Naloxone Hydrochloride Nasal Spray 4 mg — Twin Pack is the only FDA-approved, prescription-strength over-the-counter intranasal opioid overdose reversal agent available without a prescription in the United States. Each twin pack contains two single-dose nasal spray devices, each delivering 4 mg of naloxone HCl. No needles, no injection training, no prescription required. Designed for administration by bystanders, law enforcement, EMS, and clinical personnel responding to known or suspected opioid overdose. SKU: 5057884. Vendor: MEDTECH Resource. Classified as an Airway/opioid antagonist intervention in the MARCH framework.
Naloxone has a shorter duration of action than most opioids. After administering the first dose, call emergency services immediately. The patient may relapse into respiratory depression before EMS arrives. A second dose (from the second device in this twin pack) may be administered 2–3 minutes after the first if there is no response or if the patient re-sedates. Naloxone is not a substitute for emergency medical care.
Key Features
Product Specifications
| Specification | Detail |
|---|---|
| Vendor | MEDTECH Resource |
| SKU | 5057884 |
| Active Ingredient | Naloxone Hydrochloride 4 mg per device |
| Delivery Route | Intranasal spray |
| Spray Volume | 0.1 mL per device (40 mg/mL concentration) |
| Devices Per Pack | 2 single-dose nasal spray devices |
| FDA Status | FDA-approved OTC (NDA 208411, Rx-to-OTC switch approved March 2023) |
| Shelf Life (Current Manufacture) | 4 years (extended per FDA acknowledgment, January 2024) |
| Mechanism of Action | Competitive mu-opioid receptor antagonist |
| Half-Life (Intranasal) | ~2.08 hours (healthy adults, IN administration) |
| Bioavailability (Intranasal vs. IM) | ~50% (4 mg IN ≈ 0.4 mg IM) |
| Prescription Required | No — OTC, available without prescription |
| Patient Population | Adults and pediatric patients |
| pH Range (Solution) | 3.5 to 5.5 |
| Configuration | Individual item — twin pack (2 devices) |
Who Should Carry Naloxone?
With opioid overdose deaths exceeding 80,000 annually in the United States, naloxone access is now a public safety infrastructure issue — not just a clinical one. The twin pack format is appropriate for a broad range of responders and bystanders:
- Law enforcement and security personnel — first on scene before EMS in the majority of opioid overdose calls. The intranasal format requires no injection training, making it practical for officers and security staff with basic first aid knowledge.
- EMS and fire departments — for supplemental stock in BLS units, as a backup to IV/IM naloxone formulations, and for community distribution programs.
- Harm reduction organizations and community health workers — distributing naloxone to high-risk individuals, their families, and peer networks as part of overdose prevention programs.
- Schools, universities, and employer wellness programs — the OTC approval and no-needle format make it appropriate for placement in AED-adjacent emergency stations, coaches' bags, and workplace first aid kits.
- Families and caregivers of individuals using prescription opioids — accidental overdose from prescription pain medications is a leading cause of unintentional opioid deaths. Having naloxone available at home is a recognized harm-reduction strategy endorsed by the FDA and SAMHSA.
- Tactical medics and combat lifesavers — in environments where fentanyl exposure incidents (either accidental or as a chemical threat vector) may occur, naloxone is an essential counteragent within the airway management capability set.
How to Administer Naloxone Nasal Spray
Clinical Context — Why the Twin Pack Matters
The fentanyl-driven opioid crisis has significantly increased the dose of naloxone required to reverse overdose compared to heroin-era data. Fentanyl is 50–100 times more potent than morphine and binds mu-opioid receptors with very high affinity. Illicitly manufactured fentanyl (IMF) and fentanyl analogs may require multiple doses of naloxone for full reversal — a clinical reality that makes the twin pack the minimum recommended configuration for community distribution and first-responder carry.
The SAMHSA National Practice Guidelines for Opioid Overdose Prevention Programs and the American College of Emergency Physicians (ACEP) both recommend that naloxone distributed for community use be in a multi-dose format precisely because of the prevalence of high-potency synthetic opioids in the current illicit drug supply.
For organizations integrating naloxone into public access emergency kits, vehicle first aid kits, or law enforcement patrol bags, the twin pack format ensures that the second dose is always co-located with the first — a critical consideration when time to response is measured in minutes.
Frequently Asked Questions
Do I need a prescription to purchase naloxone nasal spray?
No. As of March 2023, the FDA approved Narcan 4 mg nasal spray for over-the-counter sale without a prescription. Any individual, organization, school, employer, or public safety agency can purchase it directly without a physician order.
Is it safe to give naloxone if I'm not sure opioids are involved?
Yes. Naloxone has no pharmacological effect in the absence of opioids. If the patient has not taken opioids, naloxone will not cause harm. Given the stakes of an unrecognized opioid overdose, administering naloxone empirically in an unconscious person with unknown cause of collapse is a clinically sound decision endorsed by major toxicology and emergency medicine guidelines.
Why does this product come in a twin pack rather than a single dose?
Synthetic opioids — particularly fentanyl and its analogs — often require more than one dose of naloxone for full overdose reversal. A single 4 mg dose may be insufficient in high-potency fentanyl overdoses. The twin pack ensures that a second dose is always immediately available without requiring a resupply run, making it the minimum standard for community and first-responder naloxone distribution.
How long does naloxone's effect last and what happens after it wears off?
Naloxone's plasma half-life via intranasal administration is approximately 2 hours. Many opioids — particularly long-acting formulations and fentanyl patches — have a longer duration of action than naloxone. This means the patient may relapse into overdose (re-sedation) after naloxone wears off while the opioid is still active. This is why calling emergency services immediately and maintaining patient observation until EMS arrives is essential, regardless of apparent recovery.
Can naloxone be used for pediatric patients?
Yes. The FDA has established the safety and effectiveness of Narcan 4 mg nasal spray in pediatric patients for known or suspected opioid overdose. The same initial 4 mg single-nostril dose applies to pediatric patients — no dose adjustment is required for standard overdose reversal indications.
What is the shelf life of this naloxone nasal spray?
For newly manufactured product (produced after January 2024), the shelf life is 4 years from manufacture date. Always verify the printed expiration date on each device's packaging. Expired product should be replaced — do not rely on outdated naloxone for emergency use. MED-TAC sources this product through authorized distributors to ensure current manufacture dates.
Where should naloxone be stored?
Store naloxone nasal spray at controlled room temperature (59°F–77°F / 15°C–25°C), away from direct sunlight. Avoid storage in environments that regularly exceed 104°F (40°C) — such as the interior of a vehicle during summer months — which may degrade the formulation. For vehicle kits or leave-in storage applications, rotate stock per the printed expiration date and store in insulated pouches to buffer temperature extremes.
Specifications coming soon. Contact us for detailed product information.
FREQUENTLY ASKED QUESTIONS
