Nalmefene

Nalmefene (Revex) is a long-acting injectable pure opioid antagonist recently introduced in the United States. It binds all opioid receptors and reverses the effects of opioid agonists at those receptors. The onset of action is

2 minutes after IV administration. Hepatic metabolism is slow and occurs via glucuronide conjugation to inactive metabolites. Its half-life of 11 hours is about 5 times that of naloxone. Indications include use in postoperative settings to reverse respiratory depression and in opioid overdose. Due to the long duration of action of nalmefene, however, naloxone may be preferred for treatment of overdose because it produces a shorter duration of withdrawal effects.

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