Poisoning/overdose:

Indications for: Nalmefene Hydrochloride Injection

Reversal of opioid drug effects, including respiratory depression, induced by either natural or synthetic opioids. Management of known or suspected opioid overdose.

Adult Dosage:

IV route preferable: see full labeling. Reversal of opioid effects: see full labeling. Suspected opioid overdose (non-opioid dependent): initially 0.5mg/70kg, may follow with 2nd dose of 1mg/70kg if needed, 2–5mins later; do not give additional doses if no response after a total dose of 1.5mg/70kg. If opioid dependency suspected, may use an initial challenge of 0.1mg/70kg; if no evidence of withdrawal in 2mins, administer 0.5mg/70kg. Renal failure: give incremental doses more slowly (over 60secs).

Children Dosage:

Not established.

Nalmefene Hydrochloride Injection Warnings/Precautions:

Risk of recurrent respiratory depression. Cardiovascular disease or risk. Known or suspected opioid dependence. Caution when administering after high doses of opioids. Seizure disorders. Elderly. Pregnancy. Nursing mothers.

Nalmefene Hydrochloride Injection Classification:

Opioid antagonist.

Nalmefene Hydrochloride Injection Interactions:

Caution with concomitant cardiotoxic drugs. Incomplete reversal of buprenorphine. Possible risk of seizures with flumazenil. 

Adverse Reactions:

Nausea, vomiting, tachycardia, hypertension, post-op pain, fever, dizziness, headache, chills, hypotension, vasodilation; acute withdrawal symptoms.

Note:

Formerly known under the brand name Revex.

Metabolism:

Hepatic (glucuronide conjugation).

Drug Elimination:

Renal (major), fecal (17%). Half-life: 10.8 ± 5.2 hours.

How Supplied:

Single-dose vials (2mL)—10