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Drug overview for NALOXONE HCL (naloxone hcl):
Generic name: NALOXONE HCL (nal-OX-one)
Drug class: Opioid Antagonists
Therapeutic class: Antidotes and other Reversal Agents
Naloxone hydrochloride is an opioid antagonist.
No enhanced Uses information available for this drug.
Generic name: NALOXONE HCL (nal-OX-one)
Drug class: Opioid Antagonists
Therapeutic class: Antidotes and other Reversal Agents
Naloxone hydrochloride is an opioid antagonist.
No enhanced Uses information available for this drug.
DRUG IMAGES
No Image Available
The following indications for NALOXONE HCL (naloxone hcl) have been approved by the FDA:
Indications:
Opioid overdose
Opioid-induced respiratory depression
Risk mitigation for opioid overdose
Professional Synonyms:
Opiate-induced respiratory depression
Opioid agonist overdose
Opioid-induced inadequate ventilation
Indications:
Opioid overdose
Opioid-induced respiratory depression
Risk mitigation for opioid overdose
Professional Synonyms:
Opiate-induced respiratory depression
Opioid agonist overdose
Opioid-induced inadequate ventilation
The following dosing information is available for NALOXONE HCL (naloxone hcl):
Naloxone is used for the complete or partial reversal of opioid-induced depression, including respiratory depression, caused by natural and synthetic opioids (e.g., codeine, diphenoxylate, fentanyl citrate, heroin, hydromorphone, levorphanol, meperidine, methadone, morphine, oxymorphone, concentrated opium alkaloids, propoxyphene) and certain opioid partial agonists (e.g., butorphanol, nalbuphine, pentazocine). Reversal of respiratory depression resulting from overdosage of opioid partial agonists (e.g., buprenorphine, pentazocine) may be incomplete and require higher or more frequent doses of naloxone.
The availability of naloxone as prefilled syringes and as nasal spray formulations facilitates administration by family members or other caregivers; such treatment is not a substitute for emergency medical care. Administration of naloxone should be accompanied by other resuscitative measures such as administration of oxygen, mechanical ventilation, or artificial respiration. When administering naloxone outside of a supervised medical setting, always seek emergency medical assistance after the first dose is administered.
Naloxone is used in both adults and pediatric adults (including neonates) to reverse the effects of opioids. Naloxone has been given to the mother shortly before delivery+, but it is preferable to administer the drug directly to the neonate if needed after delivery.
Naloxone hydrochloride injection containing 5 mg per 0.5 mL (Zimhi(R)) is a higher concentration of the drug for IM or subcutaneous use in adults and pediatric patients for emergency treatment of known or suspected opioid overdose. The preparation is commercially available as single-dose prefilled syringes that are administered using a delivery device.
Naloxone hydrochloride 5 mg/0.5 mL was developed in response to increasing reports indicating that multiple 2-mg doses of naloxone have been required in resuscitations. Efficacy of this preparation for community use is supported by pharmacokinetic bridging studies.
Naloxone is used for the diagnosis of suspected or known acute opioid overdosage.
Naloxone is commercially available as naloxone hydrochloride; dosage is expressed in terms of the salt.
The manufacturers make no specific recommendations at this time for dosage in diagnosis of suspected or known acute opioid overdosage. However, if no response is observed after administration of 10 mg of naloxone, the diagnosis of opioid-induced toxicity should be questioned.
Following the use of opioids during surgery, excessive doses of naloxone hydrochloride may result in significant reversal of analgesia and cause agitation.
The availability of naloxone as prefilled syringes and as nasal spray formulations facilitates administration by family members or other caregivers; such treatment is not a substitute for emergency medical care. Administration of naloxone should be accompanied by other resuscitative measures such as administration of oxygen, mechanical ventilation, or artificial respiration. When administering naloxone outside of a supervised medical setting, always seek emergency medical assistance after the first dose is administered.
Naloxone is used in both adults and pediatric adults (including neonates) to reverse the effects of opioids. Naloxone has been given to the mother shortly before delivery+, but it is preferable to administer the drug directly to the neonate if needed after delivery.
Naloxone hydrochloride injection containing 5 mg per 0.5 mL (Zimhi(R)) is a higher concentration of the drug for IM or subcutaneous use in adults and pediatric patients for emergency treatment of known or suspected opioid overdose. The preparation is commercially available as single-dose prefilled syringes that are administered using a delivery device.
Naloxone hydrochloride 5 mg/0.5 mL was developed in response to increasing reports indicating that multiple 2-mg doses of naloxone have been required in resuscitations. Efficacy of this preparation for community use is supported by pharmacokinetic bridging studies.
Naloxone is used for the diagnosis of suspected or known acute opioid overdosage.
Naloxone is commercially available as naloxone hydrochloride; dosage is expressed in terms of the salt.
The manufacturers make no specific recommendations at this time for dosage in diagnosis of suspected or known acute opioid overdosage. However, if no response is observed after administration of 10 mg of naloxone, the diagnosis of opioid-induced toxicity should be questioned.
Following the use of opioids during surgery, excessive doses of naloxone hydrochloride may result in significant reversal of analgesia and cause agitation.
Naloxone may be administered by IV, subcutaneous, or IM injection; by IV infusion; or intranasally. The drug also has been administered via endotracheal tube+ and by intraosseous+ (IO) injection.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| NALOXONE 0.4 MG/ML VIAL | Maintenance | Adults inject 0.4 milliliter (0.4 mg) over 30 second(s) by intravenous route once, may repeat at 2 to 3 minute intervals as needed |
| NALOXONE 4 MG/10 ML VIAL | Maintenance | Adults inject 0.4 milliliter (0.4 mg) over 30 second(s) by intravenous route once, may repeat at 2 to 3 minute intervals as needed |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| NALOXONE 0.4 MG/ML VIAL | Maintenance | Adults inject 0.4 milliliter (0.4 mg) over 30 second(s) by intravenous routeonce, may repeat at 2 to 3 minute intervals as needed |
| NALOXONE 4 MG/10 ML VIAL | Maintenance | Adults inject 0.4 milliliter (0.4 mg) over 30 second(s) by intravenous routeonce, may repeat at 2 to 3 minute intervals as needed |
The following drug interaction information is available for NALOXONE HCL (naloxone hcl):
There are 0 contraindications.
There are 0 severe interactions.
There are 0 moderate interactions.
The following contraindication information is available for NALOXONE HCL (naloxone hcl):
Drug contraindication overview.
*Patients with known hypersensitivity to the drug or any ingredient in the formulation.
*Patients with known hypersensitivity to the drug or any ingredient in the formulation.
There are 0 contraindications.
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Opioid withdrawal symptoms |
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Cardiac arrhythmia |
| Disease of liver |
| Opioid dependence |
The following adverse reaction information is available for NALOXONE HCL (naloxone hcl):
Adverse reaction overview.
Intranasal naloxone: Adverse effects reported in clinical trials of intranasally administered naloxone include abdominal pain, asthenia, dizziness, headache, increased blood pressure, constipation, toothache, muscle spasms, musculoskeletal pain, nasal congestion, nasal discomfort, nasal dryness, nasal edema, nasal inflammation, presyncope, rhinalgia, and xeroderma. Parenteral naloxone: Adverse effects, including serious and fatal cases, reported in clinical trials of parenterally administered naloxone for postoperative patients include cardiac arrest, dyspnea, hypotension, hypertension, pulmonary edema, and ventricular tachycardia and fibrillation. Excessive doses of naloxone in postoperative patients may result in agitation caused by significant reversal of analgesia.
Adverse effects reported in clinical trials of parenterally administered naloxone after abrupt reversal of dependence are related to acute withdrawal syndrome, which may include the following signs and symptoms: abdominal cramps, body aches, diarrhea, fever, increased blood pressure, nausea or vomiting, nervousness, runny nose, piloerection, restlessness or irritability, shivering or trembling, sneezing, sweating, tachycardia, weakness, yawning. Abrupt reversal of opioid depression may result in cardiac arrest, increased blood pressure, nausea, pulmonary edema, seizures, sweating, tachycardia, tremulousness, ventricular tachycardia and fibrillation, and vomiting. In the neonate, opioid withdrawal may also include convulsions, excessive crying, and hyperactive reflexes. Adverse effects reported in clinical trials of naloxone hydrochloride injection for IM or subcutaneous use (Zimhi(R)) included dizziness, elevated bilirubin, lightheadedness, and nausea.
Intranasal naloxone: Adverse effects reported in clinical trials of intranasally administered naloxone include abdominal pain, asthenia, dizziness, headache, increased blood pressure, constipation, toothache, muscle spasms, musculoskeletal pain, nasal congestion, nasal discomfort, nasal dryness, nasal edema, nasal inflammation, presyncope, rhinalgia, and xeroderma. Parenteral naloxone: Adverse effects, including serious and fatal cases, reported in clinical trials of parenterally administered naloxone for postoperative patients include cardiac arrest, dyspnea, hypotension, hypertension, pulmonary edema, and ventricular tachycardia and fibrillation. Excessive doses of naloxone in postoperative patients may result in agitation caused by significant reversal of analgesia.
Adverse effects reported in clinical trials of parenterally administered naloxone after abrupt reversal of dependence are related to acute withdrawal syndrome, which may include the following signs and symptoms: abdominal cramps, body aches, diarrhea, fever, increased blood pressure, nausea or vomiting, nervousness, runny nose, piloerection, restlessness or irritability, shivering or trembling, sneezing, sweating, tachycardia, weakness, yawning. Abrupt reversal of opioid depression may result in cardiac arrest, increased blood pressure, nausea, pulmonary edema, seizures, sweating, tachycardia, tremulousness, ventricular tachycardia and fibrillation, and vomiting. In the neonate, opioid withdrawal may also include convulsions, excessive crying, and hyperactive reflexes. Adverse effects reported in clinical trials of naloxone hydrochloride injection for IM or subcutaneous use (Zimhi(R)) included dizziness, elevated bilirubin, lightheadedness, and nausea.
There are 11 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Hyperbilirubinemia Hypertension Hypotension Tachycardia |
| Rare/Very Rare |
|---|
|
Cardiac arrest Dyspnea Hypoxia Pulmonary edema Seizure disorder Ventricular fibrillation Ventricular tachycardia |
There are 13 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Dizziness Injection site sequelae |
Excitement Hyperhidrosis Irritability Nausea Nervousness Tremor Vomiting |
| Rare/Very Rare |
|---|
|
Agitation Flushing Hallucinations Opioid withdrawal symptoms |
The following precautions are available for NALOXONE HCL (naloxone hcl):
Naloxone hydrochloride injection may be used to reverse the effects of opioids in pediatric patients, including neonates. In addition, safety and efficacy of naloxone hydrochloride prefilled syringes for IM or subcutaneous use (Zimhi(R)) or nasal spray (e.g., Narcan(R), Kloxxado(R)) have been established in pediatric patients of all ages for the emergency treatment of known or suspected opioid overdosage manifested by respiratory and/or CNS depression. Use of naloxone for reversal of opioid effects in pediatric patients is supported by adult bioequivalence studies and evidence from the safe and effective use of other naloxone hydrochloride products.
As in adults, naloxone may precipitate opiate withdrawal in pediatric patients who are physically dependent on opiates; however, unlike opiate withdrawal in adults, neonatal opiate withdrawal may be life-threatening and should be treated according to protocols developed by neonatology experts. To avoid abrupt precipitation of neonatal opiate withdrawal syndrome, use of a naloxone preparation that can be dosed based on weight and titrated to effect may be preferred over a preparation that delivers a fixed dose of the drug (e.g., auto-injector, nasal spray) in neonates with known or suspected exposure to maternally administered opiates. Absorption of naloxone following intranasal administration or IM or subcutaneous injection in pediatric patients may be erratic or delayed.
Pediatric patients who have responded to naloxone must be carefully monitored for at least 24 hours, since relapse may occur as the opioid antagonist is metabolized. Safety and efficacy of naloxone hydrochloride injection in the management of hypotension associated with septic shock have not been established in pediatric patients. In a study of 2 neonates with septic shock, treatment with naloxone produced a positive pressor response; however, one patient subsequently died after intractable seizures.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
As in adults, naloxone may precipitate opiate withdrawal in pediatric patients who are physically dependent on opiates; however, unlike opiate withdrawal in adults, neonatal opiate withdrawal may be life-threatening and should be treated according to protocols developed by neonatology experts. To avoid abrupt precipitation of neonatal opiate withdrawal syndrome, use of a naloxone preparation that can be dosed based on weight and titrated to effect may be preferred over a preparation that delivers a fixed dose of the drug (e.g., auto-injector, nasal spray) in neonates with known or suspected exposure to maternally administered opiates. Absorption of naloxone following intranasal administration or IM or subcutaneous injection in pediatric patients may be erratic or delayed.
Pediatric patients who have responded to naloxone must be carefully monitored for at least 24 hours, since relapse may occur as the opioid antagonist is metabolized. Safety and efficacy of naloxone hydrochloride injection in the management of hypotension associated with septic shock have not been established in pediatric patients. In a study of 2 neonates with septic shock, treatment with naloxone produced a positive pressor response; however, one patient subsequently died after intractable seizures.
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
There are limited data to date on use of naloxone in pregnant women. Naloxone should be used during pregnancy only when clearly needed. Reproduction studies in mice and rats using naloxone hydrochloride dosages of 4 and 8 times, respectively, a human dosage of 10 mg daily in a 50-kg individual demonstrated no embryotoxic or teratogenic effects.
Furthermore, no adverse effects were reported in the offspring of rats receiving naloxone hydrochloride subcutaneously at dosages of 2 or 10 mg/kg (up to 12 times a human dosage of 8 mg daily) from gestation day 15 to postnatal day 21. No embryotoxic or teratogenic effects were observed in mice and rats during the period of organogenesis with the 8 mg/0.1 mL nasal spray at doses 3 and 6 times a human dose of 16 mg.
The risk-benefit ratio must be considered before naloxone is administered to a pregnant woman who is known or suspected to be dependent on opioids, since maternal dependence may often be accompanied by fetal dependence. Naloxone crosses the placenta and may precipitate withdrawal symptoms in both the fetus and the pregnant woman. Use of naloxone in opioid-dependent pregnant women should be accompanied by monitoring for fetal distress.
It is not known if naloxone affects the duration of labor and/or delivery. However, published reports indicate that administration of naloxone during labor did not adversely affect maternal or neonatal status. Carefully monitor patients with mild to moderate hypertension who receive naloxone during labor, as severe hypertension may occur.
Furthermore, no adverse effects were reported in the offspring of rats receiving naloxone hydrochloride subcutaneously at dosages of 2 or 10 mg/kg (up to 12 times a human dosage of 8 mg daily) from gestation day 15 to postnatal day 21. No embryotoxic or teratogenic effects were observed in mice and rats during the period of organogenesis with the 8 mg/0.1 mL nasal spray at doses 3 and 6 times a human dose of 16 mg.
The risk-benefit ratio must be considered before naloxone is administered to a pregnant woman who is known or suspected to be dependent on opioids, since maternal dependence may often be accompanied by fetal dependence. Naloxone crosses the placenta and may precipitate withdrawal symptoms in both the fetus and the pregnant woman. Use of naloxone in opioid-dependent pregnant women should be accompanied by monitoring for fetal distress.
It is not known if naloxone affects the duration of labor and/or delivery. However, published reports indicate that administration of naloxone during labor did not adversely affect maternal or neonatal status. Carefully monitor patients with mild to moderate hypertension who receive naloxone during labor, as severe hypertension may occur.
It is not known whether naloxone is distributed into milk or has any effect on the breast-fed infant or on milk production; use naloxone with caution in nursing women. The drug does not affect prolactin or oxytocin concentrations in nursing women, and oral bioavailability of naloxone is minimal.
Clinical studies of naloxone did not include sufficient numbers of patients 65 years of age and older to determine whether geriatric patients respond differently than younger patients. While other clinical experience has not revealed age-related differences in response, drug dosage generally should be titrated carefully in geriatric patients, usually initiating therapy at the low end of the dosage range. The greater frequency of decreased hepatic, renal, and/or cardiac function and of concomitant disease and drug therapy observed in the elderly also should be considered.
The following prioritized warning is available for NALOXONE HCL (naloxone hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for NALOXONE HCL (naloxone hcl)'s list of indications:
| Opioid overdose | |
| T40.0x1A | Poisoning by opium, accidental (unintentional), initial encounter |
| T40.0x2A | Poisoning by opium, intentional self-harm, initial encounter |
| T40.0x3A | Poisoning by opium, assault, initial encounter |
| T40.0x4A | Poisoning by opium, undetermined, initial encounter |
| T40.1x1A | Poisoning by heroin, accidental (unintentional), initial encounter |
| T40.1x2A | Poisoning by heroin, intentional self-harm, initial encounter |
| T40.1x3A | Poisoning by heroin, assault, initial encounter |
| T40.1x4A | Poisoning by heroin, undetermined, initial encounter |
| T40.2x1A | Poisoning by other opioids, accidental (unintentional), initial encounter |
| T40.2x2A | Poisoning by other opioids, intentional self-harm, initial encounter |
| T40.2x3A | Poisoning by other opioids, assault, initial encounter |
| T40.2x4A | Poisoning by other opioids, undetermined, initial encounter |
| T40.3x1A | Poisoning by methadone, accidental (unintentional), initial encounter |
| T40.3x2A | Poisoning by methadone, intentional self-harm, initial encounter |
| T40.3x3A | Poisoning by methadone, assault, initial encounter |
| T40.3x4A | Poisoning by methadone, undetermined, initial encounter |
| T40.411A | Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter |
| T40.412A | Poisoning by fentanyl or fentanyl analogs, intentional self-harm, initial encounter |
| T40.413A | Poisoning by fentanyl or fentanyl analogs, assault, initial encounter |
| T40.414A | Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter |
| T40.421A | Poisoning by tramadol, accidental (unintentional), initial encounter |
| T40.422A | Poisoning by tramadol, intentional self-harm, initial encounter |
| T40.423A | Poisoning by tramadol, assault, initial encounter |
| T40.424A | Poisoning by tramadol, undetermined, initial encounter |
| T40.491A | Poisoning by other synthetic narcotics, accidental (unintentional), initial encounter |
| T40.492A | Poisoning by other synthetic narcotics, intentional self-harm, initial encounter |
| T40.493A | Poisoning by other synthetic narcotics, assault, initial encounter |
| T40.494A | Poisoning by other synthetic narcotics, undetermined, initial encounter |
| T40.601A | Poisoning by unspecified narcotics, accidental (unintentional), initial encounter |
| T40.602A | Poisoning by unspecified narcotics, intentional self-harm, initial encounter |
| T40.603A | Poisoning by unspecified narcotics, assault, initial encounter |
| T40.604A | Poisoning by unspecified narcotics, undetermined, initial encounter |
| T40.691A | Poisoning by other narcotics, accidental (unintentional), initial encounter |
| T40.692A | Poisoning by other narcotics, intentional self-harm, initial encounter |
| T40.693A | Poisoning by other narcotics, assault, initial encounter |
| T40.694A | Poisoning by other narcotics, undetermined, initial encounter |
| T50.7x1A | Poisoning by analeptics and opioid receptor antagonists, accidental (unintentional), initial encounter |
| T50.7x2A | Poisoning by analeptics and opioid receptor antagonists, intentional self-harm, initial encounter |
| T50.7x3A | Poisoning by analeptics and opioid receptor antagonists, assault, initial encounter |
| T50.7x4A | Poisoning by analeptics and opioid receptor antagonists, undetermined, initial encounter |
| Opioid-induced respiratory depression | |
| T40.0x1A | Poisoning by opium, accidental (unintentional), initial encounter |
| T40.0x2A | Poisoning by opium, intentional self-harm, initial encounter |
| T40.0x3A | Poisoning by opium, assault, initial encounter |
| T40.0x4A | Poisoning by opium, undetermined, initial encounter |
| T40.1x1A | Poisoning by heroin, accidental (unintentional), initial encounter |
| T40.1x2A | Poisoning by heroin, intentional self-harm, initial encounter |
| T40.1x3A | Poisoning by heroin, assault, initial encounter |
| T40.1x4A | Poisoning by heroin, undetermined, initial encounter |
| T40.2x1A | Poisoning by other opioids, accidental (unintentional), initial encounter |
| T40.2x2A | Poisoning by other opioids, intentional self-harm, initial encounter |
| T40.2x3A | Poisoning by other opioids, assault, initial encounter |
| T40.2x4A | Poisoning by other opioids, undetermined, initial encounter |
| T40.3x1A | Poisoning by methadone, accidental (unintentional), initial encounter |
| T40.3x2A | Poisoning by methadone, intentional self-harm, initial encounter |
| T40.3x3A | Poisoning by methadone, assault, initial encounter |
| T40.3x4A | Poisoning by methadone, undetermined, initial encounter |
| T40.411A | Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter |
| T40.412A | Poisoning by fentanyl or fentanyl analogs, intentional self-harm, initial encounter |
| T40.413A | Poisoning by fentanyl or fentanyl analogs, assault, initial encounter |
| T40.414A | Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter |
| T40.421A | Poisoning by tramadol, accidental (unintentional), initial encounter |
| T40.422A | Poisoning by tramadol, intentional self-harm, initial encounter |
| T40.423A | Poisoning by tramadol, assault, initial encounter |
| T40.424A | Poisoning by tramadol, undetermined, initial encounter |
| T40.491A | Poisoning by other synthetic narcotics, accidental (unintentional), initial encounter |
| T40.492A | Poisoning by other synthetic narcotics, intentional self-harm, initial encounter |
| T40.493A | Poisoning by other synthetic narcotics, assault, initial encounter |
| T40.494A | Poisoning by other synthetic narcotics, undetermined, initial encounter |
| T40.5x1A | Poisoning by cocaine, accidental (unintentional), initial encounter |
| T40.5x2A | Poisoning by cocaine, intentional self-harm, initial encounter |
| T40.5x3A | Poisoning by cocaine, assault, initial encounter |
| T40.5x4A | Poisoning by cocaine, undetermined, initial encounter |
| T40.601A | Poisoning by unspecified narcotics, accidental (unintentional), initial encounter |
| T40.602A | Poisoning by unspecified narcotics, intentional self-harm, initial encounter |
| T40.603A | Poisoning by unspecified narcotics, assault, initial encounter |
| T40.604A | Poisoning by unspecified narcotics, undetermined, initial encounter |
| T40.691A | Poisoning by other narcotics, accidental (unintentional), initial encounter |
| T40.692A | Poisoning by other narcotics, intentional self-harm, initial encounter |
| T40.693A | Poisoning by other narcotics, assault, initial encounter |
| T40.694A | Poisoning by other narcotics, undetermined, initial encounter |
| Risk mitigation for opioid overdose | |
| T40.0x1A | Poisoning by opium, accidental (unintentional), initial encounter |
| T40.0x2A | Poisoning by opium, intentional self-harm, initial encounter |
| T40.0x3A | Poisoning by opium, assault, initial encounter |
| T40.0x4A | Poisoning by opium, undetermined, initial encounter |
| T40.1x1A | Poisoning by heroin, accidental (unintentional), initial encounter |
| T40.1x2A | Poisoning by heroin, intentional self-harm, initial encounter |
| T40.1x3A | Poisoning by heroin, assault, initial encounter |
| T40.1x4A | Poisoning by heroin, undetermined, initial encounter |
| T40.2x1A | Poisoning by other opioids, accidental (unintentional), initial encounter |
| T40.2x2A | Poisoning by other opioids, intentional self-harm, initial encounter |
| T40.2x3A | Poisoning by other opioids, assault, initial encounter |
| T40.2x4A | Poisoning by other opioids, undetermined, initial encounter |
| T40.3x1A | Poisoning by methadone, accidental (unintentional), initial encounter |
| T40.3x2A | Poisoning by methadone, intentional self-harm, initial encounter |
| T40.3x3A | Poisoning by methadone, assault, initial encounter |
| T40.3x4A | Poisoning by methadone, undetermined, initial encounter |
| T40.411A | Poisoning by fentanyl or fentanyl analogs, accidental (unintentional), initial encounter |
| T40.412A | Poisoning by fentanyl or fentanyl analogs, intentional self-harm, initial encounter |
| T40.413A | Poisoning by fentanyl or fentanyl analogs, assault, initial encounter |
| T40.414A | Poisoning by fentanyl or fentanyl analogs, undetermined, initial encounter |
| T40.421A | Poisoning by tramadol, accidental (unintentional), initial encounter |
| T40.422A | Poisoning by tramadol, intentional self-harm, initial encounter |
| T40.423A | Poisoning by tramadol, assault, initial encounter |
| T40.424A | Poisoning by tramadol, undetermined, initial encounter |
| T40.491A | Poisoning by other synthetic narcotics, accidental (unintentional), initial encounter |
| T40.492A | Poisoning by other synthetic narcotics, intentional self-harm, initial encounter |
| T40.493A | Poisoning by other synthetic narcotics, assault, initial encounter |
| T40.494A | Poisoning by other synthetic narcotics, undetermined, initial encounter |
| T40.601A | Poisoning by unspecified narcotics, accidental (unintentional), initial encounter |
| T40.602A | Poisoning by unspecified narcotics, intentional self-harm, initial encounter |
| T40.603A | Poisoning by unspecified narcotics, assault, initial encounter |
| T40.604A | Poisoning by unspecified narcotics, undetermined, initial encounter |
| T40.691A | Poisoning by other narcotics, accidental (unintentional), initial encounter |
| T40.692A | Poisoning by other narcotics, intentional self-harm, initial encounter |
| T40.693A | Poisoning by other narcotics, assault, initial encounter |
| T40.694A | Poisoning by other narcotics, undetermined, initial encounter |
| T50.7x1A | Poisoning by analeptics and opioid receptor antagonists, accidental (unintentional), initial encounter |
| T50.7x2A | Poisoning by analeptics and opioid receptor antagonists, intentional self-harm, initial encounter |
| T50.7x3A | Poisoning by analeptics and opioid receptor antagonists, assault, initial encounter |
| T50.7x4A | Poisoning by analeptics and opioid receptor antagonists, undetermined, initial encounter |
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