Adapt Pharma Seeks Naloxone Dosing Guidance from FDA

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Adapt, the the manufacturer of Narcan (naloxone) Nasal Spray, 4 mg, indicated for treating opioid overdose, has petitioned FDA asking that it publish a guidance for all naloxone products to identify the “optimal fixed initial dose for each route of administration as well as the required exposure levels to achieve an efficacious onset of action and duration of effect.” The company says that what has changed recently is “an acceleration of expanded naloxone access to new potential witnesses and more potent and faster onset opioids (e.g., fentanyl) being implicated in a growing proportion of opioid overdose deaths. These provide an urgent need to ensure that new naloxone formulations intended for emergency treatment in all settings, (including non-medical settings), by anyone (including non-medically trained individuals), deliver a consistently efficacious fixed initial dose that achieves optimal exposures to naloxone (i.e. plasma levels) and can be easily and rapidly administered.”

The petition says that before approving new naloxone, the agency should define the required pharmacokinetic exposure levels for naloxone that are required to be achieved from the recommended optimal dose of naloxone, including time to onset and duration of effect. And it requests that FDA require “naloxone products from an applicant to utilize a product formulation and device that allows for an individual, (including a non-medically trained individual) in all settings, (including non-medical settings), to readily and rapidly administer a fixed initial dose.”

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