Nalorphine information from DrugsUpdate
P - Caution when used during pregnancy.
L - Caution when used during Lactation.
Nalorphine acts at two opioid receptors, at the mu receptor it has antagonistic effects and at the kappa receptors it exerts agonistic characteristics. It is used to reverse opioid overdose and in a challenge test to determine opioid dependence.
Pharmacodynamics
Nalorphine is an opioid antagonist, with properties similar to naloxone. It also has some agonist properties.
Pharmacokinetics
After oral administration, Nalorphine is absorbed rapidly in the GIT. After absorption, the drug is metabolized via the first-pass metabolism. Nalorphine is excreted mostly in the urine as urinary metabolites including glucuronide conjugates.
Nalorphine Indications / Nalorphine Uses
Reversal of opioid-induced respiratory depression (intravenously and intramuscularly).
Nalorphine Adverse Reactions / Nalorphine Side Effects
Nalorphine can cause miosis, lethargy, acute respiratory depression, drowsiness, dysphoria and nausea.
Precautions
Opioid-dependent patients may experience serious and acute withdrawal syndrome. May cause respiratory depression due to administration of other non-opioid depressants or alcohol.
Special Precautions
Patients physically dependent on opioids or who have received large doses of opioids (acute withdrawal syndrome may be precipitated). May exacerbate respiratory depression induced by alcohol or other non-opioid depressant. Pregnancy and lactation. Cardiac disease or patients receiving cardiotoxic medications.
Other Drug Interactions
Nalorphine may interact with other non-opioid depressants and cardiotoxic drugs.
Other Interactions
Do not consume alcohol. It can cause serious adverse events.
Dosage
For reversal of opioid-induced acute respiratory depression (Adults):
Consider intravenous administration of 5-10 mg of Nalorphine as hydrochloride or hydrobromide salts, every 10-15 minutes or as needed. The maximum dose should not exceed 40 mg/day.
List of Contraindications
Nalorphine and Pregnancy
USFDA pregnancy category D. Nalorphine can harm the unborn fetus. Perform pregnancy tests before using Nalorphine. Use effective contraceptive mode to prevent unintended pregnancies while taking Nalorphine
Nalorphine and Lactation
Nursing mothers should consult the healthcare provider before Nalorphine treatment.
Nalorphine and Children
Nalorphine is contraindicated in children
Storage
Intramuscular: Store at 25 °C, excursions at 15-30°C permitted. Protect from light. Intravenous: Store at 25 °C, excursions at 15-30°C permitted. Protect from light.
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