Key takeaways:
Narcan (naloxone) is a fast-acting medication that can reverse the effects of an opioid overdose.
Naloxone comes as a nasal spray or an injection. The nasal spray — as brand-name Narcan or generic RiVive — can be purchased over the counter for less than $50.
Narcan may be available for free from local and state governments as well as organizations and programs committed to reducing opioid overdose and misuse.
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Table of contents
Narcan (naloxone) works quickly to reverse the effects of an opioid overdose, the leading cause of accidental death in the U.S. An opioid overdose happens when a person takes too many narcotics at once, and it can be fatal. Most fatal opioid overdoses are caused by synthetic opioids like illicit fentanyl.
A person doesn’t have to take opioids or have a history of overdose to have Narcan with them. In fact, friends and relatives of people who take opioid medications, use illicit opioids, or have an opioid use disorder may keep Narcan on hand for emergencies.
Having Narcan on you for emergencies is similar to carrying an EpiPen to treat a severe allergic reaction. The medication can be taken by adults and children.
Naloxone is available as a nasal spray or an injection to consumers and as an intravenous drip in medical settings. The nasal spray as brand-name Narcan or generic RiVive became available over the counter without a prescription in 2023.
You can still use a prescription to access the nasal spray and injection, which may make these medications more affordable.
Can I buy Narcan (naloxone) over the counter?
Yes. In 2023, Narcan became available over the counter. Two versions are available:
Narcan: This brand-name naloxone is sold in a twin pack. Each dose of this 4 mg nasal spray has the same prescription strength as the original prescription-only Narcan.
RiVive: This generic naloxone is also sold as a box of two units. Each dose of RiVive is a 3 mg nasal spray.
How much does OTC Narcan (naloxone) cost?
OTC Narcan is available for less than $50 for each twin pack.
Brand-name Narcan is just under $50 for two doses, but the cost can vary depending on whether you get it from a pharmacy, a big-box store, or another retailer. You can also purchase Narcan online. At the time of publication, CVS and Walgreens were selling this medication for $44.99 per two-dose box.
RiVive’s initial price is $36 or less per twin pack. RiVive was developed by Harm Reduction Therapeutics, a nonprofit pharmaceutical company. RiVive can be ordered by harm-reduction organizations in the U.S. as well as states and other government entities. It is not widely available in retail outlets.
Where can I buy Narcan?
Because Narcan is available over the counter, it can be purchased at many stores where OTC medication is sold, which include:
Big-box stores
Convenience stores
Drugstores
Grocery stores
Online marketplaces
Pharmacies
Vending machines
You can also access Narcan at pharmacies with a prescription. This could be a more affordable option to reduce the cost of the medication. For instance, you may be able to use a GoodRx coupon to pay less than the OTC cost.
Using your insurance could save you money by dropping your out-of-pocket cost to your copay if it’s less than $50. According to KFF, the average copay for a Narcan prescription was $35 in 2018. It’s important to note that you may not save money or break even if you have out-of-pocket costs for an office visit to get a Narcan prescription. So consider mentioning the prescription you need during a scheduled appointment.
Do I need a prescription for Narcan?
You do not need a prescription for Narcan, but you can still get one. Your healthcare provider can write a prescription for you to pick up Narcan at the pharmacy. As mentioned, you may be able to obtain it for as little as your insurance copay, or a GoodRx coupon may make it less expensive than it is over the counter.
Where can I get free Narcan?
There are programs nationwide that provide low-cost or free Narcan, sometimes after you complete training to use the product.
Some states, including California, Kentucky, Michigan, and Minnesota, have free or low-cost Narcan available by request at clinics, through the mail, in vending machines, and at libraries.
In Ohio, Deaths Avoided With Naloxone — known as Project DAWN and coordinated by the Ohio Department of Health — has more than 180 programs that distribute free Narcan. Project DAWN also offers training to prevent opioid overdose and promote harm reduction.
Check this NEXT Distro directory to find an organization near you that may provide free Narcan and other opioid overdose prevention resources.
The bottom line
Narcan is now available over the counter for less than $50 for a twin pack of nasal sprays. You can buy Narcan at drugstores and other retailers and from online marketplaces. You may be able to access Narcan for less at a pharmacy with a prescription using your insurance or with a GoodRx coupon. You also may be able to access free Narcan in your area or by mail.
Why trust our experts?
References
Harm Reduction Therapeutics. (n.d.). RiVive is FDA approved.
Harm Reduction Therapeutics. (n.d.). RiVive (naloxone HCl nasal spray 3 mg) is now available.
Kovanis, G. (2023). Here’s how to get Narcan for free. Detroit Free Press.
Los Angeles County Library. (n.d.). Naloxone (Narcan) clinics.
Lovelace, B., Jr. (2023). Over-the-counter Narcan to cost less than $50 for a two-pack, company says. NBC News.
National Institute on Drug Abuse. (2023). Drug overdose death rates. National Institutes of Health.
NEXT Distro. (n.d.). Harm Reduction Ohio currently offers two types of naloxone.
Saunders, H., et al. (2023). Will availability of over-the-counter Narcan increase access? KFF.
Schiller, E. Y., et al. (2023). Opioid overdose. StatPearls.
U.S. Food and Drug Administration. (2023). FDA approves first over-the-counter naloxone nasal spray.
U.S. Food and Drug Administration. (2023). FDA approves second over-the-counter naloxone nasal spray product.
Vollers, A. C. (2023). States strive to get opioid overdose drug to more people. Kentucky Lantern.
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