Evidence map›Paper›PMID 41287743›Full record

ArticleCureus2025

Post-marketing Surveillance of Intranasal Nalmefene: Prevalence and Clinical Relevance of Precipitated Withdrawal.

Jordan Paavola, Phil Skolnick, Ann Wheeler, Baher Mankabady, Celine M Laffont, Christian Heidbreder

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jordan PaavolaMedical Affairs and Safety, Indivior, Inc., North Chesterfield, USA.
Phil SkolnickResearch and Development, Indivior, Inc., North Chesterfield, USA.
Ann WheelerMedical Affairs and Safety, Indivior, Inc., North Chesterfield, USA.
Baher MankabadyMedical Affairs and Safety, Indivior, Inc., North Chesterfield, USA.
Celine M LaffontResearch and Development, Indivior, Inc., North Chesterfield, USA.
Christian HeidbrederResearch and Development, Indivior, Inc., North Chesterfield, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntranasal (IN) nalmefene (OPVEE®) was approved as an opioid overdose reversal agent with a pharmacological profile distinct from IN naloxone, raising early concerns about the potential for precipitated withdrawal despite the absence of evidence.

objectiveThis study aimed to evaluate the prevalence and clinical significance of precipitated withdrawal following the administration of IN nalmefene using post-marketing surveillance data.

methodsWe conducted a comprehensive analysis of adverse event reports submitted to Indivior's Global Safety Database following the commercial launch of IN nalmefene in October 2023. Reports were screened for terms consistent with opioid withdrawal syndromes, and cases were assessed for temporal association, severity, and clinical outcomes.

resultsThrough July 2025, there have been 246 confirmed reversals with IN nalmefene across the United States. Among the total adverse event reports received (n=15), instances of precipitated withdrawal were rare (n=2). Most reports lacked sufficient clinical details to confirm causality, and no consistent pattern of severe or treatment-limiting withdrawal emerged. The overall signal strength for precipitated withdrawal was low, with no indication of a disproportionate reporting trend.

conclusionsPost-marketing surveillance data suggest that the risk of precipitated withdrawal with IN nalmefene is low in real-world settings. These findings support the continued deployment of IN nalmefene as a life-saving intervention while underscoring the importance of ongoing pharmacovigilance to monitor for emerging safety signals.

Indexed as

fentanylnalmefeneopioid overdoseprecipitated withdrawalsynthetic opioids

Identifiers

PMID41287743
PMCPMC12640375

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.