Can't Find Naloxone? Here Are Your Alternatives

Naloxone is the gold standard for reversing opioid overdoses. But what happens when you can't find it? Maybe your pharmacy is out of stock, your usual formulation is unavailable, or you need something different for your situation.

The good news is that there are alternatives. In this guide, we'll explain what Naloxone is, how it works, and walk you through the real alternatives available in 2026.

What Is Naloxone?

Naloxone is an opioid antagonist — a medication designed to rapidly reverse the effects of opioid overdose. It's used in emergencies when someone has taken too much of an opioid drug (like Fentanyl, Heroin, Oxycodone, or Morphine) and is experiencing life-threatening symptoms, especially slowed or stopped breathing.

Brand names include Narcan, Kloxxado, RiVive, and Zimhi. The most common version — Narcan 4 mg nasal spray — has been available over the counter since 2023.

For a detailed overview, see our post on what is Naloxone: uses, dosage, and what you need to know.

How Does Naloxone Work?

Naloxone works by competing with opioids for the same receptors in the brain — specifically the mu-opioid receptors. When someone overdoses, opioids flood these receptors and suppress breathing. Naloxone rushes in, kicks the opioids off those receptors, and restores normal breathing — usually within 2-5 minutes.

The key limitation of Naloxone is its short duration of action — typically 30 to 90 minutes. This means the opioid's effects can return after Naloxone wears off, which is why calling 911 is always necessary even after administering Naloxone.

Learn more in our detailed guide: how does Naloxone work: mechanism of action explained.

Alternatives to Naloxone

1. Nalmefene (Opvee) — Longer-Acting Opioid Reversal

Nalmefene, sold under the brand name Opvee, is an opioid antagonist nasal spray approved by the FDA in 2023. It works similarly to Naloxone but has one major advantage: a much longer duration of action.

Key facts about Nalmefene (Opvee):

• How it works: Same mechanism as Naloxone — blocks opioid receptors to reverse overdose
• Duration: Up to 8 hours (compared to 30-90 minutes for Naloxone)
• Administration: Nasal spray, similar to Narcan
• Advantage: Less likely to need a second dose, especially useful against long-acting opioids like Fentanyl
• Availability: Prescription required; available at many pharmacies
• Cost: Approximately $60-$100 per dose

Nalmefene is a particularly good option when dealing with synthetic opioid overdoses involving Fentanyl, which can outlast the effects of standard Naloxone.

2. Kloxxado — Higher-Dose Naloxone Nasal Spray

If standard Narcan (4 mg) isn't cutting it — especially in Fentanyl-related overdoses — Kloxxado offers a higher 8 mg dose of Naloxone in a nasal spray.

Key facts about Kloxxado:

• Dose: 8 mg Naloxone per spray (double the standard Narcan dose)
• Why it exists: Designed specifically for the era of high-potency synthetic opioids
• Administration: Same as Narcan — spray into one nostril
• Prescription: Required (not available OTC)
• Cost: $75-$120 per kit without insurance

Kloxxado isn't technically a "different" drug — it's still Naloxone — but its higher dose makes it a practical alternative when standard doses may not be enough.

3. Zimhi — High-Dose Naloxone Auto-Injector

Zimhi delivers 5 mg of Naloxone via an intramuscular auto-injector, similar in design to an EpiPen. It's designed for use by non-medical people in community settings.

Key facts about Zimhi:

• Dose: 5 mg Naloxone intramuscular injection
• Administration: Auto-injector into the outer thigh (can be given through clothing)
• Advantage: Higher dose than standard injection; easy to use without training
• Prescription: Required
• Cost: $300-$500 without insurance; often covered by insurance plans

Zimhi is a good option for people who prefer an injectable over a nasal spray, or when nasal administration isn't practical (e.g., the person has significant nasal congestion or facial trauma).

4. Naltrexone — For Ongoing Opioid Use Disorder Treatment

Naltrexone is another opioid antagonist, but it serves a different purpose than Naloxone. Rather than reversing an acute overdose, Naltrexone is used for long-term maintenance treatment of opioid use disorder (OUD) and alcohol dependence.

Key facts about Naltrexone:

• Forms: Oral tablets (ReVia) or monthly injection (Vivitrol)
• Purpose: Prevents the euphoric effects of opioids, reducing cravings and relapse risk
• Not for emergencies: Naltrexone does NOT reverse an active overdose
• Prescription: Required
• Cost: Oral generic: $30-$60/month; Vivitrol injection: $1,500-$2,000/month (often covered by insurance)

Important: Naltrexone is not a substitute for Naloxone in an emergency. If someone is overdosing, you need Naloxone (or Nalmefene), not Naltrexone. However, if you're looking for ongoing treatment for opioid use disorder, Naltrexone may be part of the conversation with your doctor.

Quick Comparison Table

Here's how these options compare:

• Narcan (Naloxone 4 mg nasal spray): OTC, $35-$50, lasts 30-90 min
• RiVive (Naloxone 3 mg nasal spray): OTC, lower cost, lasts 30-90 min
• Kloxxado (Naloxone 8 mg nasal spray): Rx, $75-$120, lasts 30-90 min, higher dose
• Zimhi (Naloxone 5 mg auto-injector): Rx, $300-$500, lasts 30-90 min, injectable
• Opvee (Nalmefene nasal spray): Rx, $60-$100, lasts up to 8 hours
• Naltrexone: Rx, $30-$2,000/month, for long-term OUD treatment only

How to Decide Which Option Is Right for You

For most people, OTC Narcan or RiVive is the best first choice — it's accessible, affordable, and easy to use. If you're concerned about Fentanyl exposure, ask your doctor about Kloxxado or Opvee (Nalmefene) for their higher dose or longer duration.

If you can't find any Naloxone products in your area, use Medfinder to check real-time pharmacy stock, or read our guide on how to find Naloxone in stock near you.

Final Thoughts

While Naloxone (especially Narcan) remains the most widely available and recommended option for opioid overdose reversal, it's reassuring to know that alternatives exist. Whether it's a higher-dose Naloxone product, a longer-acting agent like Nalmefene, or a different formulation entirely, you have options.

The most important thing is to have something on hand. Any of these medications is better than none when an overdose occurs. Talk to your pharmacist or doctor about which option makes the most sense for your situation, and use Medfinder to locate it near you.