Naltrexone Treatment: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Naltrexone is a prescription medication used to treat alcohol use disorder, opioid use disorder, chronic pain, and certain compulsive behaviors. It works by blocking the effects of opioids and reducing cravings for alcohol. Naltrexone is available in both oral and injectable forms. Always consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Naltrexone Medication

US Brand Name: Vivitrol, ReVia

Generic Name: Naltrexone

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.

Pharmacologic Category: Opioid Antagonist

Naltrexone belongs to a class of medications known as opioid antagonists, which work by blocking the effects of opioids in the brain.

Naltrexone Dosage

Naltrexone is prescribed for a variety of conditions, and the dosage and frequency depend on the specific condition being treated. Always follow your doctor’s instructions and consult them before making any changes to your dose. If you need assistance, our telemedicine providers are available to help.

Naltrexone for Alcohol Use Disorder

Oral: 50 mg once daily

Injectable: 380 mg intramuscularly once every 4 weeks

Length of treatment: Typically long-term, based on individual needs

Naltrexone for Opioid Use Disorder

Oral: 50 mg once daily

Injectable: 380 mg intramuscularly once every 4 weeks

Length of treatment: Typically long-term, based on individual needs

Naltrexone for Alcohol Dependence

Oral: 50 mg once daily

Injectable: 380 mg intramuscularly once every 4 weeks

Length of treatment: Typically long-term, based on individual needs

Naltrexone for Opioid Dependence

Oral: 50 mg once daily

Injectable: 380 mg intramuscularly once every 4 weeks

Length of treatment: Typically long-term, based on individual needs

Naltrexone for Chronic Pain

Oral: Low-dose naltrexone (typically 1.5 mg to 4.5 mg daily)

Length of treatment: Varies based on pain management needs

Naltrexone for Bulimia Nervosa

Oral: 50 mg once daily

Length of treatment: Varies based on individual response

Naltrexone for Anorexia Nervosa

Oral: 50 mg once daily

Length of treatment: Varies based on individual response

Naltrexone for Post-Traumatic Stress Disorder (PTSD)

Oral: 50 mg once daily

Length of treatment: Varies based on individual response

Naltrexone for Gambling Disorder

Oral: 50 mg once daily

Length of treatment: Varies based on individual response

Naltrexone for Compulsive Sexual Behavior

Oral: 50 mg once daily

Length of treatment: Varies based on individual response

Dosage Forms and Strengths of Naltrexone

Oral Tablets: 50 mg

Injectable (Intramuscular): 380 mg/vial

Administration Instructions for Naltrexone

Naltrexone can be taken orally or administered via injection. Oral tablets are typically taken once daily, with or without food. Injectable forms are administered by a healthcare professional once every 4 weeks. It is important to follow your doctor’s instructions carefully. If you miss a dose, take it as soon as you remember, but do not double up on doses. For any questions, you can schedule a telemedicine appointment with one of our providers for further guidance.

Contraindications for Naltrexone Treatment

Contraindications are specific conditions where a medication should not be used due to potential risks. If you have any of the following conditions, Naltrexone may not be safe for you. Always consult your healthcare provider before starting any new medication.

1. Current opioid use or opioid dependence: Naltrexone blocks opioid effects. If you are currently using opioids, taking Naltrexone can cause sudden and severe withdrawal symptoms.
2. Acute hepatitis or liver failure: Naltrexone is processed by the liver. If you have liver disease, especially acute hepatitis or liver failure, taking Naltrexone could worsen your condition.
3. Allergic reaction to Naltrexone: If you have had an allergic reaction to Naltrexone in the past, you should not take it again, as it could cause a serious allergic response.
4. Positive opioid test: If you test positive for opioids, Naltrexone should not be started, as it can trigger withdrawal symptoms.

Drug-to-Drug Interactions with Naltrexone

Naltrexone can interact with other medications, potentially affecting its effectiveness or increasing the risk of side effects. It is important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Common medications that may interact with Naltrexone include:

1. Opioid pain medications: (e.g., Hydrocodone [Vicodin], Oxycodone [OxyContin], Morphine [MS Contin]) – Naltrexone blocks the effects of these medications, reducing their effectiveness and potentially causing withdrawal symptoms.
2. Antidiarrheal medications: (e.g., Loperamide [Imodium]) – Opioid-based antidiarrheal medications may be less effective when taking Naltrexone.
3. Cough medications: (e.g., Codeine [Robitussin AC], Dextromethorphan [Delsym]) – Naltrexone can reduce the effectiveness of opioid-based cough medications.
4. Disulfiram: (Antabuse) – Both Naltrexone and Disulfiram are used to treat alcohol dependence, but taking them together may increase the risk of liver damage.

Naltrexone in Pregnancy

Is it safe to take Naltrexone when pregnant?

The safety of Naltrexone during pregnancy is not fully understood due to limited research on its effects on pregnant women and their babies. If you are pregnant or planning to become pregnant, it is essential to have a detailed discussion with your healthcare provider about the potential risks and benefits of Naltrexone treatment. In some situations, the benefits of continuing Naltrexone may outweigh the risks, but this decision should be made with careful consideration and professional guidance.

Naltrexone while Breastfeeding

Is it safe to take Naltrexone while breastfeeding?

There is limited information available regarding the safety of Naltrexone during breastfeeding. It is unclear whether Naltrexone passes into breast milk or if it could affect a nursing infant. If you are breastfeeding or planning to breastfeed, it is important to consult your healthcare provider to carefully weigh the potential risks and benefits of Naltrexone therapy. Your provider may recommend an alternative treatment or suggest monitoring your baby for any potential side effects.

Estimated Cost of Naltrexone Medication

The cost of a 30-day supply of Naltrexone can vary depending on the pharmacy and your insurance coverage. Without insurance, using a GoodRx coupon, the estimated cost for a 30-day supply of Naltrexone (50 mg tablets) typically ranges from $20 to $40. Prices may differ based on location and availability, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRx to find the most affordable option for your Naltrexone treatment.

Possible Alternatives to Naltrexone

If Naltrexone is not the right option for you, there are other treatments and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine consultation with one of our providers to explore these options further.

Alternatives for Alcohol Use Disorder

Medications such as Acamprosate (Campral) and Disulfiram (Antabuse) may help reduce alcohol cravings. In addition, counseling, support groups, and lifestyle changes—such as avoiding triggers and building a strong support network—can be valuable tools in managing alcohol use disorder.

Alternatives for Opioid Use Disorder

Medications like Buprenorphine (Suboxone) and Methadone are commonly used to manage opioid dependence. Behavioral therapies and support groups are also essential components of recovery from opioid addiction.

Alternatives for Alcohol Dependence

In addition to Naltrexone, medications such as Topiramate (Topamax) and Gabapentin (Neurontin) may be used to manage alcohol dependence. Counseling and lifestyle changes, such as reducing stress and avoiding environments that encourage drinking, can also be effective in managing alcohol dependence.

Alternatives for Opioid Dependence

Besides Naltrexone, Methadone and Buprenorphine (Subutex) are effective treatments for opioid dependence. Therapy and support groups remain critical elements of a successful recovery plan.

Alternatives for Chronic Pain

Non-opioid pain relievers like Acetaminophen (Tylenol) or NSAIDs (Ibuprofen) may serve as alternatives to Naltrexone for managing chronic pain. Other options, such as physical therapy, acupuncture, and mindfulness techniques, can also help alleviate chronic pain.

Alternatives for Bulimia Nervosa

Cognitive-behavioral therapy (CBT) is considered the most effective treatment for bulimia nervosa. In some cases, antidepressants like Fluoxetine (Prozac) may be prescribed to help manage symptoms.

Alternatives for Anorexia Nervosa

Nutritional counseling and psychotherapy are the primary treatments for anorexia nervosa. In certain cases, medications like antidepressants may be used to address underlying mental health conditions.

Alternatives for Post-Traumatic Stress Disorder (PTSD)

Therapies such as trauma-focused cognitive-behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are key treatments for PTSD. Medications like Sertraline (Zoloft) or Paroxetine (Paxil) may also be prescribed to help manage symptoms.

Alternatives for Gambling Disorder

Cognitive-behavioral therapy (CBT) and support groups like Gamblers Anonymous can be effective in managing gambling disorder. In some cases, medications such as SSRIs (Selective Serotonin Reuptake Inhibitors) may be prescribed to help control urges.

Alternatives for Compulsive Sexual Behavior

Therapy, particularly cognitive-behavioral therapy (CBT), is the most effective treatment for compulsive sexual behavior. Medications like SSRIs may also be used to help manage symptoms.

Recent Updates on Naltrexone Research

Recent studies continue to explore Naltrexone’s potential beyond treating alcohol and opioid dependence. For instance, low-dose Naltrexone (LDN) is being investigated for its ability to reduce chronic pain and inflammation in conditions such as fibromyalgia and multiple sclerosis. Early research suggests that LDN may help modulate the immune system and alleviate pain, though more studies are needed to confirm its effectiveness.

Additionally, researchers are examining Naltrexone’s role in treating behavioral addictions, such as gambling disorder and compulsive sexual behavior. Preliminary findings indicate that Naltrexone may help reduce the urge to engage in these behaviors by blocking the brain’s reward system, though further research is required to establish its long-term effectiveness.

As research continues to evolve, staying informed about new developments is important. If you are interested in learning more about how Naltrexone may benefit you, consider scheduling a telemedicine consultation with one of our providers today.

James Kingsley

Learn More