Evzio Auto-Injector is classified as non-formulary, not stocked. It should be interchanged to generic nalOXone injection.

Narcan, Kloxxado, & RiVive nasal spray are non-formulary, not stocked.  For hospital setting, use intravenous, intramuscular, or nebulized nalOXone as they have a faster onset.

Pharmacists may automatically add a PRN order for nalOXone to a patient’s medication profile if the patient has opiates ordered via any route or frequency, including PRN.

To improve safety with other opiates:

1. Pharmacist can automatically add a PRN order for nalOXone for patients receiving the following:
   • Injectable opiates, PRN, scheduled or continuous
   • Oral opiates, PRN, or scheduled
   • Opiates through other routes (ex. fentaNYL patch)
2. The order would read as follows:
   • nalOXone (Narcan) 0.1 mg IV q1 min x 4 PRN RR<7, apnea, or over-sedation. Max dose of 0.4 mg
   • The order would be designated as, "Per P&T Policy," to indicate that the order had been added by the pharmacist.

Reviewed: July 22, 2014 (Evzio), and 28 June 2016 (Nasal Spray), May 2023 (Kloxxado), December 2023 (RiVive)

Spotlight Naloxone High Dose (Kloxxado)

naloxone HCI nasal spray (RiVive)

• Micromedex
• UpToDate
• Lippincott Advisor