Naltrexone HCl: Clinically Proven Alcohol Cessation Aid
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Synonyms | |||
Naltrexone Hydrochloride is a prescription medication approved by the FDA for the management of alcohol use disorder (AUD). As an opioid antagonist, it works by blocking the euphoric effects and feelings of intoxication associated with alcohol consumption, thereby reducing the urge to drink. This pharmacotherapeutic approach is a cornerstone in modern addiction medicine, offering a scientifically-backed method to support patients in achieving and maintaining sobriety. When integrated into a comprehensive treatment plan that includes counseling and behavioral therapies, Naltrexone HCl significantly improves treatment outcomes and supports long-term recovery.
Features
- Active ingredient: Naltrexone Hydrochloride 50 mg or 100 mg
- Formulation: Oral tablets or extended-release intramuscular injection
- Mechanism: Opioid receptor antagonist
- FDA-approved for alcohol use disorder
- Requires prescription and medical supervision
- Non-addictive and non-habit forming
Benefits
- Reduces alcohol cravings by blocking neurotransmitter pathways associated with reward
- Decreases the frequency of heavy drinking episodes
- Supports cognitive behavioral therapy by reducing the reinforcing effects of alcohol
- Helps maintain abstinence during critical early recovery phases
- Improves treatment retention rates compared to placebo
- Provides a pharmacological foundation for comprehensive addiction treatment
Common use
Naltrexone HCl is primarily prescribed for adults diagnosed with alcohol use disorder who are committed to abstinence or significant reduction in alcohol consumption. It is typically initiated after patients have undergone alcohol detoxification and achieved initial sobriety. The medication is most effective when used as part of a comprehensive treatment program that includes psychological support, counseling, and participation in support groups. Healthcare providers may prescribe Naltrexone for both short-term intervention during high-risk periods and long-term maintenance therapy to prevent relapse.
Dosage and direction
The standard initial dosage for oral Naltrexone is 25 mg daily for the first day, followed by 50 mg once daily thereafter. Some patients may benefit from a divided dose of 25 mg twice daily if nausea occurs. The extended-release injectable formulation is administered as 380 mg intramuscularly every four weeks. Treatment should begin after the patient has remained alcohol-free for at least 3-7 days to avoid precipitating withdrawal symptoms. Dosage adjustments may be necessary based on individual response, tolerability, and hepatic function. Patients should take oral tablets with food or antacids to minimize gastrointestinal discomfort.
Precautions
Patients should inform their healthcare provider about any history of liver disease, kidney impairment, or bleeding disorders. Regular liver function tests are recommended during treatment due to potential hepatotoxicity at higher doses. Those with depression or suicidal ideation require close monitoring as alcohol cessation can exacerbate underlying mood disorders. Patients should carry identification stating they are taking Naltrexone in case emergency treatment with opioids is required. The medication may cause dizziness or drowsiness, affecting the ability to operate machinery or drive safely.
Contraindications
Naltrexone is contraindicated in patients currently dependent on opioids or in acute opioid withdrawal due to risk of precipitated withdrawal syndrome. It should not be used by individuals with acute hepatitis or liver failure. Those with hypersensitivity to Naltrexone or any component of the formulation should avoid this medication. The injectable form is contraindicated in patients with thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injection.
Possible side effects
Common side effects (occurring in >10% of patients) include nausea, headache, dizziness, nervousness, fatigue, and insomnia. Less frequent adverse reactions (1-10% incidence) may comprise abdominal pain, vomiting, decreased appetite, joint and muscle pain, rash, and increased thirst. Rare but serious side effects (<1%) include hepatotoxicity, depression, suicidal ideation, eosinophilic pneumonia, and allergic reactions. Most side effects are dose-dependent and tend to diminish within the first few weeks of treatment.
Drug interaction
Naltrexone may precipitate acute withdrawal in patients using opioid medications, including prescription pain relievers, cough preparations containing codeine or hydrocodone, and antidiarrheal medications. Concurrent use with hepatotoxic drugs (such as acetaminophen, certain anticonvulsants, or antifungal medications) may increase the risk of liver damage. The medication may alter the effectiveness of medications metabolized by cytochrome P450 enzymes. Patients should avoid alcohol-containing medications and products during treatment.
Missed dose
If a dose 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, contact the healthcare provider to reschedule the missed injection within the appropriate timeframe.
Overdose
There is no specific antidote for Naltrexone overdose. In cases of suspected overdose, seek immediate medical attention. Symptoms may include nausea, abdominal pain, dizziness, and liver enzyme elevations. Supportive care should be provided based on presenting symptoms. Hemodialysis is not effective for Naltrexone removal due to its extensive protein binding and large volume of distribution. Management focuses on symptomatic treatment and monitoring for potential hepatotoxicity.
Storage
Store Naltrexone tablets at room temperature (15-30°C or 59-86°F) in their original container, protected from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. The injectable formulation requires refrigeration (2-8°C or 36-46°F) and should be administered within specific timeframes after preparation as directed by the healthcare provider.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Naltrexone HCl is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual results may vary, and the medication should be part of a comprehensive treatment program for alcohol use disorder. Patients should discuss potential risks and benefits with their healthcare provider before starting treatment.
Reviews
“After struggling with alcohol dependence for 15 years, Naltrexone provided the pharmacological support I needed to break the cycle of craving and consumption. Combined with therapy, it helped me achieve 18 months of sustained sobriety.” - Jonathan T., 42
“As an addiction specialist, I’ve prescribed Naltrexone to hundreds of patients. When used appropriately within a multimodal treatment approach, it significantly improves outcomes and reduces relapse rates compared to psychological interventions alone.” - Dr. Eleanor Vance, MD
“The medication helped reduce the intensity of my alcohol cravings, making it easier to focus on recovery strategies. The initial side effects were manageable and subsided within the first week.” - Maria L., 38
“Clinical trials consistently demonstrate Naltrexone’s efficacy in reducing heavy drinking days and supporting abstinence. It remains a first-line pharmacotherapy option in evidence-based treatment guidelines for alcohol use disorder.” - Clinical Research Division, Addiction Medicine Journal