Dosage for Narcan: What You Need to Know

March 1, 2023

Table of Contents

Narcan and similar medications are lifesaving drugs that can reverse an opioid overdose. They’re fairly easy to use and carry few risks. 

What Is Narcan?

Narcan is a naloxone nasal spray, capable of rapidly reversing the effects of opioids in the event of a life-threatening overdose.[1] 

Naloxone is an opioid antagonist. If a person has overdosed or consumed too much opioid, Naloxone can enter the body and kick opioids off of cell receptors, reversing the overdose. 

Narcan can be administered by a medical professional, but it can also be administered at home by a friend or family member. It is relatively easy to learn how to use and administer in case of emergency. 

Understanding Dosing

Narcan and similar drugs are usually pretty straightforward to use, but we’ve outlined some important details about dosing in the following sections:

In What Form Does Naloxone Come?

The FDA has approved naloxone drugs in three forms: injectables, auto-injectors, and nasal sprays. 

Nasal sprays appear to be the most popular option by a significant margin, as friends and family members may be more comfortable administering medication through a nasal spray than through an injection. 

In Which Strengths Is Naloxone Available?

The strength of naloxone-based drugs intended to reverse life-threatening overdoses is fairly standardized.[3] While you should always follow a doctor’s instructions and any provided with your medication, the strength of the medication is usually such that using it requires minimal decision-making on the part of the person administering the medication. 

The typical dose of non-healthcare-provided naloxone medications will be 0.4 mg for intramuscular injections and 2 mg for intranasal sprays. A higher 2 mg injection was recently approved by the FDA as well, intended for use in combatting overdoses related to especially potent opioids like fentanyl. Higher dosing is sometimes considered appropriate for patients under the effects of potent opioids, as has become more common with the rise of synthetic opioid use.[3]

One current concern is that there aren’t currently special dosing recommendations for children or pregnant people, but the current doses appear to be within a range that is safe for children. If need be, an adult dose can be administered to a child. Naloxone is also thought to be largely safe in pregnancy, and should be administered to pregnant individuals without hesitation in the case of an emergency. 

How to Administer Narcan

The American Medical Association has published a short video on how to administer naloxone nasal sprays like Narcan as well as other types of naloxone products.[4] These are the steps for administering sprays:

  • Peel the packaging back, and remove the device from the packaging.
  • Hold the device with your thumb on the bottom of the plunger and two fingers on the nozzle.
  • Place and hold the nozzle tip in either of the person’s nostrils. Your fingers should touch the bottom of their nose.
  • Push the plunger firmly, releasing the dose of naloxone into the person’s nose.

You should then call 911 if you haven’t already. An opioid overdose is a serious matter. It is important that medical professionals check for issues that may not be obvious, especially because naloxone won’t always indefinitely stop serious problems in the event of heavy drug use. In some cases, additional doses of Narcan may be needed.

Is a Narcan Overdose Possible?

Not really, no. Narcan and other naloxone drugs are considered safe and have no abuse potential. They aren’t opioids and don’t cause a high. In fact, they do the opposite by acting in opposition to opioids.

Naloxone is not known to cause harm when administered at typical doses. There have been no known fatalities reported that were connected to naloxone. 

Getting Narcan From a Pharmacy

Because it can save lives and carries few, if any, risks, policies have been put in place to make drugs like Narcan and other naloxone-based overdose reversal drugs easier to access. In most states, you can request Naloxone without a prescription, and naloxone is at least available in some form in all 50 states.[5] 

Even if Narcan or naloxone is available without a prescription, doctors can also prescribe it. They will often do so if prescribing a patient a high dose of opioids. If you have been misusing opioids, talk to your doctor about keeping a prescription for Narcan on hand and making sure you and your loved ones know how to use it. Likewise, if you have a loved one or someone you live with who uses opioids, you should consider familiarizing yourself with how to administer Naloxone in case of an emergency.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

Reviewed By

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  1. NARCAN® (Naloxone HCI) Nasal Spray. Emergent. Accessed January 2023.
  2. Statement on Continued Efforts to Increase Availability of All Forms of Naloxone to Help Reduce Opioid Overdose Deaths. U.S. Food and Drug Administration. September 2019. Accessed January 2023.
  3. Naloxone Dosage for Opioid Reversal: Current Evidence and Clinical Implications. Therapeutic Advances in Drug Safety. January 2018. Accessed January 2023.
  4. How to Administer Naloxone. American Medical Association. Accessed January 2023.
  5. Lifesaving Naloxone. Centers for Disease Control and Prevention. December 2022. Accessed January 2023.

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