Naltrexone: A Clinically Proven Solution for Alcohol Dependence
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Naltrexone is a non-addictive, FDA-approved medication used as part of a comprehensive treatment plan for alcohol use disorder (AUD). It functions as an opioid receptor antagonist, effectively reducing the craving for alcohol and diminishing the pleasurable effects associated with its consumption. When combined with counseling and behavioral therapies, Naltrexone significantly supports long-term sobriety and reduces the risk of relapse. This pharmacotherapeutic agent is a cornerstone in modern addiction medicine, offering a scientifically-backed approach to managing alcohol dependence.
Features
- Active ingredient: Naltrexone Hydrochloride
- Available in 50 mg oral tablets and extended-release injectable formulations
- Opioid receptor antagonist mechanism of action
- Typically prescribed as part of a multimodal treatment plan
- Requires prescription and medical supervision
- Manufactured under strict pharmaceutical quality standards
Benefits
- Reduces alcohol craving by modulating the brain’s reward pathways
- Decreases the euphoric effects of alcohol, reducing reinforcement of drinking behavior
- Supports adherence to abstinence goals when combined with psychosocial interventions
- Non-habit forming with no abuse potential
- Allows patients to focus on behavioral therapy and recovery skills
- Can be used for both initial treatment and maintenance therapy
Common use
Naltrexone is indicated for the management of alcohol dependence in adults who have achieved initial abstinence and are committed to maintaining sobriety. It is typically prescribed after a comprehensive medical and psychiatric evaluation confirms the diagnosis of alcohol use disorder. The medication is most effective when integrated with concurrent psychosocial support, such as cognitive behavioral therapy, motivational enhancement therapy, or participation in support groups. Treatment is usually initiated after the patient has completed alcohol detoxification and is no longer experiencing withdrawal symptoms.
Dosage and direction
The recommended dosage for oral Naltrexone is 50 mg once daily, though some protocols may utilize 100 mg every other day or 150 mg every third day. The extended-release injectable formulation is administered as 380 mg intramuscularly every four weeks. Treatment should be initiated under medical supervision after the patient has been opioid-free for at least 7-10 days. Patients should be advised to take the medication exactly as prescribed, with or without food, and at approximately the same time each day to maintain consistent blood levels. Treatment duration is individualized based on patient response and typically continues for 3-6 months or longer depending on clinical progress.
Precautions
Patients should be thoroughly evaluated for current opioid use or dependence before initiation, as Naltrexone will precipitate withdrawal in opioid-dependent individuals. Liver function tests should be performed at baseline and monitored periodically during treatment, as Naltrexone metabolism may affect hepatic enzymes. Use with caution in patients with renal impairment or acute hepatitis. Patients should carry medical identification indicating they are taking Naltrexone, as it will block the effects of opioid analgesics in emergency situations. Alcohol consumption should be avoided during treatment, though the medication reduces the reinforcing effects rather than causing a disulfiram-like reaction.
Contraindications
Naltrexone is contraindicated in patients receiving opioid analgesics, those with current physiologic opioid dependence, or those in acute opioid withdrawal. It should not be used in patients who have failed the naloxone challenge test or have a positive urine screen for opioids. Additional contraindications include acute hepatitis or liver failure, and hypersensitivity to Naltrexone or any component of the formulation. The medication is not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min).
Possible side effects
The most commonly reported adverse reactions include nausea (10%), headache (7%), dizziness (4%), nervousness (4%), fatigue (4%), insomnia (3%), and anxiety (2%). Less frequent side effects may include vomiting, decreased appetite, joint and muscle pain, rash, and somnolence. Injection site reactions (including pain, tenderness, induration, swelling, erythema, bruising, or pruritus) are common with the extended-release formulation. Hepatotoxicity has been reported at doses exceeding recommended levels. Most side effects are mild to moderate and tend to diminish with continued treatment.
Drug interaction
Naltrexone may diminish the efficacy of opioid-containing medications, including cough preparations and antidiarrheal agents. Concurrent use with hepatotoxic drugs may increase the risk of liver injury. caution is advised when co-administering with drugs that affect hepatic metabolism. Naltrexone may potentially interact with thioridazine and yohimbine. Patients should inform all healthcare providers about their Naltrexone therapy before receiving any new medications.
Missed dose
If a dose is missed, it should be taken as soon as remembered 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, if a scheduled injection is missed, the healthcare provider should be contacted to reschedule administration as soon as possible.
Overdose
In the event of overdose, supportive treatment should be initiated with attention to the possibility of naloxone-resistant opioid overdose if opioids are co-ingested. There is no specific antidote for Naltrexone overdose. Management should focus on symptomatic and supportive care, including monitoring of vital signs and hepatic function. Hemodialysis is not expected to enhance elimination of Naltrexone due to its extensive tissue distribution and protein binding.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container, tightly closed, and protect from moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. The extended-release suspension should be administered immediately after mixing.
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 plan that includes psychosocial support. Patients should discuss all potential risks and benefits with their healthcare provider before beginning treatment.
Reviews
Clinical studies demonstrate that Naltrexone reduces heavy drinking days by approximately 25-30% compared to placebo when used as directed. In a 12-week multicenter trial published in the Archives of General Psychiatry, patients receiving Naltrexone had significantly fewer drinking days (25.8% vs 37.8%) and lower relapse rates (23% vs 54%) compared to placebo. Meta-analyses confirm its efficacy particularly in patients with high craving levels. Many addiction specialists report improved treatment outcomes when Naltrexone is combined with comprehensive behavioral therapy, noting particularly good results in motivated patients who actively participate in their recovery program.