Naltrexone

Other CNS Drugs · Narcotic antagonist

Indications

Maintenance of abstinence in alcohol dependence. Maintenance therapy in detoxified, formerly opioid dependent patient.

Dosage

Adults: Alcohol dependence: 1 tab daily for at least 3 mth. Opioid dependence: Perform naloxone challenge test before initiating treatment, see literature. Initially 25 mg daily, then 50 mg daily for minimum 3 mth. Dosing schedule can be adapted to improve compliance. See literature. Max daily dose: 150 mg. Children: Not recommended.

Adverse Effects

GI upset, headache, sleep disorders, mood disorders, restlessness, anxiety, increased thirst, dizziness, stupor, shivering, sweating, increased lacrimation, increased energy, depression, irritability, rash, pruritus, chest pain, arthralgia, myalgia, urinary retention, impotence, anorexia, asthaenia, tachycardia, palpitation, ECG changes, hyperhidrosis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Contraindicated or not recommended. Contraindications: Acute hepatitis, opioid dependent patients, symptoms of opioid withdrawal, severe hepatic or renal impairment. Precautions: Mild to moderate hepatic or renal impairment, perform LFTs before and during treatment. Ensure patient opioid free, before starting treatment. Elderly.

Interactions

Opioid, acamprosate, sedatives.

Advice to Patient

Contact prescriber if there is acute headache, yellowing of skin or eyes, chills, increased sweating, colour change of urine or stool, chest pain, palpitations, unusual joint pain. Do not take any new medication especially opiates during therapy without consulting prescriber. Carry medical identification card mentioning names of medicines you take. Rehabilitation therapy is required along with medication. On start of therapy or change of dosage, patient should be watched carefully for suicidal tendency by caregiver or family.

Pharmacokinetics

Absorption: Well absorbed from the GI tract. Metabolism: Extensively hepatic. Undergoes first-pass metabolism. Half-life elimination: Approx. 4 hrs. Time to peak, plasma: 1 hr. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.