Buprenorphine and Naloxone Toxicity - Uses and Side Effects

Introduction

Naloxone is a synthetic opioid antagonist used to treat opioid drug dependency or addiction, acute and chronic pain. The Naloxone injection is combined with other drugs to avoid its misuse by drug abusers. The medication works by reversing the action of opioids, such as central nervous system and respiratory depression conditions.

Naloxone usually does not cause any severe side effects or does not have any significant abuse potential. However, the medication can cause toxicity or adverse effects through interaction with other drugs such as alcohol, cannabis, antiallergic, muscle relaxants, and opioid pain relievers. Naloxone may be toxic and cause psychological and physical dependence with mild to moderate symptoms.

What Are the Side Effects Caused by Buprenorphine/Naloxone Toxicity?

The side effects caused by Naloxone toxicity are as follows:

• Abdominal cramps.

• Irritability.

• Body ache.

• Diarrhea.

• Fever.

• Restlessness.

• Nervousness.

• Shivering.

• Memory loss.

• Dry mouth.

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• Headache.

• Dizziness.

• Vomiting.

• Insomnia.

• Constipation.

• Nausea.

• Memory loss.

• Low blood pressure.

• Sweating.

• Urinary retention.

• Irregular heartbeats.

• Seizures.

• Running nose.

• Yawning.

• Excess fluid in lungs.

• Severe withdrawal symptoms.

What Are the Medical Uses of Buprenorphine/Naloxone?

Naloxone is used in medical practice for various conditions.

These include:

• Naloxone is primarily used to treat opioid dependency and overdose.

• The medication is also used to treat acute and chronic opioid toxicity in the body and mental and respiratory depression caused by opioid overdose.

• Due to misuse or overdose, Clonidine toxicity can cause hypotension or low blood pressure. Naloxone is used as an antidote for Clonidine toxicity.

• Naloxone is also used to improve blood flow in people with spinal, septic, cardiogenic, and hemorrhagic shock.

• Naloxone can also treat itchiness caused by opioids.

• It is also used in treating constipation induced by opioids.

• Naloxone is combined with Buprenorphine to treat opioid withdrawals and uncomfortable behavior. The medication combination is mainly used to treat a person undergoing de-addiction therapy.

What Are Buprenorphine and Naloxone Used in Combination?

Naloxone belongs to the opioid antagonist group and blocks the effects of opioids. It helps to prevent drug abuse of this medication. Naloxone can immediately stop the action of opioid drugs and can produce severe withdrawal symptoms. It is available in the form of injections and nasal sprays.

Buprenorphine- It produces similar effects to opioid drugs but also has the property to block the action of other opioids. This medication helps in treating opioid drug addiction by reducing drug cravings and withdrawal symptoms. It is available in tablets, implants under the skin, injection solutions, or skin patches.

What Are the Long-Term Effects of Buprenorphine/Naloxone?

Buprenorphine/Naloxone treats opioid dependency with prolonged usage, often leading to Naloxone toxicity.

The long-term effects are as follows:

• Liver damage.

• Abuse and dependence.

• Hormonal problems (such as adrenal insufficiency).

What Is the Route of Administration of Buprenorphine/Naloxone?

A doctor can administer naloxone through various routes, such as:

• Intravenous Route- The effects of Naloxone through the IV route is very rapid, but locating venous access becomes difficult for people using drugs frequently. The onset of Naloxone occurs within one to two minutes, and the effects last for almost 40 minutes.

• Intranasal Route- This route of administration of Naloxone is usually preferred for a person who is unresponsive or unconscious. This route delays the medication effects, but portable nasal sprays have made Naloxone more useful.

• Intramuscular Route- Naloxone injection is also administered into the muscle, and the effects are produced within two to four minutes and last up to 30 to 120 minutes. Intramuscular injections are available as auto-injectors, pre-filled injections, or vials.

What Precautions Should Be Taken Before Using Naloxone Injection?

Precautions that a person should take before using Naloxone include:

• Naloxone can cause allergic reactions. Therefore, a person must inform the doctor about being allergic to Naloxone or any other drug.

• Always inform the doctor about any medical condition a person suffers from, such as head injury, seizures, asthma, tumors, chronic obstructive pulmonary disorders, liver disease, digestive diseases, or mental disorders.

• Naloxone can cause drowsiness and dizziness in a person. Avoid taking this medication with other drugs like cannabis and alcohol, as it can lead to severe breathing problems, which can be fatal.

• Buprenorphine or Naloxone can also alter the heart rhythm (QT prolongation). Therefore, a person must use the medicine after the doctor's advice. In case of any symptoms like fainting, irregular heartbeat, or severe dizziness, consult the doctor immediately.

• Tooth and gums problems are also caused by Naloxone medication. Consult the dentist immediately.

• Naloxone injection is given after surgery to minimize the effects of opioids. A person should Inform the doctor before surgery about all the medications they are taking.

• Pregnant women or those planning for a child should be given this medication when it is urgently needed. This medication can cause minor congenital disabilities in newborns and harm the fetus.

• Naloxone does not have any significant effects on breast milk. However, consult the doctor immediately if a baby shows troubled breathing or unusual sleepiness.

How Is Opioid Addiction Treated With Buprenorphine and Naloxone?

Buprenorphine and Naloxone are used to treat opioid addiction in the following ways:

• Induction Phase- The combination medicine is prescribed to a person suffering from short-acting opioid addiction, such as morphine or heroin. Oral tablets under the tongue are given during the induction phase of the treatment. Tablets are not kept in the cheeks as they can cause withdrawal symptoms.

• Maintenance Phase- This phase is obtained once a person becomes stable with a specific dose of the combination medicine. Medication is given as oral tablets to be kept under the tongue and in the cheek. This prolonged treatment plan lasts up to weeks, months, or years.

Conclusion:

Naloxone is primarily used to treat overdose and toxicity caused by opiates. The medication is usually given as an injection through an intravenous route for rapid onset. There are no specific side effects associated with Naloxone, and it is generally considered safe for treatment.

A person with overdoses on opioids experiences breathing difficulty and brain damage. Therefore, Naloxone helps to inhibit the action of these excessive opioids in the body and blocks their functioning. The side effects produced by the medication are not usually long-lasting or fatal. However, a person should consult the nearest health center in an emergency.