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Opvee

nalmefene
Used for Opioid Overdose
Used for Opioid Overdose

Opvee (nalmefene) is a nasal spray that's used to reverse an emergency opioid overdose. It was approved by the FDA in May 2023, but won't likely be available until October 2023 according to the manufacturer. It's meant to be used in both healthcare and community settings, but it currently requires a prescription. The most common side effects are nasal discomfort, headache, and nausea.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Connie Zheng, PharmD
Last reviewed on May 29, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Opvee (nalmefene)?

What is Opvee (nalmefene) used for?

  • Emergency treatment of opioid overdose in people age 12 years and older

How Opvee (nalmefene) works

Opvee (nalmefene) is an opioid antagonist. It blocks opioid receptors (signaling proteins) so that opioids can't work on them. This can help reverse symptoms like slowed breathing and low blood pressure that happen during an opioid overdose.

Are you looking for information on nalmefene injection instead?

Drug Facts

Common BrandsOpvee
Drug ClassOpioid antagonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Opvee (nalmefene) essentials

Health: Opioid Antagonists: closeup person using nasal spray 1335207910

Opvee vs. Narcan: 6 Similarities and Differences Between These Opioid Reversal Medications

Written by Jennifer Gershman, PharmD, CPh, PACS
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What are the side effects of Opvee (nalmefene)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nasal discomfort (29%)
  • Headache (27%)
  • Nausea (17%)
  • Dizziness (9%)
  • Hot flush (8%)
  • Vomiting (6%)
  • Anxiety (5%)

Other Side Effects

  • Feeling tired
  • Stuffy nose
  • Throat irritation
  • Nose pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Sudden opioid withdrawal symptoms: feeling anxious or irritable, pain, fast heartbeat, sweating, vomiting, shakiness

Source: Prescribing Information

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

  • Chills
  • Dizziness
  • Headache
  • Irritability
  • Irritation inside the nose or throat
  • Nausea
  • Vomiting
pros-and-cons

Pros and cons of Opvee (nalmefene)

thumbs-up

Pros

Works quickly to reverse the effects of opioids

Comes as an easy-to-use nasal spray

Stored at room temperature, making it convenient for travel

thumbs-down

Cons

Only available with a prescription

Might need to give multiple doses

Can cause opioid withdrawal symptoms, such as anxiety, sweating, and vomiting

pharmacist-tips

Pharmacist tips for Opvee (nalmefene)

pharmacist

  • During an opioid overdose, the person who needs help often can't give themselves Opvee (nalmefene) because they're not awake or can't breathe. It's important for family and friends to recognize the signs and symptoms of an opioid overdose (unusual sleepiness, trouble breathing, small pupils, slow pulse) so they can help their loved one in need. Family and friends should also be familiar with how to give Opvee (nalmefene) in an emergency.

    • Opvee (nalmefene) nasal spray only contains one dose. If you need to use additional doses, you'll need to use a new nasal spray each time.

      • You don't need to "prime" or assemble Opvee (nalmefene) nasal spray.

        • If you suspect someone has overdosed on opioids, lay the person on their back and give Opvee (nalmefene) right away. Giving this medication quickly can lower the risk of serious harm or death.

          • Support the back of the neck so the head tilts back while you spray Opvee (nalmefene) into the nostril.

            • After giving the first dose of Opvee (nalmefene), call 911 for medical help. Then, roll the person on their side and watch them for 2 to 5 minutes to see if they wake up. Administer repeat doses if needed (see dosing section), and stay with them until medical help arrives.

              • Make sure to replace Opvee (nalmefene) before its expiration date, because it might not work as well after it expires.

                faqs

                Frequently asked questions about Opvee (nalmefene)

                Is Opvee (nalmefene) over the counter?
                No. Opvee (nalmefene) is only available with a prescription from a healthcare provider.
                How fast does Opvee (nalmefene) work?
                Opvee (nalmefene) typically works within 2 to 5 minutes. In studies, the full effects on breathing took up to 15 minutes. If it isn't working within 5 minutes of giving a dose, repeat the dose. You can continue to repeat a dose using a new nasal spray every 2-5 minutes until medical help arrives.
                How many doses of Opvee (nalmefene) are in each nasal spray?
                Each Opvee (nalmefene) nasal spray contains one dose, and it can't be reused. Opvee (nalmefene) is available as a carton that contains two nasal spray devices, or two doses.
                What's the difference between Opvee (nalmefene) and naloxone (Narcan, Kloxxado, Zimhi)?
                Both Opvee (nalmefene) and naloxone (Narcan, Kloxxado, Zimhi) are medications that are used to treat an opioid overdose. Similar to Opvee (nalmefene), naloxone is available as both an injection (Zimhi) and nasal spray (Narcan, Kloxxado). While both medications work within a few minutes to reverse symptoms of an opioid overdose, Opvee (nalmefene) lasts longer compared to naloxone. Opvee (nalmefene) is currently only available with a prescription, while naloxone (Narcan) nasal spray is available over the counter (OTC).
                Should I keep Opvee (nalmefene) in the refrigerator?
                No. Opvee (nalmefene) should be kept at room temperature. Keep it in its original container to protect it from light, and don't open the blister packs until you're ready to use the nasal spray.
                When will Opvee (nalmefene) be available?
                According to the manufacturer, Opvee (nalmefene) is expected to be available in the United States after October 2023.
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                What are the risks and warnings for Opvee (nalmefene)?

                Opvee (nalmefene) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                risk-warning

                Risk of symptoms of opioid overdose returning

                • Risk factors: Taking long-acting opioids

                  It's possible for symptoms of an opioid overdose to come back again, even after responding well to Opvee (nalmefene). This might be the case for people who took more than one form of opioids, with the effects of certain ones lasting longer than that of others. This is why it's important to get medical help after the first dose of Opvee (nalmefene) and watch the person the whole time while you're waiting. If their symptoms worsen after you've given Opvee (nalmefene) and it's been 2 to 5 minutes after the dose, give another dose in the other nostril.

                  risk-warning

                  Repeated doses of Opvee (nalmefene) needed to reverse certain medications

                  • Risk factors: Taking pain medications that contain buprenorphine or pentazocine

                    If someone is taking opioids that have mixed activities (blocking and stimulating at opioid receptors), like buprenorphine, Opvee (nalmefene) might not work as well. They might need multiple doses of Opvee (nalmefene) to reverse the effects of this type of medication. Make sure to always use a new nasal spray for repeated doses.

                    risk-warning

                    Opioid withdrawal

                    • Risk factors: Regular use of opioids | Infants (under a month old) who have received opioids | Use of opioids during surgery

                      Opvee (nalmefene) can cause a sudden opioid withdrawal. Symptoms can include pain, body aches, diarrhea, fast heartbeat, fever, sweating, nausea, vomiting, irritability, and trembling. The risk is higher in those who regularly take opioids or have received opioids during a surgery. Let the provider know right away and monitor these symptoms carefully in someone who has just received Opvee (nalmefene).

                      Don't try to take opioids to treat withdrawal symptoms on your own, because this could lead to a life-threatening overdose when the effects of Opvee (nalmefene) wear off.

                      dosage

                      Opvee (nalmefene) dosage forms

                      The average cost for 1 carton of two nasal sprays of 2.7mg of Opvee (nalmefene) is $103.61 with a free GoodRx coupon. This is 15.08% off the average retail price of $122.01.
                      carton
                      Carton
                      DosageQuantityPrice as low asPrice per unit
                      two nasal sprays of 2.7mg1 carton$103.61$103.61

                      Typical dosing for Opvee (nalmefene)

                      Each spray of Opvee (nalmefene) contains 2.7 mg of nalmefene.

                      The typical dose is 1 spray in one nostril as a single dose. After the first dose, call 911.

                      If the person doesn't respond after 2 to 5 minutes, spray a second dose in the other nostril using a new nasal spray. Continue to repeat the dose with a new nasal spray every 2 to 5 minutes if the person doesn't respond, until medical help arrives.

                      More on Opvee (nalmefene) dosage forms

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                      Opvee (brand)
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                      alternatives

                      What are alternatives to Opvee (nalmefene)?

                      There are a number of medications that your doctor can prescribe in place of Opvee (nalmefene). Compare a few possible alternatives below.
                      Opvee (nalmefene)
                      Used for:

                      • Emergency treatment of opioid overdose in people age 12 years and older

                      $103.61 Lowest GoodRx priceView Prices
                      Naloxone
                      Used for:

                      • Emergency treatment of opioid overdose in children and adults

                      • Raising blood pressure in the case of septic shock - naloxone IV injection only

                      • Post-surgery slowed breathing caused by opioids - naloxone IV injection only

                      $37.65 Lowest GoodRx priceView Prices

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                      References

                      Best studies we found

                      Indivior Inc. (2023). Opvee® (nalmefene) nasal spray [package insert]. 

                      Indivior PLC. (2023). Indivior announces U.S. Food and Drug Administration approval of Opvee® (nalmefene) nasal spray, an opioid overdose rescue medicine for natural and synthetic opioids like fentanyl.

                      U.S. Food and Drug Administration. (2023). FDA approves prescription nasal spray to reverse opioid overdose.

                      GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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