Antidote: naloxone

Naloxone is an opioid antagonist used to reverse the effects of the opioid in patients with hypoventilation. Support of airway and breathing is the priority to prevent hypoxia while waiting for naloxone to take effect.

A bolus dose of naloxone should be used initially; repeat bolus doses titrated to clinical effect may be required. A naloxone infusion may be indicated for patients in whom toxicity recurs after initial response to naloxone bolus.

In patients with opioid-dependence, titrate naloxone to avoid acute withdrawal. Sudden or complete reversal of opioid toxicity can cause complications, including agitation and behavioural disturbance and, rarely, cardiovascular effects.