Increasing Awareness of Naloxone-Induced Noncardiogenic Pulmonary and Peripheral Edema

Abstract Introduction Naloxone use has increased in recent years response to the nation’s opioid crisis. Once only available health care professionals, it is now obtainable by prescription for persons at risk substance overdose and their families. Increasing its availability seen some as an “over-the-counter solution” problem. However, while naloxone been viewed relatively safe, with a low side effect profile when appropriately dosed monitored, not without safety concerns that may go unrecognized or misattributed other causes. Methods Here we present case study of 41-year-old female who presented our medication-assisted treatment (MAT) clinic complaining sudden onset weight gain, shortness breath, upper lower extremity peripheral edema, tachycardia, insomnia, nocturnal enuresis. These symptoms made difficult her work housekeeping job, resulting missed workdays. She had primary provider prescribed rescue inhaler breath. This patient previously treated disorder buprenorphine/naloxone experienced similar symptoms, which disappeared she relapsed on opioids. reappeared upon resuming treatment. Results The was identified experiencing effects naloxone, causing noncardiogenic edema. Her MAT medication switched buprenorphine. Within two weeks heart rate returned normal, lost weight, no longer enuresis needed inhaler. edema resolved so able walk better resume work. At same time, buprenorphine continued relieve cravings. There dearth information related naloxone-induced Our received formal evaluation pulmonary but cardiac were consistent diagnosis. Although mentioned product literature, not. A literature search indicates number studies have since 2018, one discovered. Conclusions/Importance used variety settings differing types providers. As increases, there will likely be corresponding increase incidences and/or effects. Providers patients are aware these manifestations relationship easily attribute presenting cardiogenic causes, this illustrates. It important providers all consider new breath within context person’s whole implications mental well physical health. Funding No