Naltrexone

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Generic Name: Naltrexone Brand Name(s): Generics only. No brands available.

Uses

What is naltrexone used for?

Naltrexone blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse. An opioid is sometimes called a narcotic. Naltrexone is used as part of a treatment program for drug or alcohol dependence.

Naltrexone is used to prevent relapse in people who became dependent on opioid medicine and then stopped using it. Naltrexone can help keep you from feeling a “need” to use the opioid.

Naltrexone is also used to treat alcoholism by reducing your urge to drink alcohol. This may help you drink less or stop drinking completely. Naltrexone will not cause you to “sober up” and will not decrease the effects of alcohol you recently consumed.

Naltrexone is not a cure for drug addiction or alcoholism.

Naltrexone may also be used for purposes not listed in this medication guide.

How should I take naltrexone?

Take this medication by mouth with or without food, usually 50 milligrams once daily or as directed by your doctor. This medication may be given as part of a program where a health care professional will watch you take the medication. In this case, your doctor may order a higher dose (100-150 milligrams) to be taken every 2-3 days to make it easier to schedule clinic visits. Naltrexone may be taken with food or antacids if stomach upset occurs.

A urine test should be done to check for recent opiate drug use. Your doctor may give you another medication (naloxone challenge test) to check for opiate use. Do not use any opiates for at least 7 days before starting naltrexone. You may need to stop certain opiate drugs (such as methadone) 10 to 14 days before starting naltrexone.

Dosage is based on your medical condition and response to treatment. Your doctor may start you at a lower dose and monitor you for any side effects or withdrawal symptoms before increasing your dose. Take this medication as directed. Do not increase your dose, take it more often, or stop taking it without your doctor’s approval.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Tell your doctor if you start using drugs or alcohol again.

How do I store naltrexone?

Naltrexone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store naltrexone in the bathroom or the freezer. There may be different brands of naltrexone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush naltrexone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using naltrexone?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of naltrexone or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not use naltrexone if:

  • You are having withdrawal symptoms from drug or alcohol addiction.
  • You have used any opioid medicine within the past 10 days (including fentanyl, Vicodin, OxyContin, and many others).
  • You have used methadone or buprenorphine (Subutex, Butrans, Suboxone, Zubsolv) in the past 14 days.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using naltrexone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking naltrexone. Naltrexone is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from naltrexone?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Using opioid medicine while you are taking naltrexone could stimulate opioid withdrawal symptoms. Common withdrawal symptoms are yawning, irritability, sweating, fever, chills, shaking, vomiting, diarrhea, watery eyes, runny nose, goose bumps, body aches, trouble sleeping, and feeling restless.

Call your doctor at once if you have:

  • Severe nausea, vomiting, or diarrhea
  • Mood changes, confusion, hallucinations (seeing or hearing things)
  • Depression, thoughts about suicide or hurting yourself
  • Liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)

Common side effects may include:

  • Nausea, vomiting, stomach pain
  • Headache, dizziness, drowsiness
  • Anxious or nervous
  • Sleep problems (insomnia)
  • Muscle or joint aches

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with naltrexone?

Naltrexone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with naltrexone?

Naltrexone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with naltrexone?

Naltrexone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Kidney disease
  • Liver disease
  • A bleeding or blood-clotting disorder such as hemophilia

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using naltrexone.

What is the dose of naltrexone for an adult?

Usual Adult Dose for Alcohol Dependence

Oral Tablets: 50 mg orally once a day.

Extended-release injectable suspension: 380 mg every 4 weeks (or once a month) via intramuscular gluteal injection, alternating buttocks.

Usual Adult Dose for Opiate Dependence

Treatment should not be attempted unless the patient has remained free of opioids for at least 7 to 10 days. Opioid abstinence should be verified by analysis of urine for absence of opioids. The patient should not be manifesting withdrawal signs or reporting withdrawal symptoms.

If there is any question of occult opioid dependence, perform a naloxone challenge test and do not initiate naltrexone therapy until the naloxone challenge is negative. The naloxone challenge test should not be performed in a patient showing clinical signs or symptoms of opioid withdrawal, or whose urine contains opioids. The naloxone challenge can be repeated in 24 hours.

Initial dose: 25 mg orally one time.

Maintenance dose: If no withdrawal signs occur, 50 mg orally once a day may be started.

Alternative dose schedules: (to improve compliance) 50 mg orally on week days and 100 mg orally on Saturday; or 100 mg orally every other day; or 150 mg orally every third day.

Extended-release injectable suspension: 380 mg every 4 weeks (or once a month) via intramuscular gluteal injection, alternating buttocks.

What is the dose of naltrexone for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is naltrexone available?

Naltrexone is available in the following dosage forms and strengths:

  • Tablet, oral: 50 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of naltrexone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 26, 2017 | Last Modified: July 31, 2017

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