The Committee on Drugs has previously suggested in its Emergency Drug Dose Statement (Pediatrics 1988;81:462-465) that a dose of 0.01 to 0.1 mg/kg of naloxone would be appropriate, with a minimum dose of 0.5 mg for newborns. In an earlier commentary, "Naloxone Use in Newborns" (Pediatrics 1980;65:667-669), a dose of 0.01 mg/kg was recommended. To clarify this wide dose range, the following statement is to be substituted.
Dose: (Intoxication with opiates) IV, intratracheal—0.1 mg/kg from birth (including premature infants) until age 5 years or 20 kg of weight, at which time a minimum 2-mg dose should be used. These doses may be repeated as needed to maintain opiate reversal.
The use of neonatal naloxone (Narcan 0.02 mg/ mL) is no longer recommended because unacceptable fluid volumes will result, especially to small neonates. Preparations containing 0.4 mg/mL or 1 mg/mL of naloxone are available and can be accurately dosed with appropriate sized syringes (1 mL).
- Copyright © 1989 by the American Academy of Pediatrics