The effect of naloxone treatment on opioid-induced side effects

Abstract

Background:To evaluate the effects of naloxone on opioid-induced side effects, the present meta-analysis was constructed.Methods:Electronic databases including PubMed, EMBASE, and CNKI (China National Knowledge Internet) were used for literature search. Studies on comparison of opioid-side effects between naloxone-treated group and placebo or normal saline-related group were included in the meta-analysis. Heterogeneity analysis was performed with Chi-square and I2 test. Pooled analysis was based on fixed-effects model, if heterogeneity between the eligible studies was negligible (I2 < 50%, P > 0.05), otherwise, random-effects model was used. Sensitivity analysis was applied to assess the robustness of the results and publication bias was evaluated by Begg and Egger test.Results:Thirteen studies including 1138 patients were included in the meta-analysis. Pooled analysis indicated that naloxone could significantly reduce the occurrence of pruritus (RR [risk ratio] = 0.252, 95% CI [confidence interval] = 0.137–0.464), nausea (RR = 0.323, 95% CI = 0.245–0.428), and vomiting (RR = 0.338, 95% CI = 0.192–0.593) which were induced by opioids. However, naloxone did not relieve pain (standardized mean difference [SMD] = −0.052, 95% CI = −0.453 to 0.348) and somnolence (RR = 0.561, 95% CI = 0.287 to 1.097) in patients received opioid treatment. Additionally, there were no significant publication bias between the included studies (Begg test, P = 0.602; Egger test, P = 0.388).Conclusion:Addition of naloxone might act as an effective treatment for prophylaxis of opioid-induced pruritus, nausea, and vomiting in clinical practice.

The Polyanalgesic Consensus Conference (PACC): Recommendations for Intrathecal Drug Delivery: Guidance for Improving Safety and Mitigating Risks

“…When symptoms such as somnolence occur, reduction, elimination, or reversal of the opioid is indicated, with observation of the patient also recommended (9,17). Naloxone should be administered as required and re-dosed to prevent continued opioid depression, as dictated by the specific pharmacokinetic profile of the opioid used (18). Trialing opioid therapy in an outpatient site of service using a conservative dose has recently been recommended by the PACC.…”

Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

“…Patient preference and ease of administration in a non-hospital setting lean toward intramuscular or intranasal use; however, intranasal forms are not readily available in some countries, including Australia [ 19 ]. In small doses, naloxone is also indicated for reducing constipation associated with chronic opioid use; however, this is not the focus of this review [ 20 ].…”

Two‐year outcomes following naloxone administration by police officers or emergency medical services personnel

“…As a harm reduction strategy, naloxone is not intended to reduce drug use or provide treatment for drug use, but is intended to mitigate the more serious consequence of illicit opioid use as part of a broader public health strategy (Beletsky, Rich, & Walley, 2012; Hawk, Vaca, & D'Onofrio, 2015; Kolodny et al., 2015; Nelson, Juurlink, & Perrone, 2015). Naloxone is a lifesaving medication (Chamberlain & Klein, 1994; He, Jiang, & Li, 2016), and efforts are underway nationwide to increase the availability of naloxone beyond medical professionals. For example, as of 2014, nearly 650 community‐based organizations reported providing naloxone kits to laypersons (Wheeler, Jones, Gilbert, & Davidson, 2015).…”