The only significant contraindication to naloxone use is a prior allergic reaction and hypersensitivity. In those rare cases, narcotic pain relief should be avoided from the onset and ketamine used.
Potential side effects include analgesia reversal, tremors, hyperventilation, drowsiness, sweating, increased BP, tachycardia, nausea, and vomiting.
Drug interactions include cardiotoxic drugs (may cause serious CV effects) – use together cautiously, reverses analgesic effects of narcotic (opiate) agonists.
The Onset/Peak/Duration for naloxone is 1-2 min/5-15 min/variable.
Tactical considerations for naloxone: An overdose of naloxone is unlikely if used as indicated; naloxone should be readily available anytime narcotics are being administered; titrate to effect (resolving narcotic overdose signs and symptoms) but continue to manage casualty’s pain; naloxone may wear off prior to opiate – observe closely for signs of recurrent opiate overdose.