A new medication to reverse drug overdoses is rolling out to pharmacies in the state, the latest step in the struggle against opioids and other addictive drugs.

The drug, called nalmefene, was approved by the Food and Drug Administration for use as a nasal spray last year. New Hampshire Department of Health and Human Services has issued a standing order to all pharmacies across the state to dispense nalmefene to people without the need of a prescription.

“It has a longer half-life than naxolone, a greater affinity to opioid mu receptor, which means it can displace a more potent opioid. That means it potentially could require less redosing than naxolone when a person has an opioid overdose with high-potency drug like fentanyl,” said DHHS Chief Medical Officer Jonathan Ballard. It also stays in the body longer than naxolone, the drug used in Narcan.

However, Ballard cautioned that nalmefene is so new that it’s not clear how it will compare to Narcan when used in the field.

“There are no head-to-head studies that indicates one is better than the other,” he said.  “We haven’t seen much real-world data yet to understand fully whether one medication might be preferable to another.”

Regardless of which is preferable, he said, it provides another tool in the fight against addiction and overdoses.

Under the brand name Opvee, nalmefene has a retail price of $90 for two sprayers, and is covered by Medicaid and many private insurance programs. For the time being it will be available to individuals in pharmacies and not through programs such as the Doorways, the state’s system for people seeking help with substance use disorders, although Ballard said the state is examining the possibility of providing such access. 

New Hampshire also has a standing order for naloxone, making it available from pharmacies without a prescription.

Over the past year, the state says it has invested close to $3 million in State Opioid Response funds to increase public access to naloxone to prevent opioid overdose deaths. In 2023, New Hampshire became the first state in the nation to launch statewide placement of NaloxBoxes, which provide public access to Narcan.