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CompletedNCT05377255Updated Aug 19, 2026

Pharmacokinetics (PK) and Safety of Multiple Doses of Intranasal Naloxone in Healthy Adults

A Phase 1 interventional study of 16 mg naloxone AP003 and 8 mg naloxone NARCAN Nasal Spray in Opioid Overdose, sponsored by Emergent BioSolutions. Completed at 1 site in United States. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Emergent BioSolutions · Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was May 2022, 4 years 6 months ago, and no results have been posted to the registry.
Phase
Phase 1
Study type
Interventional
Enrollment
24
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
All
01

Study summary

This study will be a Phase 1, single-center, open-label, randomized cross-over study to evaluate the PK of a new AP003 device which delivers two sprays of 4 mg naloxone hydrochloride intranasally.

Read the detailed description

Based on the intended AP003 product presentation there will be two devices in each carton allowing for administration of a total of 16 mg. This study is designed for subjects to receive naloxone therapy either through the AP003 device or through the currently approved NARCAN® nasal spray (4 mg) device (per label), reference therapy. After administration of the therapy patients will be followed by a 48-hour washout period before treatment crossover. Key study parameters include safety and PK. Safety evaluations will include but not limited to complete and system directed physical examinations (including signs of nasal irritation such as erythema, edema, and erosion), administration of a Brief Smell Identification Test (B-SIT), assessments of vital signs, 12 lead electrocardiogram (ECG), continuous cardiac telemetry monitoring (CCT) , clinical laboratory tests (e.g., hematology, chemistry, urinalysis, pregnancy test), and evaluation of adverse events.

02

Conditions studied

  • Opioid Overdose

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Keywords

  • NARCAN
  • Opioid Overdose
  • Naloxone
  • Intranasal
03

In context

Opiate Overdose

70 studies on the registry are indexed under Opiate Overdose; 11 are open to participants now.

This study's enrollment of 24 is below the median of 184 across 48 interventional studies indexed under Opiate Overdose.

Browse Opiate Overdose studies →

Lead sponsor

Emergent BioSolutions is the lead sponsor of 47 studies on the registry; 7 are open to participants now.

Of its 11 completed or terminated interventional studies of FDA-regulated products, 7 (64%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Are able to consent and freely provide .
  • Females and males 18-55 years of age, inclusive.
  • Have a (BMI) less than or equal to 34.0 kg/m2.
  • Generally healthy, in the opinion of the Investigator, based on medical history, physical examination, vital signs, screening laboratory assessments and 12-lead evaluation.
  • If female:

    1. Have a negative pregnancy test at Screening (serum pregnancy test) and before dosing at Day -1 (urine pregnancy test)
    2. Female subjects of non- must be:

      • (spontaneous amenorrhea for at least 12 months prior to dosing) with confirmation by documented FSH levels ≥40 mIU/mL; or
      • Surgically sterile (bilateral oophorectomy, bilateral salpingectomy, hysterectomy, or tubal ligation) at least 3 months prior to dosing.
    3. Women of childbearing potential who are not planning to be pregnant during the study period and who are using one of the following effective methods of during the study period and for at least 30 days after last study visit:

      • Simultaneous use of hormonal contraceptive (e.g. oral, patch, depot injection, implant, vaginal ring, intrauterine device) or non- hormonal intrauterine device for at least 4 weeks prior to dosing (must agree to use the same contraceptive throughout the study) and condom for the male partner.
      • Simultaneous use of diaphragm or cervical cap with spermicide and condom for the male partner, started at least 21 days prior to dosing.

Exclusion criteria

Exclusion Criteria:

  • Participants planning to become pregnant during the study or currently breastfeeding.
  • Any acute condition, in the opinion of the Investigator, that is not fully resolved at least 4 weeks prior to baseline.
  • Participant has a deviated septum, previous rhinoplasty, abnormal nasal anatomy, other nasal symptoms (i.e., blocked and/or runny nose), or other nasal surgeries (i.e., polyp removal) within 1 year, or needs to use another nasal spray product during study.
  • Participant with current upper respiratory infection (URI) or has had URI within 7 days prior to screening.
  • Subject has had an episode of epistaxis within 30 days prior screening or has experienced recurrent episodes of epistaxis within 1 year prior to screening.
  • Participant has used any prescription or nonprescription drugs/supplements with increased risk of bleeding within 28 days or 5 half-lives (whichever is longer) or complementary and alternative medicines within 28 days before the first dose of study drug with exception of oral . All other prescription medications, over-the-counter, and natural health products within 14 days or 5 half-lives prior to the first dosing.
  • Participant is currently participating in another clinical study of an drug or has been dosed with any investigational drug within 30 days or 5 half-lives (whichever is longer) of the compound.
  • Had a history of abuse or current misuse of illicit drugs, alcohol, or tobacco:

    1. alcohol abuse (regularly drinks more than 14 units of alcohol per week; 1 unit = 360 mL of beer, 150 mL of wine, or 45 mL of spirit [40% a/v]) or history of alcohol abuse within 6 months prior to Screening
    2. positive for recent alcohol use (by breathalyzer) at Screening or Baseline (Day -1)
    3. a history or evidence of abuse of licit or illicit drug substances or a positive urine drug screen (a urine sample was obtained for testing to determine the presence or absence of Schedule 1 or Schedule 2 typical drugs of abuse or their metabolites, including opioids, amphetamine derivatives, cocaine, and other analytes as needed) or drugs of abuse prior to Screening. History of cannabinoid use within 1 year prior to Screening or any current evidence of abuse.
    4. use of tobacco-containing products or had a history of tobacco use within 1 year prior to the screening visit
    5. use of e-cigarettes and/or nicotine replacement products or had used these products within 1 year prior to the screening visit.
  • Participant who had consumed xanthine containing products (e.g., tea, coffee, cola), caffeine, within 24 hours of check-in. Participants had to refrain from ingesting these throughout the study
  • History of severe allergic reaction or anaphylaxis to any component of the investigational product
  • Participant had a positive test result at Screening for (HIV) 1 or 2 antibody, virus antibodies, or surface antigen
  • Participant was unable or unwilling to undergo venipuncture for blood sample collection because of poor tolerability or unlikely to complete the trial due to poor venous access
  • Participant who had donated plasma or whole blood within 30 days and 60 days, respectively, prior to dosing
  • On standard 12-lead , a interval using the Fredericia formula (QTcF) interval >450 msec for males and females. If a single ECG QTcF is >450, two more ECGs were obtained over a 5-10 min period and the average of the QTcF interval from the 3 ECGs readings were to be used to determine eligibility
  • Planned medical or surgical procedure that could have adversely impact the participant's participation or the conduct of the study
  • Any disease, including serious medical or psychiatric condition and/or abnormality of laboratory parameters and/or any other reason, which in the opinion of the Investigator and/or medical monitor (MM) compromised the safety of the participant or integrity of the study, interfered with the participant participation in the trial, or compromised the trial objectives
  • Participant had a B-SIT score outside of the normative range (10-12) at screening.
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
24 participants (actual)

Study arms

  • Other
    Arm 1 Interventional Therapy

    Subjects will first receive 4 doses of 4 mg each (total: 16 mg) of naloxone through the AP003 device (Arm 1) before the washout period.

    Combination Product: 16 mg naloxone AP003 · Combination Product: 8 mg naloxone NARCAN Nasal Spray

  • Other
    Arm 2 Reference Therapy

    Subjects will first receive 2 doses of 4 mg each (total: 8 mg) of the naloxone through the NARCAN Nasal Spray device (reference therapy, Arm 2) before the washout period.

    Combination Product: 16 mg naloxone AP003 · Combination Product: 8 mg naloxone NARCAN Nasal Spray

Interventions

  • Combination product16 mg naloxone AP003

    4 doses of 4 mg each (total: 16 mg) of naloxone through the AP003 device

  • Combination product8 mg naloxone NARCAN Nasal Spray

    2 doses of 4 mg each (total: 8 mg) of the naloxone through the NARCAN Nasal Spray device

06

What researchers measure

Primary outcomes

  1. Mean naloxone plasma concentration AP003 dosing periods.

    The mean naloxone plasma concentration during the two AP003 dosing periods.

    Time frame: PK samples taken at various timepoints over the course of Pre-dose and post-dose for 12 hours.

  2. Mean naloxone plasma concentration Narcan dosing periods

    The mean naloxone plasma concentration during the two Narcan dosing periods.

    Time frame: PK samples taken at various timepoints over the course of Pre-dose and post-dose for 12 hours.

  3. Incidence of treatment emergent adverse events (TEAEs), serious adverse events (SAE)

    Incidence of treatment emergent adverse events (TEAEs), serious adverse events (SAE) by treatment thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

  4. Incidence of abnormal vital signs

    Incidence of abnormal vital signs (heart rate, blood pressure, and respiration rate) by treatment thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

  5. Incidence of clinically significant ECG

    Incidence of clinically significant ECG by treatment thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

  6. Incidence of clinical laboratory changes

    Incidence of clinical laboratory changes by treatment thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

  7. Incidence of adverse events of special interest (AESI) indicating of nasal irritation

    Incidence of adverse events of special interest (AESI) indicating of nasal irritation (erythema, edema, and erosion) by treatment thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

  8. Incidence of changes in B-SIT assessment

    Incidence of changes in B-SIT assessment within an AP003 period thru End of Study Visit (within 7 days after 2nd dose).

    Time frame: Through end of study visit (within 7 days after second dose)

07

Study locations

1 site
  • Syneos Health Clinical Research Services
    Miami, Florida 33136, United States
08

References and documents

Publications

  • Cassie D, Warnock B, Akhtar F, McCloskey D, Wyatt D. A Phase 1, Open-Label, Randomized Study to Investigate the Pharmacokinetics and Safety of Multiple Doses of Intranasal Naloxone in Healthy Participants. Clin Transl Sci. 2026 Jul;19(7):e70640. doi: 10.1111/cts.70640. PubMed 42332351 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2022 to primary completion in May 2022, 1 month.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 11, 2022
First posted
May 17, 2022
StartActual
Mar 28, 2022
Primary completionActual
May 10, 2022
CompletionActual
May 10, 2022
Last update
Aug 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05377255
Responsible party
Sponsor
First posted
May 17, 2022
Start date
Mar 28, 2022
Primary completion
May 10, 2022
Completion
May 10, 2022
Last update
Aug 19, 2026

Study contacts

Nino Joy, MD
study director · Emergent BioSolutions

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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