Jared asked
Hello, what pain medications am I able to take if I am also taking naloxone?
At a glance
- Injectable naloxone should not be used with opioid medications as it will reverse their effects and could precipitate withdrawal. Oral naloxone, which is available in combination with opioid drugs, is not well absorbed and shouldn't affect opioid medications unless abused (i.e. injected).
Answer
This is a great question, and I will do my best to answer it without getting into too much detail on a somewhat confusing subject.
What Exactly Is Naloxone?
Naloxone is an opioid antagonist and is generally used to reverse the severe side effects of opioid overdoses, such as respiratory depression.[1]
Additionally, naloxone can be used to treat other opioid side effects such as constipation and itching.
While naloxone is available as a single agent in many pharmaceutical products, it is also added to various opioid pain medications to deter abuse.
Examples of this include:
- Suboxone (Buprenorphine/Naloxone)
- Targiniq (Oxycodone/Naloxone) - No longer on the market
- Zubsolv (Buprenorphine/Naloxone)
It certainly seems contradictory for naloxone (an opioid antagonist) to be added to opioid agonists (e.g., oxycodone) but I will explain below how this works.
How Does Naloxone Work To Deter Abuse?
Naloxone is added to the above products to deter abuse. When naloxone (in combination with an opioid) is taken as directed (e.g., by mouth, under the tongue), its effect is very minimal since it is not very well absorbed. The presence of naloxone does not change the pain relieving ability of the medications.[2]
However, if the drugs mentioned above (e.g. Suboxone) are abused and injected, the naloxone kicks in and neutralizes the pain relieving and euphoric effects.
Even worse, sometimes naloxone, when given to patients who have been chronically taking opioid pain medications, can cause them to have withdrawal symptoms.[3]
Injectable naloxone is available to reverse of opioid-induced respiratory depression as well as other opioid side effects. If you take opioid pain medication by mouth, injectable naloxone will reverse the pain-relieving effects of the opioid pain medication.
To answer your question, you do not want to take opioid pain medications if you are also taking injectable naloxone. So what pain medications can you take if you are on naloxone?
Safe Pain Meds With Naloxone
If you are taking injectable naloxone, there are many options for pain relief and therapy will most likely depend on the type of pain you have. In general, as long as the pain medication you are considering is not an opioid, you should be safe.
For acute, non-neuralgic pain, the following are all options:
- Tylenol (acetaminophen)
- NSAIDs (e.g., ibuprofen, naproxen, meloxicam, Celebrex)
- Topical products such as lidocaine and Aspercreme (Trolamine Salicylate).
For neuralgia, there are many options as well, including gabapentin and Lyrica, as well as a variety of antidepressants and anticonvulsants.
I recommend you speak with your doctor to find an option that will work best for your situation.
