Related Guidance:

Poisoning and toxicity: resources to support answering questions (SPS)

Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Anaesthetics, LocalTetracaine as Ametop®4% gel: £1.08 (1.5g)First line.
Lidocaine5% ointment: £10.50 (15g)Second line.
Lidocaine with prilocaine as Emla®2.5% and 2.5% cream: £2.25 (5g), £12.30 (30g)Third line.
Opioid receptor antagonistNaloxone400mcg/ml solution for injection ampoule: £41.23 (10)

Acute opioid overdose–high-dose regimen [when rapid titration with naloxone is necessary to reverse potentially life-threatening effects]

Initially 400 micrograms, then 800 micrograms for up to 2 doses at 1 minute intervals if no response to preceding dose, then increased to 2 mg for 1 dose if still no response (4 mg dose may be required in seriously poisoned patients), then review diagnosis; further doses may be required if respiratory function deteriorates following initial response, intravenous administration has more rapid onset of action, doses may be given by intramuscular route but only if intravenous route is not feasible.
2mg/2ml solution for injection pre-filled syringe: £18.00 (1)