Opvee, a recently approved nasal spray for opioid overdose reversal, offers a faster and longer-lasting alternative to Narcan, but experts warn its focus on synthetic opioids like fentanyl and outdated data could mask potential drawbacks.
Approved in 2023, Opvee works similarly to Narcan by blocking opioid receptors. However, it boasts a six-hour duration compared to Narcan’s one-hour effect.
“There’s already an opioid receptor antagonist on the market, naloxone,” said Chris Edwards, an assistant professor at the University of Arizona College of Pharmacy. Naloxone has been the gold standard since the 1970s for this indication.”
But Opvee was studied in the 1990s and was approved with the original data, sparking concerns.
“Opvee was originally studied in the ’90s which was the same data that they used to get it approved this time around but heroin was the predominant opioid that was being used recreationally,” Edwards said.
And now different drugs are being seen in opioid overdoses.
“When you look at stats from Pima County, specifically looking at opioid-related overdoses, about 75% of patients who have had an opioid overdose have fentanyl in their system, said Edwards.
The original study involved injections, whereas Opvee is a nasal spray.
Edwards said, It was originally approved in 1995 as an injectable formulation, and all of the data that they used to get it all the data that they used for the most recent FDA submission.
Another concern is the extended duration of action, which could worsen withdrawal symptoms.
“And the concern with Opvee or Namaphine is with a longer duration of action, that means that youre going to potentially prolong that precipitated withdrawal, which means more discomfort for that patient,” Edwards said.
Despite these concerns, Edwards emphasizes the importance of having at least one form of opioid receptor antagonist readily available in homes where opioids are being prescribed, whether it’s Narcan or Opvee.