Pediatric Narcan dosage: which option is correct?

• A. 0.1 mg/kg IM (not to exceed 0.4 mg/dose)
• B. 0.2 mg/kg IM
• C. 2 mg IN
• D. 0.5 mg IV

Answer: (A)

Pediatric naloxone dosing uses weight-based dosing to safely reverse opioid effects in a child. The recommended starting dose is 0.1 mg/kg given by intramuscular injection, with a maximum single dose of 0.4 mg. This approach provides effective reversal while minimizing the risk of overdosing a small child and reduces the chance of precipitating withdrawal or agitation. If there’s incomplete response, the same dose can be repeated every 2–3 minutes per protocol, up to the maximum per dose, and additional dosing may be required depending on clinical status and the opioid involved. Remember that naloxone acts quickly but has a shorter half-life than many opioids, so re-narcotization is possible and ongoing monitoring, airway support, and readiness for repeat dosing are essential. Other routes or fixed higher doses do not align with the standard pediatric weight-based starting approach.