Potential dangerous side effects with the over administration or rapid administration of Naloxone.

While Naloxone has been proven to be an effective treatment in the patients suffering from respiratory depression secondary to Opioid use; there is a growing and troubling number of reports of potentially life threatening side effects with excessive dosing or rapid administration of Naloxone. 

It has been well documented that patients receiving Naloxone may experience symptoms of Opioid withdrawal. These symptoms may include: nausea, vomiting, headache and irritability.  

The administration of high-dose Naloxone and/or rapidly infused Naloxone may cause catecholamine release and consequently pulmonary edema, hypertension, and cardiac arrhythmia. These risks warrant the cautious use of Naloxone and adequate monitoring of the cardio-respiratory status of the patient after Naloxone administration is indicated. 

The best treatment is prevention. Administer Naloxone slowly and give it 1-3 minutes to be absorbed. If your patient's respiratory status is poor use the BVM to support ventilations until the Naloxone begins to work.  

Remember that Naloxone has a short half life so it may be necessary to administer a 2nd dose if you are still with your patient after 20 to 30 minutes and they show signs of the Naloxone losing its reversal effects.