Over-the-counter (OTC) naloxone nasal spray
FAQ for Washington State organizations that distribute or prescribe naloxone
Updated September 4, 2024
Background
Naloxone is now available over-the-counter at many local pharmacies and other places that sell OTC medications. The price is about $45. Anyone can purchase this medication without a prescription.
On March 29, 2023, the US Food and Drug Administration approved the first over-the-counter (OTC) naloxone nasal spray product, NARCAN Nasal Spray, manufactured by Emergent Biosolutions.
On July 28, 2023, the FDA approved a second OTC naloxone nasal spray, called RiVive produced by Harm Reduction Therapeutics, a non-profit company. This product is available to organizations that distribute naloxone, and not to individuals.
Responses to the questions below come from staff at the WA Dept of Health (DOH) and the WA Health Care Authority (HCA). For additional questions please contact:
DOH: The OEND Program will continue. Depending on price of the OTC product(s), we may offer different manufacturer products than are currently available. Our goal is to distribute the least expensive versions of naloxone (both nasal and intramuscular) to maximize our resources and get the greatest number of naloxone kits out to the community.
DOH: DOH will update the WA Statewide Standing Order, as needed, to include the OTC products. While people will not need the standing order to purchase OTC naloxone products, people will be able to use the standing order (which functions like a prescription) to obtain health insurance coverage for the medication. (Note: insurance coverage for naloxone varies, so ask your health insurance provider about what is covered and potential co-pays).
HCA: Yes, Apple Health (WA Medicaid) pays for OTC naloxone. Though a prescription will still be needed to bill Apple Health for naloxone, the Statewide Standing Order for naloxone remains in effect and can be used as that prescription. More details from HCA will be released soon.
No. The only over-the-counter naloxone products are nasal sprays.
You can purchase over-the-counter naloxone in the same places you buy things like ibuprofen and common cold medicines, such as drug store shelves, grocery stores, gas stations, and convenience stores.
The price for Narcan Nasal Spray is be about $45.
HCA: OTC nasal naloxone will not affect SB 5195; the requirements to dispense and bill for take-home naloxone will remain.