This is NARCAN
Nasal Spray

Ready-to-use
Needle-Free
Concentrated 4 mg Dose

Not a substitute for emergency medical care.
Repeated doses may be necessary.

Please see Indications and Important Safety Information   *Administer in accordance with the Instructions for Use.

NARCAN™ Nasal Spray is a pure opioid antagonist indicated for emergency use outside of a hospital to reverse known
or suspected opioid overdose, as manifested by respiratory and/or severe central nervous system depression.

NARCAN™ Nasal Spray can be administered by a bystander (non-healthcare professional) before emergency medical
assistance becomes available, but it is not intended to be a substitute for professional medical care.
Emergency medical assistance (calling 911) should be requested immediately when an opioid overdose is suspected,
before administering naloxone.

NARCAN™ Nasal Spray Device

Narcan Shield

WHAT IS
NARCAN™ NASAL SPRAY?

The first and only nasal naloxone available in North America for the emergency treatment of an opioid overdose.

NARCAN™ Nasal Spray counteracts the effects of an opioid overdose. Signs of an opioid overdose include:

  • Slow or weak breathing
  • Gradual increase in breathing followed by a decrease in breathing and airflow
  • Trouble breathing or not breathing
  • Deep snoring or gurgling noises
  • Dizziness, confusion, drowsiness including extreme drowsiness
  • Passing out
  • Collapse and coma
  • Unable to be woken up by touch, shaking of shoulders or shouting
  • Slow or no heartbeat
  • Cold, pale, clammy skin
  • Very small pupils, like a pinpoint

Before administering NARCAN™ Nasal Spray, call 911 for emergency medical help. Do this immediately if you suspect or are aware of an opioid overdose.

Make sure to watch the person who received NARCAN™ Nasal Spray. You may need to give additional doses of NARCAN™ Nasal Spray until emergency medical help arrives.

You may need to help the person who received NARCAN™ Nasal Spray. The patient may have a reaction such as becoming aggressive, shaking and/or vomiting.

Please see Indications and Important Safety Information on this page in the use of this product.


SEE HOW IT WORKS

Learn about how NARCAN™ Nasal Spray can reverse the effects of opioids in the event of an overdose.

This video is also available for download.

WHO IS AT RISK?

Anyone exposed to prescription or illegal opioids should be aware of risk factors that may lead to an accidental opioid overdose.

People at higher risk of opioid overdose1

  • people with opioid dependence, in particular following reduced tolerance (following detoxification, release from incarceration, cessation of treatment);
  • people who inject opioids;
  • people who use prescription opioids, in particular those taking higher doses;
  • people who use opioids in combination with other sedating substances;
  • people who use opioids and have medical conditions such as HIV, liver or lung disease or suffer from depression;
  • household members of people in possession of opioids (including prescription opioids).

Risk factors for overdoses with prescribed opioids include a history of substance use disorders, high prescribed dosage, male gender, older age, multiple prescriptions including benzodiazepines, mental health conditions and lower socioeconomic status.

HOW TO BUY
NARCAN™ NASAL SPRAY

Organizations wishing to order NARCAN™ Nasal Spray :

  • Place your order by telephone at 1-877-870-2726 from 8 am until 9 pm Eastern Standard Time or contact ADAPT Customer Support by e-mail at adaptcanada@customer-support.ca

View Terms and Conditions

Individuals, families, and caregivers wishing to order NARCAN™ Nasal Spray:

Talk to your pharmacist. In December 2016, the National Association of Pharmacy Regulatory Authorities (NAPRA) recommended that Naloxone Nasal Spray, when indicated for emergency use for opioid overdose, be made available as a Schedule II drug. This means that any patient or patient’s agent can obtain NARCAN™ Nasal Spray directly from a community pharmacist without a prescription. Call your local pharmacy beforehand to confirm that they have NARCAN™ Nasal Spray in-stock; if the pharmacy does not stock NARCAN™ Nasal Spray they can likely order it on your behalf.2 In some provinces*, NARCAN™ Nasal Spray has made an unscheduled drug, meaning that it can be purchased outside of pharmacies.

*Check with your local pharmacist about how to access NARCAN™ Nasal Spray in your province.

HOW TO USE
NARCAN™ NASAL SPRAY

In opioid overdose emergencies, recognizing symptoms and taking prompt action is critical. NARCAN™ Nasal Spray can be administered by a bystander (non-health care professional) before emergency medical assistance becomes available, but it is not intended to be a substitute for professional medical care. Emergency medical assistance (calling 911) should be requested immediately when an opioid overdose is suspected, before administering naloxone.


ADMINISTERING NARCAN™ NASAL SPRAY:

Follow this step-by-step guide to using NARCAN™ Nasal Spray in the event of an opioid overdose.

  1. PEEL
    Peel back package

    Peel back the package to remove the device. Hold the device with your thumb on the bottom of the plunger and two fingers on the nozzle.

  2. PLACE
    Place the tip of the nozzle in nostril

    Place and hold the tip of the nozzle in either nostril until your fingers touch the bottom of the patient’s nose.

  3. PRESS
    Press the plunger firmly

    Press the plunger firmly to release the dose into the patient’s nose.

Administer in accordance with the Instructions for Use.


Not a Substitute for Emergency Medical Care. Before administering NARCAN™ Nasal Spray, call 911 for emergency medical help. Do this immediately if you suspect or are aware of an opioid overdose.

Do this even if the person wakes up. Keep the patient under surveillance or close watch. If breathing does not return to normal or if breathing difficulty resumes, after 2-3 minutes, give an additional dose of NARCAN™ Nasal Spray using a new device in the alternate nostril.

Please see additional safety considerations below.

SEE HOW TO USE
NARCAN™ NASAL SPRAY

In this video, you will learn:

  • How to recognize symptoms of an opioid overdose
  • How to administer NARCAN™ Nasal Spray
  • How to evaluate and support
This video is also available for download.

Serious Warnings and Precautions

  • Before administering NARCAN™ Nasal Spray, call 911 for emergency medical help. Do this immediately if you suspect or are aware of an opioid overdose.
  • Make sure to watch the person who received NARCAN™ Nasal Spray. You may need to give additional doses of NARCAN™ Nasal Spray until emergency medical help arrives.
  • You may need to help the person who received NARCAN™ Nasal Spray. The patient may have a reaction such as becoming aggressive, shaking and/or vomiting. You will need to pay special attention when giving NARCAN™ Nasal Spray to a newborn who is less than four weeks old or a pregnant woman. Some of these reactions can be life-threatening for a newborn or a fetus.

Indications and Clinical Use

NARCAN™ Nasal Spray is a pure opioid antagonist indicated for emergency use outside of a hospital to reverse known or suspected opioid overdose, as manifested by respiratory and/or severe central nervous system depression.

NARCAN™ Nasal Spray can be administered by a bystander (non-healthcare professional) before emergency medical assistance becomes available, but it is not intended to be a substitute for professional medical care. Emergency medical assistance (calling 911) should be requested immediately when an opioid overdose is suspected, before administering naloxone.

Contraindications

  • Patients who are hypersensitive to this drug or to any ingredient in the formulation or component of the container.

Most Serious Warnings & Precautions

  • Emergency medical assistance (calling 911) should be requested immediately when an opioid overdose is suspected, before using naloxone.
  • Individuals with a satisfactory response to an initial dose of naloxone should be kept under continued surveillance.
  • Caregivers administering naloxone should be prepared to act in response to or assist the patient in cases of potential adverse reactions such as aggressive reactions, convulsions and vomiting. Special attention is warranted if naloxone is administered to a neonate or a pregnant woman.

Other Relevant Warnings and Precautions

  • In opioid dependent people, naloxone may trigger an acute opioid withdrawal syndrome
  • Rebound opioid toxicity, including respiratory depression, following the temporary reversal of the opioid overdose
  • Not effective against respiratory depression due to non-opioid drugs
  • Rare cases of cardiac arrest, tachycardia and ventricular fibrillation
  • Post-operative consideration: instances of hypotension, hypertension, ventricular tachycardia and fibrillation, dyspnea, pulmonary edema and rare cases of cardiac arrest have been reported. Death, coma, and encephalopathy have been reported as sequelae of these events
  • Rare cases of convulsions or seizures
  • Irritability and aggressive behaviour
  • Gastrointestinal reactions including diarrhea, nausea, vomiting and abdominal cramps
  • Use in nursing women has not been established

For More Information:

Please consult the product monograph at http://narcannasalspray.ca/pdf/NARCAN-Product-Monograph-ca-en.pdf for important information relating to contraindications, adverse reactions, drug interactions, patient selection, and dosing information which have not been discussed in this piece.

The product monograph is also available by calling 1-844-898-0657.

Please see full Product Information including the Patient Information for NARCAN™ Nasal Spray.

Adapt Pharma Logo

References

1 World Health Organization. “Management of Substance Abuse: Information sheet on opioid overdose.” November 2014. http://www.who.int/substance_abuse/information-sheet/en/ Accessed March 1, 2017.

2 Ontario College of Pharmacists. “Dispensing or Selling Naloxone: Guidance for pharmacy professionals when dispensing or selling naloxone as a Schedule II drug.” February 9, 2017. http://www.ocpinfo.com/library/practice-related/download/Naloxone.pdf Accessed March 1, 2017.

3 NARCAN™ Nasal Spray Product Monograph. Adapt Pharma Operations Limited, March 24, 2017.

4 Howlett, K et al. “How Canada got addicted to fentanyl.” Globe and Mail, January 5, 2017. http://www.theglobeandmail.com/news/investigations/a-killer-high-how-canada-got-addicted-tofentanyl/article29570025/ Accessed January 10, 2017.

5 National Institutes of Health, PubChem Open Chemistry Database, Carfentanil, Available at: https://pubchem.ncbi.nlm.nih.gov/compound/carfentanil#section=Top Accessed on January 20, 2017.

6 Harm Reduction Coalition. “Overdose FAQs.” http://harmreduction.org/issues/overdose-prevention/overview/overdose-faqs/ Accessed January 11, 2017.

7 Government of Canada. “Opioids.” http://healthycanadians.gc.ca/healthy-living-vie-saine/substance-abus…icomanie/prescription-abuse-abus-ordonnance/opiods-opiodes-eng.php#a2 Accessed Jan 9, 2017.

8 Government of Canada. “Opioids.” Available at: https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/opioids.html Accessed January 25, 2017.

Distributed by Adapt Pharma Canada Ltd. Mississauga, ON L5N 6A6 CANADA

© 2017 ADAPT Pharma Canada Ltd. NARCAN is a trademark licensed to ADAPT Pharma Operations Limited.

*All other trademarks are the property of their respective owners.

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