Key takeaways:
Narcan (naloxone) is FDA approved for over-the-counter (OTC) use. It’s a 4 mg nasal spray that can quickly reverse an opioid overdose.
OTC Narcan is safe to give to kids and adults of all ages. It’s a recommended medication to have at your disposal no matter if you’re taking your first opioid medication or if you’ve been taking one for years.
OTC Narcan is now available for purchase. You can find it online, at pharmacies, and at many big box retailers.
If you follow U.S. news, featured stories about opioid overdoses have likely been on your feed. For good reason, too. Opioid use disorder and accidental opioid overdose can happen to anyone without the right precautions. But since opioids can also manage hard-to-treat pain, they’re a necessary part of life for many people.
To maximize the benefits of your prescription, it’s important to find the right balance between taking an opioid and managing its potential risks. Just like anything else in life, an effective backup plan is one way to manage this risk.
Narcan (naloxone) is a top-rated way to reverse an opioid overdose when needed. No matter if you’re taking an opioid for the first time or you’ve been taking one for years, quick access to a bottle of Narcan can make all the difference. And now, as of late March 2023, it’s FDA approved for over-the-counter (OTC) purchase.
How does OTC Narcan compare to original Narcan?
OTC Narcan comes as a single use, 4 mg nasal spray. It’s the same product as the prescription-only version of Narcan that’s been approved since 2015. It’s also the first version of naloxone to be approved for OTC use.
So, why is it available OTC now? Narcan’s manufacturer submitted new data to the FDA that shows it can be safely used by the public without the supervision of a healthcare provider. This was done through a process called “Rx-to-OTC switch.” Generic versions of OTC Narcan may also be approved in the future if generic drug manufacturers submit their own approval requests.
However, Narcan is only one version of naloxone. These forms of naloxone are still only available with a prescription from your healthcare provider:
When will OTC Narcan be available?
OTC Narcan is now available for purchase. It launched in the U.S. in early September 2023. It was previously only available behind the pharmacy counter.
Where to get OTC Narcan
You should be able to find OTC Narcan at most places you can purchase OTC medications. You’ll likely be able to find it on store shelves alongside Tylenol (acetaminophen), Benadryl (diphenhydramine), and other products you purchase on an as-needed basis.
Specific product availability will depend on the company, but likely outlets include:
Pharmacies
Grocery stores
Big box retailers
Online marketplaces
Convenience stores
How much does OTC Narcan cost?
OTC Narcan costs $45 per package.
However, there are some ways to save. Some states — like Ohio, Delaware, and Iowa — offer programs to obtain Narcan for free. Some health insurance plans also cover it at no additional cost to you.
GoodRx can also help you save. If you fill it through the pharmacy, generic Narcan’s price at certain pharmacies is as low as $44.14 with a free GoodRx discount. Pharmacists have standing orders to dispense non-OTC versions of naloxone without a healthcare provider’s OK. And if you have a health savings account or a flexible spending account, Narcan should count as a qualifying product.
Who should use OTC Narcan?
Adults and kids of all ages are eligible to receive Narcan. The main prerequisite is that you’re taking an opioid medication. Oxycodone (OxyContin), fentanyl, and morphine (MS Contin) are common examples of opioids.
If you or someone in your life takes an opioid, it’s a good idea to keep Narcan on hand. Opioid overdoses can happen even if you’re taking an opioid as prescribed. Think of it as another tool to have in your first aid kit — nothing more. It’s similar to keeping an EpiPen (epinephrine) or Benadryl on hand in case you experience an allergic reaction.
How is OTC Narcan administered?
If you’re experiencing an opioid overdose, you likely won’t be able to administer Narcan yourself. It’s important that people close to you know how to administer Narcan so they can provide assistance when needed. It’s equally important that they can recognize the signs and symptoms of an opioid overdose.
Here are some quick tips for administering Narcan nasal spray:
Make sure the person is lying on their back.
Remove Narcan from its outer packaging.
Tilt back the person’s head while supporting their neck.
Place the tip of the nasal spray into one nostril; press the plunger to release a dose of Narcan.
Adjust their body so they’re positioned on their side.
Call 911.
Administer another dose of Narcan every 2 to 3 minutes until you see a response or emergency services arrive.
What are the side effects of Narcan?
Narcan’s main side effects are better described as side effects of opioid withdrawal. Narcan is a type of opioid blocker, so it quickly reverses the effects of your opioid medication.
Soon after one or more doses of Narcan are administered, you or a loved one may experience:
Nausea or vomiting
Anxiety or irritability
Shivering or trembling
A fast heart rate
Diarrhea
Stomach pain
Body aches
These side effects may feel severe. But these side effects outweigh the risks of an untreated opioid overdose.
And, there’s another plus. If you aren’t sure if someone is having an opioid overdose, you can administer Narcan anyway. If they didn’t actually take an opioid, Narcan won’t do anything negative. The side effects described above are caused by quick opioid reversal — not Narcan itself.
The bottom line
Narcan (naloxone) is FDA approved for over-the-counter use. This 4 mg nasal spray is now available for purchase, too. You should be able to find this opioid reversal treatment at pharmacies, big box retailers, online, and more. It was previously only available for purchase behind the pharmacy counter.
Why trust our experts?
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.
References
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Emergent. (2023). U.S. FDA approves over-the-counter designation for Emergent BioSolutions’ NARCAN® Nasal Spray, a historic milestone for the opioid overdose emergency treatment.
Hikma Specialty USA Inc. (2022). KLOXXADO- naloxone hcl spray [package insert].
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Kaléo. (2022). FDA approves Kaléo’s naloxone auto-injector 10 mg for the treatment of known or potential exposure to ultra-potent weaponized opioids.
National Institute on Drug Abuse. (2021). Naloxone for opioid overdose: Life-saving science.
Proficient Rx LP. (2022). NARCAN- naloxone hydrochloride spray [package insert].
U.S. Food and Drug Administration. (2023). Access to Naloxone can save a life during an opioid overdose.
U.S. Food and Drug Administration. (2023). FDA approves first over-the-counter naloxone nasal spray.
