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Intranasal (IN) naloxone administration is an effective alternative to intravenous (IV) or intramuscular (IM) naloxone by emergency medical services for opioid overdoses and has been used successfully for this purpose as reported in clinical observational studies and a randomized controlled trial. Most of the published clinical studies concerning IN administration used an improvised kit of 2 mg naloxone/2 mL saline and a mucosal atomizer device (MAD), which is not FDA-approved for this indication. Pharmacokinetic (PK) data using these kits is not available in the published literature. This study is designed to determine the PK of naloxone following one and two IN administrations using the improvised kits compared to 2 and 4 mg delivered IN using the FDA-approved Narcan nasal spray device and 2 mg administered IM using the Evzio autoinjector.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mucosal Atomization (1 administration) | Experimental | One Intranasal administration of 2 mL naloxone using a mucosal atomization device and syringe (1 mL/nostril) |
|
| Mucosal Atomization (2 administrations) | Experimental | Two Intranasal administrations of 2 mL naloxone using mucosal atomization device and syringe (1 mL/nostril) 2 minutes apart |
|
| Narcan 2mg | Experimental | One Intranasal administration of 2 mg naloxone using Narcan nasal spray |
|
| Narcan 4mg | Experimental | One Intranasal administration of 4 mg naloxone using Narcan nasal spray |
|
| Intramuscular auto injector | Experimental | One Intramuscular administration of 2 mg naloxone using Evzio auto-injector |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Naloxone | Drug | Comparing pharmacokinetics of naloxone |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic parameters of naloxone | Maximum plasma concentration, time of maximum observed concentration and area under the concentration-time curve | 11 days |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Assessments | Number of participants with AEs, vital signs, ECG, laboratory changes and nasal irritation following the administration of naloxone. | 16 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Debra Kelsh, MD | Vince and Associates Clinical Research | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vince and Associates Clinical Research | Overland Park | Kansas | 66212 | United States |
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| ID | Term |
|---|---|
| D009293 | Opioid-Related Disorders |
| ID | Term |
|---|---|
| D000079524 | Narcotic-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D009270 | Naloxone |
| D013594 | Syringes |
| ID | Term |
|---|---|
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
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This will be an inpatient open-label, randomized, 5-period, 5-treatment, 5-sequence, crossover study involving approximately 30 healthy subjects.
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| Mucosal atomization device and syringe | Device | Injection |
|
| Narcan | Device | Nasal Spray |
|
| Intramuscular Auto Injector | Device | Intramuscular injection |
|
|
| D006572 |
| Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D004864 | Equipment and Supplies |