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Opvee
nalmefene nasal
Adult Dosing .
Dosage forms: SPRAY: 2.7 mg per actuation
opioid overdose
- [1 actuation in one nostril x1]
- Info: may repeat dose in alternate nostrils q2-5min until pt responsive or EMS arrives
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: SPRAY: 2.7 mg per actuation
opioid overdose
- [12 yo and older]
- Dose: 1 actuation in one nostril x1; Info: may repeat dose in alternate nostrils q2-5min until pt responsive or EMS arrives
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: cardiovascular dz
- caution: opioid addiction
Drug Interactions .
Overview
nalmefene
opioid antagonist, central
-
None
No significant interactions known or found for this drug. Caution always advised with multiple medications.
Adverse Reactions .
Serious Reactions
- opioid withdrawal, severe
- seizures
- pulmonary edema
- ventricular tachycardia
- ventricular fibrillation
- cardiac arrest
Common Reactions
- nasal discomfort
- headache
- nausea
- dizziness
- hot flash
- vomiting
- anxiety
- fatigue
- nasal congestion
- throat irritation
- rhinalgia
- hyperhidrosis
- erythema
- dysgeusia
- appetite decr.
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Look/Sound-Alike Drug Names
nalmefene confused with: naloxone
Pregnancy/Lactation .
Pregnancy
Clinical Summary
benefits outweigh risks during pregnancy; no human data available; no known risk of fetal harm based on animal data at 114x recommended human dose w/ IV route; risk of fetal and neonatal opioid withdrawal based on drug's mechanism of action
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: liver; CYP450: 3A4/5 (minor) substrate; UGT: 1A3, 1A8, 2B7 (primary) substrate
Excretion: urine 83% (<5% unchanged), feces 17%; Half-life: 11.4h
Subclass: Toxicity: Drugs
Mechanism of Action
antagonizes various opioid receptors (opioid antagonist)
Formulary .
No Formulary Selected
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