ZIMHI – 5 mg Naloxone IM

Adamis prescription drugs is looking for FDA approval for ZIMHI™(naloxone) Injection, a 5(FIVE) milligram IM dose of naloxone to be used in suspected opioid overdose.


In EMS, we attempt to titrate naloxone to the smallest doable quantity to cut back respiratory melancholy.  We’ve got that luxurious as a result of we supply bag valve masks, which allow us to breathe for apneic or agonal sufferers till they can ventilate on their very own. 

A number of years in the past ADAPT prescription drugs got here out with a four mg intranasal product, NARCAN.  Our native fireplace and police departments began carrying it, and we began displaying up on scene simply in time for the victims to take a seat bolt upright and projectile vomit on us.

four mg intranasal is roughly equal to 2 mg IM primarily based on bioavailability.

The one time I’ve ever given 2 mg IM in a single shot is when I’ve a affected person who will not be solely apneic, however cyanotic and I’m having problem discovering a pulse.  Apart from that, I exploit a lessor quantity.  My most well-liked dose in these affected person I can achieve IV entry on, is 0.1 mg IV Q 1 minute till respirations decide up.

5 mg IM goes to trigger some severe opioid withdrawal syndrome in overdosed folks with historical past of opioid use.  I consider it will be felony to permit EMS to hold and administer such doses.  I’ve a unique view in the case of layperson administration.

I assist administer Connecticut’s SWORD program, the place EMS calls in to the Connecticut Poison Management Heart after every opioid overdose they reply to and supply solutions to a lot of questions, together with how a lot naloxone the affected person acquired, who gave it, and whether or not or not there have been ant negative effects.  I’ve learn over 8,000 of those reviews.  It’s not unusual for overdose victims to obtain 8, 12, 16 and even 24 mgs of naloxone from laypeople.  As a result of naloxone doesn’t instantly resuscitate folks and when you’re standing subsequent to somebody who’s blue, I believe there’s a tendency of laypeople to simply unload the whole lot they’ve as a result of they don’t know what else to do.

It’s arduous to argue that placing somebody into withdrawal is worse than not restoring their respiratory when you lack means to breathe for the particular person whereas ready for the naloxone to kick in.

You can provide the excessive doses to put folks.  Simply preserve the supercharged doses out of EMS drug containers.

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