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Substance and addiction prevention branch

Over the Counter (OTC) Naloxone

OTC Naloxone

As of July 2023, the U.S. Food and Drug Administration (FDA) has approved two OTC naloxone nasal sprays for use without a prescription. Narcan® and RiVive™ will be available for consumers to purchase, making overdose reversal medications more widely available.​

​What is Narcan®​?

Narcan® is the approved branded 4 milligram (mg) naloxone hydrochloride (HCl) nasal spray from Emergent BioSolutions. It is a life-saving medication used to reverse an opioid overdose, including heroin, fentanyl, and prescription opioid medications. 

Narcan® nasal spray is now available to purchase OTC in places like drug stores, convenience stores, grocery stores and gas stations, as well as online.

Read the FAQs​​​ to learn more about OTC Narcan® 

What is RiVive™?

RiVive™ is the approved branded 3 mg naloxone HCl nasal spray from Harm Reduction Therapeutics (HRT). RiVive™ is delivered as an atomized spray for the emergency treatment of an opioid overdose.

HRT anticipates RiVive™ will be available by early 2024 primarily to U.S. harm reduction organizations and state governments. ​

W​​hat does​ this mean for California?

OTC Narcan® and RiVive™ will increase naloxone access options for Californians and help save lives of those experiencing an opioid overdose.

Individuals who purchase Narcan® or RiVive™  OTC can access training and information on how to administer it on the CDPH Naloxone webpage​. It is also important for individuals who purchase Narcan®  or RiVive™ to familiarize themselves with the signs of an overdose.​

How to recognize an opioid overdose:

Recognizing the signs of an overdose can save a life. Signs of an overdose may 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 (especially in lips and nails)

​California Departmen​t of Public Health (CDPH) Standing Order

CDPH will continue to maintain its Statewide Standing Order, which has assisted countless community organizations in being able to receive no-cost naloxone through the Department of Health Care Services Naloxone Distribution Project.

Other information and Resources

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