When and how to give Prenoxad Injection

Prenoxad Injection is intended for emergency use in the home or other non-medical setting by appropriate individuals or in a health facility setting for the complete or partial reversal of respiratory depression induced by natural and synthetic opioids, including methadone, diamorphine (diacetylmorphine [INN]) and certain other opioids such as dextropropoxyphene and certain mixed agonist/antagonist analgesics: nalbuphine and pentazocine. For this reason Prenoxad Injection should be carried by persons at risk of such events.[1]

Follow the steps in the flow chart, to guide you through when and how to administer Prenoxad Injection (naloxone hydrochloride 1mg/ml solution for injection).[2]

when and how to give prenoxad injection

If the casualty regains consciousness

The casualty will NOT KNOW that they have been rescued from an overdosed state once they regain consciousness and may therefore be unaware of the ongoing danger to them. The casualty may become agitated or even aggressive, due to the withdrawal symptoms they may be experiencing.[3]

If a casualty regains consciousness/wakes up BEFORE the ambulance arrives, the helper should:

  1. Explain to the casualty what has happened. Tell the casualty that they overdosed, could not be woken/were having breathing problems etc
  2. Offer reassurance, explaining that they have been given Prenoxad Injection to help restore their breathing and save their life
  3. Explain to the casualty that the withdrawal symptoms they are experiencing (if this is the case) are temporary[4] and will gradually ease within the next hour or so.[3] Also explain that this is because the Prenoxad Injection will wear off and that they are in danger of going back into overdose during this time[3]
  4. The casualty should be told not to use any drugs, including alcohol[5]
  5. Tell the casualty that it is extremely important that they are seen by the ambulance crew when they attend

References

  1. Prenoxad Injection. Summary of Product Characteristics. VIEW
  2. Prenoxad Patient Information Leaflet. VIEW
  3. Wermeling, DP. Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access. Therapeutic Advances in Drug Safety 2015;6(1):20–31. VIEW
  4. Sporer, KA and Kral, AH. Prescription naloxone: a novel approach to heroin overdose prevention. Annals of Emergency Medicine 2007;49(2):172-177. VIEW
  5. NHS Lothian & Glasgow, Raigmore Hospital and Scottish Drugs Forum. National naloxone programme. APS Group Scotland DPPAS11546. 2011.2