A recent study published in The Journal of Clinical Pharmacology reveals that intramuscular nalmefene effectively reverses fentanyl-induced respiratory depression. This research, sponsored by Purdue’s subsidiary, Imbrium Therapeutics, utilized a clinical model of opioid-induced respiratory depression (OIRD) in healthy volunteers.
Results demonstrated that 1 mg of intramuscular nalmefene reversed the respiratory depression caused by fentanyl similarly to or better than both intramuscular and intranasal naloxone. While not a perfect simulation of real-world overdose situations, the OIRD model allows for a controlled comparison of the time course and magnitude of respiratory depression reversal between different opioid antagonists.
Nalmefene hydrochloride injection is already approved for reversing opioid effects, including respiratory depression. Its long duration of action makes it a valuable treatment option, particularly for overdoses involving potent, long-acting synthetic opioids like fentanyl. However, healthcare providers must remain vigilant for the potential recurrence of respiratory depression even after a successful initial reversal.
The study highlighted that intramuscular nalmefene and naloxone had a faster onset of action than intranasal naloxone. Furthermore, consistent with its longer half-life, nalmefene exhibited a longer duration of reversal, maintaining higher mean respiratory minute volume throughout the 90-minute observation period.
Although the study had a limited sample size, the consistent results from two treatment administrations strengthened the findings. However, limitations include maintaining constant fentanyl concentrations, which is not realistic in real-world scenarios, and the 90-minute observation period, which didn’t allow assessment of reversal duration beyond that timeframe.
The increasing prevalence of overdoses and deaths related to potent synthetic opioids like fentanyl necessitates stronger, longer-acting antagonist treatments. This study provides valuable data on nalmefene’s potential in addressing this critical public health crisis. Further research and real-world data analysis will provide a more comprehensive understanding of how nalmefene can be effectively integrated into opioid overdose treatment protocols.
Jon Napitupulu is Director of Media Relations at The Clinical Trial Vanguard. Jon, a computer data scientist, focuses on the latest clinical trial industry news and trends.
