Uses
What is Zurnai used for?
Zurnai (nalmefene) is commonly used to reverse a known or suspected opioid overdose. Opioid overdose symptoms can include unusual sleepiness, extreme difficulty waking up, slow or shallow breathing problems, or not breathing at all.
Zurnai is used only during emergencies. Anyone using Zurnai should also seek medical care right away.
Zurnai may also be used for other conditions as determined by your healthcare provider.
How does Zurnai work (mechanism of action)?
An opioid, such as oxycodone, morphine, codeine, or fentanyl, is a medicine used to treat certain types of pain. When too much opioid is available to attach to opioid receptors, it can lead to an opioid overdose. Zurnai works to block the effects of opioids at their receptors and temporarily reverses the effects of too much opioid medicine.
How is Zurnai supplied (dosage forms)?
Zurnai is available in the following dosage forms that are injected into a muscle (intramuscular) or under the skin (subcutaneous).
- 1.5 mg/0.5 mL prefilled auto-injector
How should I store Zurnai?
Zurnai should be stored in its original carton at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place away from light. Do not refrigerate or freeze Zurnai.
Side Effects
What are the most common side effects of Zurnai?
The most common side effects of Zurnai are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Feeling hot, hot flush, or a burning sensation
- Nausea or vomiting
- Headache
- Dizziness
- Chills
- Feeling pain from things that normally do not cause you pain
- Irregular heartbeat
- Ringing in or discomfort in your ears
- Irritability
- Feeling abnormal
There may be other side effects of Zurnai that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Zurnai?
While less common, the most serious side effects of Zurnai are described below, along with what to do if they happen.
Severe Allergic Reactions. Zurnai may cause allergic reactions, which can be serious. Stop using Zurnai and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Recurrent Slow Breathing and Extreme Sleepiness. After a dose of Zurnai, it is possible that the symptoms of opioid overdose (such as slowed breathing, extreme sleepiness, or small pupils) either do not completely go away, or go away and then come back. Call for emergency medical help after any dose of Zurnai is given. After giving someone a dose of Zurnai, stay with the person until medical help arrives. Repeat doses of Zurnai may be needed to prevent slowed breathing and extreme sleepiness from coming back until medical help arrives. Repeat doses can be given every 2 to 5 minutes. A new Zurnai auto-injector should be used for each dose.
Sudden Opioid Withdrawal. Zurnai is used to reverse an opioid overdose. Using Zurnai may cause opioid withdrawal symptoms in someone who has been using opioids regularly. You should always call for medical help right away when using Zurnai. If emergency help is not already on the way, seek medical help right away if you have any of the following symptoms of sudden opioid withdrawal.
- Body aches
- Goosebumps
- Diarrhea, nausea, vomiting
- Sweating
- Fever
- Shivering, shaking, or trembling
- Stomach cramps
- Fast heartbeat
- Increased blood pressure
- Runny nose, sneezing
- Yawning
- Nervousness, restlessness, irritability
- Feeling weak
Warnings & Precautions
Who should not use Zurnai?
Allergies to Ingredients. People who are allergic to any of the following should not use Zurnai.
- Zurnai
- Nalmefene
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Zurnai.
What should I know about Zurnai before using it?
Do not use Zurnai unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Keep Zurnai and any sharps disposal containers that you have out of the reach of children.
Make sure family members, caregivers, and anyone else who may need to use Zurnai know where it is kept and how to use it. You can share the detailed Instructions for Use information that comes in each Zurnai carton to help explain how Zurnai should be used.
Use Zurnai right away if you think someone has signs or symptoms of an opioid overdose, even if you are not sure. Too much opioid can cause severe injury or even death. You, your family, and any caregivers that may need to use Zurnai should be familiar with the symptoms of an opioid overdose, which can include the following.
- Extreme drowsiness or sleepiness
- Slowed breathing or not breathing at all
- Very small or pinpoint pupils (the black section in the center of your eye)
- Slow heartbeat
- Low blood pressure
Always call 911 or get medical help right away after using Zurnai, even if the person who got a dose of Zurnai wakes up. Sometimes the dose of Zurnai wears off (symptoms of the opioid overdose come back) before medical help arrives. If this happens, it may be necessary to give another dose of Zurnai. Zurnai can be given every 2 to 5 minutes (using a new Zurnai auto-injector) if the person is not responding or responds but then has breathing problems again.
Zurnai should only be injected into the outer thigh. Zurnai should not be injected anywhere else on the body. If needed, a Zurnai injection can be given through clothing.
Each Zurnai auto-injector can only be used one time. Do not test it or prime it. Once Zurnai has been used, or if the blue cap has been removed and Zurnai was not used right away, it should be replaced with a new one.
You will know a full dose of Zurnai has been given when the viewing window is all orange and fully blocked. If the viewing window is not completely orange after using Zurnai, another dose with a new Zurnai auto-injector should be given.
Always inspect Zurnai before using it. Since Zurnai is only used during emergencies, it is a good idea to inspect Zurnai every month to make sure it is still usable. The liquid inside of Zurnai can be seen through the small viewing window. The liquid should be clear and may range from colorless to light yellow. There may be a few air bubbles in the liquid, which is normal. However, if Zurnai is a different color, cloudy, or contains small particles, do not use it. It should be replaced.
Check the expiration date each month when you inspect Zurnai. Be sure to replace Zurnai with a new one before it expires because you never know when it will be needed.
Zurnai contains a needle and should not be thrown away in the trash. Instead, it should be disposed of in a sharps container. Ask your healthcare provider about how to throw away any used or expired Zurnai.
Zurnai is used to reverse the symptoms of an opioid overdose. Sometimes this can lead to uncomfortable side effects and feelings (withdrawal symptoms). Do not take or use large amounts of opioids to get rid of these uncomfortable side effects and feelings. Doing so could lead to an opioid overdose or even death.
Zurnai may not work as well to reverse overdose or breathing problems caused by some opioid medicines, such as buprenorphine or pentazocine. Repeat doses of Zurnai may be needed to reverse slowed breathing or extreme sleepiness if these medicines are involved in the overdose.
What should I tell my healthcare provider before using Zurnai?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Zurnai is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have heart problems.
Pregnancy. It is not known if or how Zurnai could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. If you are pregnant and have symptoms of an opioid overdose, you should use Zurnai and get emergency help right away.
Breastfeeding. It is not known if Zurnai passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
How can I get more information about Zurnai?
For more information about Zurnai, you can visit the manufacturer’s website at www.zurnai.com or call them at 888-726-7535.
Interactions
Does Zurnai interact with foods or drinks?
There are no known interactions between Zurnai and foods or drinks.
It is unknown if drinking alcohol will affect Zurnai. Drinking alcohol can increase your risk of opioid overdose. The risk of dizziness may also be increased if you drink alcohol while using Zurnai.
Does Zurnai interact with other medicines (drug interactions)?
There are no known interactions between Zurnai and other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Overdose/Missed Dose
What should I do if I accidentally use too much Zurnai?
If you or someone else has used too much Zurnai, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Zurnai?
Zurnai is used during emergencies only. Always get medical help right away after using a dose of Zurnai.