Zurnai
NALMEFENE HYDROCHLORIDE
Indications and usage 1 INDICATIONS AND USAGE ZURNAI is indicated for the emergency treatment of known or suspected opioid overdose induced by natural or synthetic opioids in adults and pediatric patients aged 12 years and older, as manifested by respiratory and/or central nervous system depression.
ZURNAI is intended for immediate administration as emergency therapy in settings where opioids may be present.
Structured Monograph
Clinical summary
Indications and usage 1 INDICATIONS AND USAGE ZURNAI is indicated for the emergency treatment of known or suspected opioid overdose induced by natural or synthetic opioids in adults and pediatric patients aged 12 years and older, as manifested by respiratory and/or central nervous system depression. ZURNAI is intended for immediate administration as emergency therapy in settings where opioids may be present. ZURNAI is not a substitute for emergency medical care. ZURNAI is an opioid antagonist indicated for the emergency treatment of known or suspected opioid overdose induced by natural or synthetic opioids in adults and pediatric patients aged 12 years and older, as manifested by respiratory and/or central nervous system depression. ( 1 ) ZURNAI is intended for immediate administration as emergency therapy in settings where opioids may be present. ( 1 ) ZURNAI is not a substitute for emergency medical care. ( 1 ) Dosage and administration 2 DOSAGE AND ADMINISTRATION ZURNAI is for intramuscular and subcutaneous use only. ( 2.1 ) Seek emergency medical care immediately after use. ( 2.1 ) Administer ZURNAI to the outer thigh, through clothing if necessary. ( 2.1 ) Administer additional doses of ZURNAI using a new ZURNAI auto-injector for each dose. If the patient does not respond or responds and then relapses into respiratory depression, additional doses of ZURNAI may be given every 2 to 5 minutes until emergency medical assistance arrives. ( 2.2 ) See Full Prescribing Information and Instructions for Use for important information on how to safely administer ZURNAI. ( 2.1 ) Additional supportive and/or resuscitative measures may be helpful while awaiting emergency medical assistance. ( 2.2 ) 2.1 Important Administration Instructions All approved nalmefene products achieve plasma concentrations that have been shown to be efficacious in reversing the effects of opioid overdose. Comparing different products on a nominal mg-for-mg basis may be misleading. ZURNAI is for intramuscular and subcutaneous use only. The device is ready to use. No device assembly is required. Do not prime or test prior to administration. ZURNAI delivers its entire contents automatically, upon injection. Inject ZURNAI into the anterolateral aspect of the thigh. ZURNAI can be administered through clothing if necessary. Do not reuse ZURNAI. Each ZURNAI device contains a single dose of nalmefene and cannot be reused. Because treatment of suspected opioid overdose must be performed by someone other than the patient, instruct the prescription recipient to inform those around them about the presence of ZURNAI and the Instructions for Use . Instruct the patient or caregiver to read the Instructions for Use at the time they receive a prescription for ZURNAI. Emphasize the following instructions to the patient or caregiver: – Administer ZURNAI as quickly as possible because prolonged respiratory depression may result in damage to the central nervous system or death. – Always seek emergency medical assistance after administration of the first dose of ZURNAI in the event of a suspected, potentially life-threatening opioid emergency. Keep the patient under continued surveillance until emergency personnel arrive. – Additional doses of ZURNAI may be required until emergency medical assistance becomes available. – If available, re-administer ZURNAI using a new auto-injector, every 2 to 5 minutes if the patient does not respond or responds and then relapses into respiratory depression. – Once the safety seal is broken and blue cap is removed, ZURNAI must be used immediately or disposed of properly. Do not attempt to replace the blue cap once it is removed. – Visually inspect ZURNAI through the viewing window for particulate matter and discoloration prior to administration. Do not administer unless the solution is clear, free of particulates, and the glass container is undamaged. – Administer ZURNAI according to the printed instructions on the device label, carton, and the Instructions for Use. ⮚ Place the needle guard of ZURNAI against the outer thigh. Press the needle end firmly into the injection site until you hear a click and then hold for 3 seconds. After 3 seconds, the viewing window should turn completely orange, signaling that ZURNAI has delivered the intended dose of nalmefene. ⮚ Remove ZURNAI from the outer thigh. ⮚ Call for emergency medical assistance immediately after administration of the first dose of ZURNAI. ⮚ Move the patient on their side (recovery position). Remain with the patient until emergency medical assistance arrives, even if the patient wakes up. 2.2 Dosing in Adults and Pediatric Patients 12 Years and Older Initial Dosing : The recommended dose of ZURNAI in adults and pediatric patients aged 12 years and older is 1.5 mg delivered by intramuscular or subcutaneous injection into the anterolateral aspect of the thigh, through clothing if necessary. Repeat Dosing : Seek emergency medical assistance as soon as possible after admini
Monitoring
- • 5 WARNINGS AND PRECAUTIONS Risk of Recurrent Respiratory and CNS Depression : A recurrence of respiratory depression is possible, therefore, keep the patient under continued surveillance and administer repeat doses of ZURNAI using a new auto-injector with each dose while awaiting emergency medical assistance.
- • ( 5.1 ) Risk of Limited Efficacy with Partial Agonists or Mixed Agonists/Antagonists : Reversal of respiratory depression by partial agonists or mixed agonist/antagonists such as buprenorphine and pentazocine, may be incomplete.
- • Repeat doses may be required.
- • ( 5.2 ) Precipitation of Severe Opioid Withdrawal : The use of ZURNAI in patients who are opioid dependent may precipitate opioid withdrawal.
Interaction Notes
- • Review official label interaction section.