloxone” cross) 2 (0.4 mg/1 ml) vials or ampoules (a small glass container) of naloxone. 2 safety-engineered syringes with 25g, 1” needles attached.

Does Narcan expire? ›

Do not use NARCAN® Nasal Spray if you are allergic to naloxone hydrochloride or any of the ingredients in NARCAN® Nasal Spray. What will be the new shelf life of NARCAN® Nasal Spray? NARCAN® Nasal Spray expiration will be changed from 2 years to 3 years on newly manufactured NARCAN® Nasal Spray units.

How much naloxone do you take for an overdose? ›

Adults and children—At first, 2 or 4 milligrams (mg) (1 spray into one nostril). Another spray may be given into the other nostril every 2 to 3 minutes until the patient responds or until emergency medical assistance becomes available.

Does Narcan work on anything other than opioids? ›

Will naloxone (Narcan) work if the person overdosed on something other than an opioid? No. Naloxone (Narcan) will only work to reverse the effects of opioids.

How many doses of Narcan can you give? ›

There's no limit or maximum number of Narcan doses that can be given to someone. Narcan begins working within 2 to 3 minutes after it's given. If the person who receives Narcan doesn't start to breathe normally within that period of time, you should give them another dose of the drug.

What is the illegal drug in nasal spray? ›

Fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Illegal fentanyl is sold in the following forms: as a powder, dropped on blotter paper like small candies, in eye droppers or nasal sprays, or made into pills that look like real prescription opioids.

What is Rinofluimucil nasal spray used for? ›

Rinofluimucil is indicated in the treatment of acute and subacute rhinitis, chronic and muco-crusted rhinitis, vasomotor rhinitis and sinusitis. It is a nasal spray based on N-Acetylcysteine and Tuaminoheptane sulfate for the treatment of rhinitis, sinusitis and nasal congestions.

What is the difference between Kloxxado and Narcan? ›

What is the difference between Kloxxado® and Narcan® (naloxone HCl) nasal spray 4 mg? Kloxxado® contains 8 mg of naloxone per spray, whereas Narcan® only contains 4 mg of naloxone per spray. Both products come with two devices per box, so with Kloxxado® you're getting twice as much naloxone per box.

What is the new alternative to Narcan? ›

Now pharmaceutical companies are creating stronger versions of naloxone medications to keep up. One of those new versions is Zimhi. Unlike Narcan, which is administered to a victim's nasal passages, Zimhi is an injectable, like an EpiPen.

How do you get Kloxxado? ›

Getting Kloxxado® is simple and easy

Kloxxado® nasal spray is available at your local pharmacy with a prescription from your doctor. Ask your doctor if a prescription for naloxone is right for you.

Is Zimhi available? ›

Zimhi is available as a brand name drug only, a generic version is not yet available.

Does Medicare pay for Narcan? ›

Narcan is usually covered under Medicare Part D, the prescription drug benefit. It should be noted, however, that costs and coverage vary by plan. If you have Original Medicare, you can enroll in a stand-alone Prescription Drug Plan (PDP) to get help paying for medications prescribed by your physicians.

Can you buy Narcan over the counter in NY? ›

Anyone who needs naloxone can get it at participating pharmacies, without a prescription. This includes people at risk of overdosing and people who may witness someone else overdosing.

How much does it cost to treat an overdose? ›

The average cost for an overdose patient who was treated and released totaled $504, but the average cost rose to $11,731 for those who were treated and admitted to a hospital and $20,500 for those who required ICU care.

How much does a naloxone kit cost? ›

Cost of naloxone: Depending on the specific form of naloxone used by the department, the cost of a single naloxone rescue kit ranges from approximately $22-$60 for intranasal kits.

Does Medicare pay for naloxone? ›

Naloxone is a drug Medicare covers that your doctor may prescribe as a safety measure to rapidly reverse the effects of an opioid overdose.

Is naloxone available in generic? ›

Narcan is available as the generic drug naloxone. Like the brand-name version, it comes as a nasal spray. A generic drug contains the same active ingredient as the brand-name version. A generic is considered just as safe and effective as the original drug.

Can anyone use a naloxone kit? ›

Naloxone kits are available to anyone who is: currently using opioids or is a past opioid user who is at risk of returning to opioid use, or. a family member, friend or other person in a position to assist a person at risk of overdose from opioids.

Can you take naloxone at home? ›

Because you can't use naloxone on yourself, let others know you have it in case you experience an opioid overdose.

How much does Evzio cost? ›

It's a talking auto-injector with naloxone, the antidote to reverse opioid overdoses. It's easy to use for people with no medical training. The actual drug naloxone can cost as little as a nickel a dose, according to industry insiders. But Evzio costs a lot more: its price tag is over $4,000.

How long is Narcan nasal spray good for? ›

NARCAN® Nasal Spray expiration will be changed from 2 years to 3 years on newly manufactured NARCAN® Nasal Spray units.

Does insurance cover Narcan spray? ›

Generally, yes. Health insurance often covers Narcan, but some health plans may have copays. Others may have a $0 copay.

Does Medicare pay for gabapentin? ›

If you're suffering from peripheral neuropathy or a related nerve condition that requires gabapentin, the good news is that virtually all Medicare benefits plans cover the drug under Part D.

What is the spray for overdose? ›

NARCAN®(naloxone HCl) Nasal Spray is an opioid antagonist indicated for the emergency treatment of known or suspected opioid overdose, as manifested by respiratory and/or central nervous system depression.

What is equivalent to Narcan? ›

Naloxone Alternatives Compared
NaloxoneNarcan (naloxone)Kloxxado (naloxone)
Dosage Form(s) Available
Injectable solution Nasal sprayNasal sprayNasal spray
Brand Names
Kloxxado, Narcan, ZimhiOther naloxone brands include: Kloxxado, ZimhiOther naloxone brands include: Narcan, Zimhi
39 more rows

What is Nalixone used for? ›

Naloxone is a medicine that rapidly reverses an opioid overdose. It attaches to opioid receptors and reverses and blocks the effects of other opioids. Naloxone is a safe medicine. It only reverses overdoses in people with opioids in their systems.

What is the brand name of naloxone injection? ›

Also known as the brand name product Narcan, naloxone is currently available by intramuscular (IM) or subcutaneous (SubQ) injection, nasal spray, or intravenous (IV) infusion.

Can Narcan be used for other things? ›

No. Naloxone (Narcan) will only work to reverse the effects of opioids.


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