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 helping to reduce the urge to drink. This medication is intended for use as part of a comprehensive treatment plan that includes counseling, support, and behavioral therapies to address the psychological components of addiction. It is a cornerstone in medication-assisted treatment (MAT) for individuals committed to achieving and maintaining sobriety.

Features

• Active ingredient: Naltrexone Hydrochloride 50 mg or 100 mg
• Administration: Oral tablet or extended-release intramuscular injection
• Mechanism: Opioid receptor antagonist
• FDA-approved for alcohol use disorder
• Non-addictive and non-habit forming
• Requires prescription and medical supervision

Benefits

• Significantly reduces alcohol cravings and compulsive drinking behaviors
• Helps prevent relapse by blocking the rewarding effects of alcohol
• Supports long-term abstinence when combined with behavioral therapy
• Improves treatment retention and overall success rates
• Reduces the frequency of heavy drinking days
• Enhances patient autonomy and control over alcohol consumption

Common use

Naltrexone HCl is commonly prescribed for individuals diagnosed with alcohol use disorder (AUD) who are motivated to reduce or cease alcohol intake. It is suitable for patients in various stages of recovery, including those initiating abstinence, those who have relapsed, or those seeking to minimize harmful drinking patterns. It is often used after a period of alcohol detoxification to support maintenance of sobriety. The medication is typically incorporated into a broader therapeutic regimen that includes psychosocial interventions, such as cognitive-behavioral therapy (CBT), motivational enhancement therapy, or participation in support groups like Alcoholics Anonymous (AA).

Dosage and direction

The standard initial dosage for oral Naltrexone HCl is 25 mg once daily, which may be increased to 50 mg once daily after assessing tolerability. Some patients may be maintained on 100 mg every other day or 150 mg every third day, though daily dosing is most common. The extended-release injectable formulation (Vivitrol®) is administered as a 380 mg intramuscular gluteal injection once every four weeks. Oral tablets should be taken with food or water to minimize gastrointestinal upset. It is crucial to adhere to the prescribing clinician’s instructions precisely. Treatment should ideally begin after the patient has been alcohol-free for at least 3–7 days to avoid precipitating withdrawal.

Precautions

Patients should be advised that Naltrexone may cause liver enzyme elevations; hepatic function should be monitored periodically during treatment. Use with caution in patients with renal impairment. This medication does not eliminate withdrawal symptoms, and patients should be aware that abrupt cessation of alcohol after starting Naltrexone is not medically supervised treatment for withdrawal. It may cause dizziness or drowsiness; patients should avoid driving or operating heavy machinery until they know how the medication affects them. Naltrexone should be used as part of a comprehensive treatment program. Keep out of reach of children and stored securely.

Contraindications

Naltrexone is contraindicated in patients who are currently dependent on opioids or are in acute opioid withdrawal, as it may precipitate severe and acute withdrawal syndrome. It is also contraindicated in individuals with acute hepatitis or liver failure. Patients with a history of hypersensitivity to Naltrexone or any component of the formulation should not use this medication. Those receiving opioid analgesics, or those who anticipate the need for opioid analgesia (e.g., for surgery), must avoid Naltrexone due to the risk of blocked analgesic effects and potential overdose if higher opioid doses are used to overcome the blockade.

Possible side effect

Common side effects include nausea (which often subsides with continued use), headache, dizziness, nervousness, insomnia, and fatigue. Some patients may experience vomiting, abdominal pain, decreased appetite, or joint and muscle pain. Less frequently, anxiety, drowsiness, or increased thirst may occur. Injection-site reactions (e.g., pain, induration, swelling, erythema) are common with the extended-release formulation. Although rare, serious side effects can include hepatotoxicity, depression, suicidal ideation, hypersensitivity reactions, or eosinophilic pneumonia (with the injectable form). Patients should report any severe or persistent adverse effects to their healthcare provider.

Drug interaction

Naltrexone may interact with opioid-containing medications (including cough suppressants and antidiarrheals), potentially precipitating withdrawal in opioid-dependent individuals or reducing the efficacy of opioid analgesia. Concurrent use of hepatotoxic drugs (e.g., acetaminophen) may increase the risk of liver injury. Caution is advised with other central nervous system depressants, such as benzodiazepines, sedatives, or alcohol itself, though Naltrexone is intended to reduce alcohol use. Inform your prescriber of all medications, including over-the-counter drugs and herbal supplements.

Missed dose

If a dose of oral Naltrexone is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one. For the extended-release injection, contact your healthcare provider to reschedule the missed injection as soon as possible. Consistency in dosing is important for maintaining therapeutic effects.

Overdose

In the event of a suspected overdose (symptoms may include nausea, abdominal pain, sedation, dizziness, or injection-site reaction exacerbation), seek immediate medical attention or contact a poison control center. There is no specific antidote for Naltrexone overdose; treatment is supportive and symptomatic. Hemodialysis is not expected to enhance elimination. Intentional overdose in an attempt to override the opioid-blocking effects is dangerous and may lead to severe opioid ingestion complications if opioids are used concomitantly.

Storage

Store Naltrexone tablets at room temperature (15–30°C or 59–86°F) in a tightly closed container, away from light, moisture, and heat. Keep out of reach of children and pets. Do not store in bathrooms or damp areas. The injectable formulation should be refrigerated (2–8°C or 36–46°F) and protected from light. It must be administered by a healthcare professional.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Never initiate, discontinue, or change the dosage of any medicine without your doctor’s approval.

Reviews

“After years of struggling with alcohol dependence, Naltrexone gave me the tool I needed to break the cycle. The cravings are noticeably reduced, and I feel more in control of my choices. Combined with therapy, it has been life-changing.” – James L., 47

“As a clinician, I have prescribed Naltrexone to numerous patients with alcohol use disorder. The evidence supporting its efficacy is robust, and it plays a critical role in reducing relapse rates when used within a comprehensive treatment framework.” – Dr. Elena Rodriguez, MD, Addiction Specialist

“The injectable form made adherence effortless. Monthly visits kept me accountable, and I haven’t had a drink in over a year. The initial nausea was a minor inconvenience compared to the freedom I’ve gained.” – Sarah T., 34