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Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose
Psychiatry International
  • Adam M. Kaye, University of the Pacific
  • Amber N. Edinoff, Massachusetts General Hospital
  • Catherine A. Nix
  • Tanner D. Reed
  • Elizabeth M. Bozner
  • Mark R. Alvarez
  • Mitchell C. Fuller
  • Fatimah Anwar
  • Elyse M. Cornett, Louisiana State University Health Sciences Center - Shreveport
  • Alan David Kaye, Louisiana State University Health Science Center
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
DOI
10.3390/psychiatryint2040028
Publication Date
10-14-2021
Abstract

Opioid use disorder is a well-established and growing problem in the United States. It is responsible for both psychosocial and physical damage to the affected individuals with a significant mortality rate. Given both the medical and non-medical consequences of this epidemic, it is important to understand the current treatments and approaches to opioid use disorder and acute opioid overdose. Naloxone is a competitive mu-opioid receptor antagonist that is used for the reversal of opioid intoxication. When given intravenously, naloxone has an onset of action of approximately 2 min with a duration of action of 60–90 min. Related to its empirical dosing and short duration of action, frequent monitoring of the patient is required so that the effects of opioid toxicity, namely respiratory depression, do not return to wreak havoc. Nalmefene is a pure opioid antagonist structurally similar to naltrexone that can serve as an alternative antidote for reversing respiratory depression associated with acute opioid overdose. Nalmefene is also known as 6-methylene naltrexone. Its main features of interest are its prolonged duration of action that surpasses most opioids and its ability to serve as an antidote for acute opioid overdose. This can be pivotal in reducing healthcare costs, increasing patient satisfaction, and redistributing the time that healthcare staff spend monitoring opioid overdose patients given naloxone.

Creative Commons License
Creative Commons Attribution 4.0 International
Citation Information
Adam M. Kaye, Amber N. Edinoff, Catherine A. Nix, Tanner D. Reed, et al.. "Pharmacologic and Clinical Considerations of Nalmefene, a Long Duration Opioid Antagonist, in Opioid Overdose" Psychiatry International Vol. 2 Iss. 28 (2021) p. 365 - 378 ISSN: 2673-5318
Available at: http://works.bepress.com/adam-kaye/193/