Indications reversal of opioid-induced respiratory depression; reversal of neonatal respiratory depression resulting from opioid administration to mother during labour; overdosage with opioids.

Cautions: cardiovascular disease or those receiving cardiotoxic drugs (serious adverse cardiovascular effects reported); physical dependence on opioids (precipitates withdrawal); pain, has short duration of action (repeated doses or infusion may be necessary to reverse effects of opioids with longer duration of action); In postoperative use, the dose should be titrated for each patient in order to obtain sufficient respiratory response.

Side Effects: hypotension, hypertension, ventricular tachycardia and fibrillation, cardiac arrest; hyperventilation, dyspnea, pulmonary oedema; less commonly agitation, excitement, paraesthesia.

Dose: by IV injection, 100-200 mcg (1.5-3mcg/kg). Adjusted according to the response, then 100 mcg every 2 minutes.

Neonates, by SC or IM or IV injection, 10 mcg/kg repeated every 2 minutes or 200 mcg (60 mcg/kg) by IM injection as a single dose.