Over the Counter (OTC) Naloxone
There are two OTC naloxone nasal sprays available without a prescription: Narcan® and RiVive™ - providing anyone with access to life-saving overdose reversal medication in stores or online.
What are Narcan® and RiVive™?
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Narcan®: A 4 milligram (mg) naloxone hydrochloride (HCl) nasal spray used to reverse an opioid overdose, including heroin, fentanyl, and prescription opioid medications. It is widely available in drug stores, convenience stores, grocery stores, gas stations, and online.
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RiVive™: A 3 mg naloxone HCl nasal spray that is also used to reverse an opioid overdose.
Who Can Use Naloxone?
- Naloxone is safe for all ages – from infants to older adults.
- It is not addictive and won't harm someone if opioids aren't in their body.
- If you suspect an overdose, use naloxone immediately and call 911.
How to Recognize an Opioid Overdose
Recognizing the signs of an overdose can save a life. Common signs include:
- Small, constricted “pinpoint pupils"
- Falling asleep or losing consciousness
- Slow, weak, or no breathing
- Choking or gurgling sounds
- Limp body
- Cold and/or clammy skin
- Discolored skin (such as blue or gray lips and nails)
Statewide Standing Order for Naloxone
A standing order is no longer needed to acquire NARCAN® naloxone nasal spray, or other approved over-the-counter naloxone nasal sprays, however it can provide additional liability protections, see: CA Civil Code Section 1714.22. All other formulations and dosages of naloxone, including intramuscular naloxone, remain available by prescription only and require a standing order to acquire and distribute. CDPH will continue to maintain its Statewide Standing Order, which has assisted countless community organizations in being able to receive free naloxone through the Department of Health Care Services Naloxone Distribution Project.