Comparison of a New Intranasal Naloxone Formulation to Intramuscular Naloxone: Results from Hypothesis-generating Small Clinical Studies

Clin Transl Sci. 2017 Sep;10(5):380-386. doi: 10.1111/cts.12473. Epub 2017 May 23.

Abstract

Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of i.v., i.m., and a new i.n. naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to i.m. naloxone, geometric mean (90% confidence interval [CI]) absolute bioavailability of i.n. naloxone was modestly lower (55%; 90% CI, 43-70% vs. 41%; 90% CI, 27-62%), whereas average (±SE) mean absorption time was substantially shorter (74 ± 8.8 vs. 6.7 ± 4.9 min). The opioid-attenuating effects of i.n. naloxone were compared with i.m. naloxone (2 mg) after administration of oral alfentanil (4 mg) to a separate group of six healthy volunteers pretreated with 240 mL of water or grapefruit juice. The i.m. and i.n. naloxone attenuated miosis by similar extents after water (40 ± 15 vs. 41 ± 21 h*%) and grapefruit juice (49 ± 18 vs. 50 ± 22 h*%) pretreatment. Results merit further testing of this new naloxone formulation.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Administration, Intranasal
  • Administration, Intravenous
  • Adult
  • Alfentanil / administration & dosage
  • Alfentanil / pharmacology
  • Analgesics, Opioid / pharmacology
  • Area Under Curve
  • Chemistry, Pharmaceutical
  • Female
  • Healthy Volunteers
  • Humans
  • Injections, Intramuscular
  • Male
  • Miosis / drug therapy
  • Naloxone / administration & dosage*
  • Naloxone / pharmacokinetics
  • Naloxone / therapeutic use
  • Time Factors
  • Young Adult

Substances

  • Analgesics, Opioid
  • Alfentanil
  • Naloxone