Naltrexone: A Clinically Proven Medication to Stop Drinking
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Synonyms | |||
Naltrexone is an FDA-approved medication specifically designed to support the reduction of alcohol consumption in adults with alcohol use disorder (AUD). It functions as an opioid receptor antagonist, effectively modulating the brain’s reward pathways associated with alcohol intake. By diminishing the pleasurable effects of drinking, it helps reduce cravings and supports long-term abstinence goals as part of a comprehensive treatment plan that includes counseling and behavioral therapy.
Features
- Active ingredient: Naltrexone Hydrochloride
- Available in 50 mg oral tablets or extended-release injectable formulations
- Non-addictive and non-habit forming
- Requires prescription and medical supervision
- Compatible with most comprehensive AUD treatment programs
Benefits
- Reduces alcohol cravings by blocking opioid receptors in the brain
- Decreases the rewarding effects of alcohol consumption
- Supports adherence to treatment plans when combined with therapy
- Helps maintain abstinence and prevent relapse
- Improves overall treatment outcomes in alcohol use disorder
- Available in multiple formulations to suit individual patient needs
Common use
Naltrexone is prescribed for adults diagnosed with alcohol use disorder who are committed to reducing or stopping alcohol consumption. It is typically initiated after a period of alcohol detoxification, when the patient has achieved initial abstinence. The medication is most effective when used as part of a comprehensive treatment program that includes behavioral therapy, counseling, and support group participation. Healthcare providers may prescribe naltrexone for both short-term and long-term management of alcohol dependence, depending on individual patient needs and response to treatment.
Dosage and direction
The standard recommended dosage for naltrexone tablets is 50 mg once daily, with or without food. Treatment is typically initiated after the patient has remained alcohol-free for at least 3-7 days. The extended-release injectable formulation is administered as 380 mg intramuscularly every four weeks by a healthcare professional. Dosage adjustments may be necessary for patients with renal impairment. Patients should follow their healthcare provider’s instructions precisely and not adjust dosage without medical consultation. Treatment duration varies based on individual response and should be determined by a qualified medical professional.
Precautions
Patients should inform their healthcare provider about any liver conditions, as naltrexone metabolism involves the liver. Regular liver function tests may be recommended during treatment. Those with depression or other psychiatric conditions should be closely monitored, as naltrexone may potentially exacerbate these conditions. Patients should avoid opioid medications while taking naltrexone, as it will block their effects and may precipitate withdrawal symptoms. Caution is advised when operating machinery or driving until the patient knows how naltrexone affects them. Alcohol consumption while taking naltrexone should be avoided, as it can lead to unexpected reactions and reduced treatment efficacy.
Contraindications
Naltrexone is contraindicated in patients receiving opioid analgesics, those currently dependent on opioids, or those in acute opioid withdrawal. It should not be used by individuals with acute hepatitis or liver failure. Patients with hypersensitivity to naltrexone or any component of the formulation should avoid this medication. Those with failed naloxone challenge test or positive urine screen for opioids are not candidates for naltrexone therapy. The medication is not recommended for individuals with severe renal impairment without careful dose adjustment and monitoring.
Possible side effects
Common side effects may include nausea (occurring in approximately 10% of patients), headache, dizziness, nervousness, fatigue, and insomnia. Some patients may experience vomiting, decreased appetite, joint and muscle pain, or anxiety. Injection site reactions, including tenderness, induration, pain, and bruising, may occur with the extended-release formulation. Rare but serious side effects include hepatotoxicity, depression, suicidal ideation, and severe allergic reactions. Patients should report any persistent or severe side effects to their healthcare provider immediately. Most side effects are mild to moderate and tend to diminish with continued treatment.
Drug interaction
Naltrexone may interact with opioid-containing medications, including cough suppressants and antidiarrheal agents, potentially blocking their therapeutic effects. Concurrent use with hepatotoxic drugs may increase the risk of liver damage. Medications that affect liver enzymes, particularly CYP3A4 inducers or inhibitors, may alter naltrexone concentrations. Caution is advised when combining naltrexone with disulfiram due to potential additive hepatotoxicity. Patients should inform their healthcare provider about all prescription medications, over-the-counter drugs, and herbal supplements they are taking before starting naltrexone therapy.
Missed dose
If a dose of oral naltrexone is missed, patients should take it as soon as they remember, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed one. For the extended-release injection, appointments should be rescheduled as soon as possible if missed. Consistent adherence to the prescribed regimen is important for optimal treatment outcomes, and patients should discuss any pattern of missed doses with their healthcare provider.
Overdose
In case of suspected overdose, medical attention should be sought immediately. Symptoms may include nausea, vomiting, abdominal pain, dizziness, and lethargy. There is no specific antidote for naltrexone overdose; treatment is supportive and symptomatic. Hemodialysis is not expected to enhance elimination of naltrexone significantly due to its extensive tissue distribution. Patients should be monitored for signs of hepatotoxicity, and appropriate supportive measures should be implemented. The extended-release formulation may pose additional challenges in overdose situations due to sustained drug release.
Storage
Naltrexone tablets should be stored at room temperature (15-30°C or 59-86°F) in their original container, protected from light and moisture. The medication should be kept out of reach of children and pets. Unused portions should be properly disposed of according to local regulations. The extended-release injection requires refrigeration between 2-8°C (36-46°F) and should not be frozen. Once reconstituted, the injection must be administered within 24 hours if refrigerated or within 4 hours if kept at room temperature.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Naltrexone should only be used under the supervision of a qualified healthcare professional who can properly diagnose alcohol use disorder and determine appropriate treatment. Individual results may vary, and the medication should be part of a comprehensive treatment program. Patients should not initiate or discontinue naltrexone without medical guidance. Always consult with a healthcare provider for personalized medical advice and to discuss potential risks and benefits based on individual health status.
Reviews
Clinical studies demonstrate that naltrexone significantly improves treatment outcomes for alcohol use disorder when combined with psychosocial support. In randomized controlled trials, naltrexone-treated patients showed significantly higher rates of abstinence and reduced heavy drinking days compared to placebo. Many patients report decreased alcohol cravings and improved ability to maintain treatment goals. Healthcare providers note that patient response varies, with some individuals experiencing dramatic improvements while others show more modest benefits. Long-term follow-up studies indicate that continued treatment adherence correlates with sustained recovery outcomes.