Patient Medication Information: uses, side effects, how to take - Narcan Nasal Spray
Serious warnings and precautions box
What NARCAN NASAL SPRAY is used for:
NARCAN NASAL SPRAY is used to treat someone who has overdosed on opioids. It can be used by anyone to reverse the effects of the overdose until medical help arrives. Signs of an opioid overdose include:
- Trouble breathing or not breathing
- Extreme drowsiness
- Pale and clammy skin
- Slow or no heartbeat
- Passing out
- Unable to be woken up by touch, shaking of shoulders or shouting
- Very small pupils, like a pinpoint
It is recommended to have naloxone readily available if an opioid overdose occurs. It can be given by you to someone who has overdosed on opioids or be given to you by someone else if you are experiencing an opioid overdose. Call 911 right away and follow the instructions provided with NARCAN NASAL SPRAY.
- 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.
How NARCAN NASAL SPRAY works:
Opioid drugs work by acting on specific receptors found in the brain and in the nervous system. When these drugs attach to those receptors, they reduce the amount of pain felt. Taking too many opioids can lead to an overdose and that can stop someone from breathing. The person may also experience other symptoms. NARCAN NASAL SPRAY stops the opioids from being attached to the receptors, which reverses the effects and symptoms of the overdose.
The ingredients in NARCAN NASAL SPRAY are:
Medicinal ingredient: naloxone hydrochloride
Non-medicinal ingredients: benzalkonium chloride, disodium ethylenediaminetetraacetate, sodium chloride, hydrochloric acid and purified water
NARCAN NASAL SPRAY comes in the following dosage form:
Spray, metered dose: 2 mg / 0.1 mL and 4 mg / 0.1 mL
Do not use NARCAN NASAL SPRAY if:
- you are allergic to naloxone hydrochloride or to any of the other ingredients in NARCAN NASAL SPRAY.
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take NARCAN NASAL SPRAY. Talk about any health conditions or problems you may have, including if you:
- have nasal problems (e.g., abnormal nasal cavity, a blocked or runny nose, or nasal polyps). It is not known if having any nasal problems will impact how NARCAN NASAL SPRAY works. If NARCAN NASAL SPRAY is the only medication available to treat an opioid overdose, it should always be used.
- have heart disease, or any other heart problems.
- have recently had surgery.
- are pregnant or think you are pregnant. The use of NARCAN NASAL SPRAY may cause distress to your unborn baby. It should only be used during pregnancy when clearly needed. Tell your healthcare professional right away if you have used NARCAN NASAL SPRAY while pregnant.
- are breast-feeding or plan to breastfeed. It is not known if NARCAN NASAL SPRAY passes into breast milk.
Other warnings you should know about:
Opioid Withdrawal: Using naloxone on a person who is opioid-dependent may cause them to go into withdrawal. Always be prepared for potential aggressive behaviour. The person receiving NARCAN NASAL SPRAY may experience withdrawal symptoms such as:
- body aches, stomach cramps, weakness
- diarrhea
- rapid heartbeat
- fever
- runny nose, sneezing
- goosebumps, shivering or trembling
- sweating
- yawning
- nausea or vomiting
- nervousness
- restlessness or irritability
- high blood pressure
If the person is shaking or having a seizure, do not try to hold them down. Move away any sharp and dangerous objects to prevent injury. If the person is vomiting, place them on their side to prevent choking.
In an emergency, if NARCAN NASAL SPRAY is administered to an infant because no other options are available, they may experience additional withdrawal symptoms such as:
- seizures
- crying more than usual
- overactive reflexes
These symptoms can be life-threatening if not treated the right way. If NARCAN NASAL SPRAY is given to an infant, seek immediate medical help.
Non-Opioid Overdoses: NARCAN NASAL SPRAY does not reduce the effects of an overdose caused by any non-opioid drugs such as:
- barbiturates
- benzodiazepines
- psychostimulants (for example, cocaine, amphetamines or methylphenidate)
alcohol
- anesthetics
- sedatives
However, giving NARCAN NASAL SPRAY to a person because of a non-opioid overdose is unlikely to cause more harm. Make sure you get emergency help (call 911) right away.
Heart problems: After taking NARCAN NASAL SPRAY, some patients (especially patients who have had recent surgery) may experience the following side effects:
- high or low blood pressure
- a rapid or irregular heart rate
- shortness of breath
- a build up of fluid in the lungs
- cardiac arrest (heart suddenly stops beating)
These side effects were rare. It is not known if the reactions were caused by naloxone or by the overdose.
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with NARCAN NASAL SPRAY:
There are no known interactions for NARCAN NASAL SPRAY at this time.
How to take NARCAN NASAL SPRAY:
Important Points:
- NARCAN NASAL SPRAY is for use in the nose only.
- Do NOT test the NARCAN NASAL SPRAY device. Do not remove NARCAN NASAL SPRAY from the packaging until ready to use.
- Each NARCAN NASAL SPRAY device contains only 1 dose and cannot be reused.
- NARCAN NASAL SPRAY is not a substitute for emergency medical care. Always call 911 before administering NARCAN NASAL SPRAY.
- NARCAN NASAL SPRAY freezes at temperatures below -15°C. If this happens, the device will not spray. Get emergency medical help right away. Do not wait for NARCAN NASAL SPRAY to thaw.
- Healthcare professionals may recommend using an alternate form of naloxone in newborns or children under two years of age. This is because smaller doses can be given with other forms of naloxone.
Step 1: Identify Opioid Overdose & Call for Emergency Medical Help
Check for signs of an opioid overdose:
- Person does not wake up after you shout, shake their shoulders, or firmly rub the middle of their chest.
- Breathing is very slow, irregular or has stopped.
- Center part of their eye is very small, like a pinpoint.
Call 911 or ask someone to call for you.
Lay the person on their back.
Step 2: Give NARCAN NASAL SPRAY
Remove the device from the packaging. Do not test the device.
There is only one dose per device. Peel back the tab with the two circles ( ) to open the NARCAN NASAL SPRAY blister.
Tilt the person’s head back and provide support under their neck with your hand.
Hold the device with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle. Do not apply any pressure until you are ready to give the dose.
Gently insert the tip of the nozzle into one nostril.
Your fingers should be right up against the nose.
If giving to a child, make sure the nozzle seals the nostril.
Press the plunger firmly with your thumb to give the dose.
Remove the device from the nostril.
Step 3: Evaluate and support
Move the person on their side (recovery position) after giving NARCAN NASAL SPRAY. Watch them closely.
Give a second dose after 2 to 3 minutes if the person has not woken up or their breathing is not improved. Repeat Step 2 in
the other nostril, using a new NARCAN NASAL SPRAY device.
You can give a dose every 2 to 3 minutes if more are available and needed. Alternate nostrils with each dose.
Perform artificial respiration or cardiac massage until emergency medical help arrives, if you know how and if it is needed.
After emergency medical help has arrived and taken over, throw away (dispose of) any used NARCAN NASAL SPRAY device(s) in a place that is away from children.
Usual dose:
- NARCAN NASAL SPRAY is available as a 2 mg or 4 mg nasal spray device.
- The lowest available strength should be used as the initial dose.
- Administer a single spray of NARCAN NASAL SPRAY into one nostril.
- If the person does not respond or responds and then relapses, additional doses of NARCAN NASAL SPRAY may be given every 2 to 3 minutes in alternating nostrils until emergency medical assistance arrives.
Possible side effects from using NARCAN NASAL SPRAY:
These are not all the possible side effects you may have when taking NARCAN NASAL SPRAY. If you experience any side effects not listed here, tell your healthcare professional.
Side effects with NARCAN NASAL SPRAY may include:
- Swelling of the nose, dryness in the nose, congested or runny nose, sneezing
- Body aches, stomach cramps, weakness
- Rapid heartbeat
- Goosebumps, shivering, chills, shaking (tremor) or trembling
- Yawning
- Nervousness
- Pain
- Aggressive behaviours, irritability, restlessness, agitation
- High blood pressure
- Nausea, or vomiting
- Diarrhea
- Fever
- Sweating
- Seizures
- Muscle spasms
- Dizziness
- Headache
Infants under 4 weeks old:
- Seizures
- Crying more than usual
- Overactive reflexes
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting side effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
- Visiting the Web page on Adverse Reaction Reporting (canada.ca/drug-device-reporting) for information on how to report online, by mail or by fax; or
- Calling toll-free at 1-866-234-2345.
NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.
Storage:
- Store below 25°C. Can be stored up to 40°C only for short periods of time. Do not expose to excessive heat above 40°C. Protect from light.
- Do not freeze. NARCAN NASAL SPRAY freezes at temperatures below -15°C. If this happens, NARCAN NASAL SPRAY may be thawed by allowing it to sit at room temperature for 15 minutes. It may still be used if it has been thawed after being frozen.
- Do not remove NARCAN NASAL SPRAY from the packaging until ready to use.
- Replace NARCAN NASAL SPRAY before the expiration date on the carton. If only expired NARCAN NASAL SPRAY is available, it should be used in an overdose situation.
- Keep out of reach and sight of children.
If you want more information about NARCAN NASAL SPRAY:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website www.narcannasalspray.ca; via email at medicalinformation@ebsi.com; or by calling 1-844-898-0657.
Date of Authorization: 2026-05-07
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