Naloxone Nasal Spray (Padagis® 4 mg, 2-Pack)

Naloxone nasal spray is an opioid antagonist used for emergency overdose rescue. Each single-dose nasal device contains 4 mg naloxone hydrochloride (in 0.1 mL solution) – the same strength as brand-name Narcan®. Naloxone works by quickly displacing opioids from brain receptors, rapidly reversing life-threatening respiratory and CNS depression. It typically restores normal breathing within minutes. Importantly, naloxone has no effect on someone who hasn’t taken opioids (it is safe even if the person has no opioids in their system). Padagis® is a generic OTC brand of naloxone nasal spray; this 2-pack contains two separate pre-filled devices (two doses) for emergency use.

Uses and Indications

• Emergency overdose reversal: Padagis 4 mg nasal spray is indicated for known or suspected opioid overdose – especially if the person has slowed or stopped breathing or is unresponsive. It “revives” overdose victims by restoring breathing and consciousness.
• First-aid use: It is intended for immediate administration as an emergency therapy by bystanders or first responders (family, friends, paramedics, etc.) when opioids are involved. After use, emergency medical care (911) must still be sought immediately. Naloxone is not a substitute for full medical treatment; it’s a life-saving first aid that buys time until help arrives.
• No prescription needed: In the U.S., 4 mg naloxone nasal sprays (such as Padagis or Narcan) are now available over-the-counter without a prescription. They can be purchased online or at pharmacies, convenience stores, etc., ensuring broader access during the opioid epidemic.

Dosage and Administration

• Single intranasal dose: To use Padagis, insert one device’s nozzle into one nostril and press the plunger firmly. Each spray delivers a single 4 mg dose of naloxone. (The package has two devices; use one per administration.) The person should be laid on their back with head tilted, then squeeze the plunger as directed.
• Repeat if needed: If there is no response after about 2–3 minutes, use the second device to administer a second 4 mg spray (in the other nostril). Continue repeating every 2–3 minutes (with new devices) until the person begins breathing normally or emergency help arrives.
• Emergency services: Always call 911 immediately when administering naloxone. Keep giving rescue breaths or CPR if needed while waiting for responders. Naloxone’s effects may wear off, so the patient must be monitored until professionals can take over.

Key Points & Side Effects

• Mechanism: Naloxone is a pure opioid antagonist that “blocks” opioid receptors. It displaces opioids (heroin, fentanyl, oxycodone, etc.) and reverses overdose symptoms. It has no action if no opioids are present.
• Onset/duration: Onset of action is within minutes. However, naloxone’s duration (~30–90 min) may be shorter than some opioids, so rescue breathing or repeat dosing might be needed as noted above.
• Safety: Naloxone is very safe; it cannot cause opioid overdose. Because it has no effect without opioids, giving it “just in case” is safe. It is recommended for anyone at risk of witnessing an overdose.
• Withdrawal effects: In opioid-dependent individuals, naloxone precipitates acute withdrawal (which is uncomfortable but usually not life-threatening). Signs of withdrawal may include rapid heartbeat, sweating, nausea/vomiting, shaking, body aches, or agitation. These are expected side effects of reversing the overdose and generally resolve on their own.
• Common side effects (after reversal): Reported mild adverse effects include increased blood pressure, headache, muscle aches, nasal dryness or congestion, and tenderness. These are typically transient. No lasting harm comes from a single naloxone dose; managing the overdose is the priority.
• Allergies/contraindications: A true allergy to naloxone is extremely rare. The only contraindication is known hypersensitivity to naloxone (or any ingredient). (No dose adjustment is needed for age, liver/kidney function, etc., in an emergency.) If no opioids are involved, naloxone will simply have no effect.

Package Details

• Contents: Each Padagis Nasal Spray 2-pack contains two single-use nasal spray devices (each pre-filled with 4 mg naloxone). The device is discardable after spraying (do not reuse).
• Indication: The package labeling states: “Emergency Treatment of Opioid Overdose”. It may come with an instruction leaflet or quick-reference card. Follow all printed directions carefully.
• Storage: Store at room temperature (typically 20–25 °C) in original packaging, away from light and moisture. Check the expiration date; replace expired kits.