Do not drive, operate heavy machinery or perform any dangerous activities until you know how naltrexone will affect you. Naltrexone may cause dizziness and drowsiness and affect your ability to drive or operate machinery. Do not drive or perform any kind of hazardous tasks if naltrexone causes you any dizziness or other antibiotics and alcohol dangerous side effects. Make your tax-deductible gift and be a part of the cutting-edge research and care that’s changing medicine. You’ll soon start receiving the latest Mayo Clinic health information you requested in your inbox. As of December 2022, the MAT Act has eliminated the DATA-Waiver (X-Waiver) program.
- It will not prevent you from becoming impaired while drinking alcohol.
- Note that this list is not all-inclusive and includes only common medications that may interact with naltrexone.
- Some researchers also reported that administration of opioid antagonists, including naloxone (which is similar to naltrexone), decreased alcohol consumption (Hubbell et al., 1986; Reid et al., 1991).
- Naltrexone does not appear to be a hepatotoxin at the recommended doses.
Naltrexone causes withdrawal symptoms in people who are using narcotics. Always use a non-narcotic medicine to treat pain, diarrhea, or a cough. If you have any questions about the proper medicine to use, check with your doctor. Do not try to overcome the effects of naltrexone by taking narcotics. You may be more sensitive to the effects of narcotics than you were before beginning naltrexone therapy.
How to take naltrexone tablets
Trying to overcome this block is very dangerous and may cause serious injury, loss of consciousness, and death. Make sure you completely understand and accept the risks and benefits of using this medication. Naltrexone belongs to a class of drugs known as opioid antagonists and works by blocking the mu opioid receptor. It blocks the effects of alcohol and opioid medications, preventing the intoxication these substances cause. Naltrexone also modifies how the hypothalamus, pituitary gland and adrenal gland (hypothalamic-pituitary-adrenal axis, HPA axis) interact to suppress the amount of alcohol consumed. Patients transitioning from opioid agonists (buprenorphine or methadone) might be at increased risk of precipitation of withdrawal symptoms for approximately 14 days.
Exhibit 4-7 lists interactions between naltrexone and other drugs. During pregnancy, this medication should be used only when clearly needed. Tell your doctor right away if you start to feel more depressed. Also tell your doctor right away if you have thoughts about hurting yourself.
Your doctor may decide not to treat you with this medication or change some of the other medicines you take. No information is available on the relationship of age to the effects of naltrexone in geriatric patients. Tell your doctor if you are pregnant or plan to become pregnant.
Note that this list is not all-inclusive and includes only common medications that may interact with naltrexone. You should refer to the prescribing information for naltrexone for a complete list of interactions. It is not known if naltrexone passes into your milk when it is administered by IM injection, and it is not known if it can harm your baby. Talk to your healthcare provider about whether you will breastfeed or take this medication. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Your healthcare provider may need to stop treating you with this medication if you get signs or symptoms of a serious liver problem.
Exhibit 4-6 Signs and Symptoms of Liver Disease
The long-acting properties of naltrexone are due primarily to 6-β-naltrexol, which has an elimination half-life of 13 hours. Naltrexone achieves therapeutic effectiveness rapidly following the initiation of oral dosing. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Synthetic opioid antagonists can modify the action of opioids on these receptors.[9] Naltrexone competes as an antagonist at opioid receptors and can be used to treat alcohol and opioid use disorders. One controlled study (Hernandez-Avila et al., 2006; Kranzler et al., 2003) addressed targeted use of naltrexone during periods of risk for problem alcohol use. The findings and clinical experience support periodic or targeted dosing. The consensus panel recommends that liver function tests (i.e., ALT, AST, gamma glutamyltransferase, bilirubin) be performed before naltrexone treatment begins and at intervals thereafter.
When opioids must be used, it is possible to reverse the naltrexone blockade using higher than usual doses of opioids. However, because of the potential for opioid-induced respiratory depression, reversal of naltrexone blockade should be done only in medical settings with the provision for respiratory support. The dosage is based on your medical condition and response to treatment.
This medication may be given as part of a program where a health care professional will watch you take the medication. In this case, this medication may be taken every 2 to 3 days to make it easier to schedule clinic visits. Naltrexone may be taken with food or antacids if stomach upset occurs. You will need to stop using opioids (narcotics) for at least 7 to 10 days before you can start taking naltrexone. Your doctor may need to do the naloxone challenge test or a urine test for opioids to make sure you are opioid-free. Naltrexone is used to help narcotic dependents who have stopped taking narcotics to stay drug-free.
This medication should only be used during pregnancy if the potential benefits justifies the potential risk to the fetus. Carry written information with you at all times to alert healthcare providers that you are taking this medication so that they can treat you properly in an emergency. Ask your healthcare provider how you can get a wallet card to carry with you. Tell your healthcare provider about any reaction at an injection site that concerns you, gets worse over time, or does not get better by two weeks after the injection. There are no longer limits on the number of patients with OUD that a practitioner may treat with buprenorphine.
Response and effectiveness
Separate tracking of patients treated with buprenorphine or prescriptions written is no longer required. Naltrexone—and all the medications described in this TIP—does not “cure” AUDs ciprofloxacin oral route side effects the way an antibiotic cures bacterial pneumonia. However, as a part of comprehensive treatment, it may increase the likelihood of sustained remission from problem alcohol use.
This finding suggests that OPRM1 genotyping may be a useful procedure for improving identification of those patients most likely to benefit from naltrexone treatment for alcohol dependence. It also suggests that clinicians should not become discouraged if the first patients they prescribe naltrexone for do not find it beneficial. Naltrexone’s efficacy is modest, but it is significantly better than placebo in most studies, and some patients benefit from naltrexone therapy. This medication is used to prevent people who have been addicted to certain drugs (opiates) from taking them again. It is used as part of a complete treatment program for drug abuse (such as compliance monitoring, counseling, behavioral contract, lifestyle changes).
Who should not use naltrexone?
Some clinicians may choose to obtain a pregnancy test before starting naltrexone and whenever pregnancy is suspected. If a patient becomes pregnant while using naltrexone, the clinician and patient should decide whether to continue the medication, given the potential risks and benefits. Naltrexone appears to be effective for attenuating craving in people who are alcohol dependent (Monti et al., 1999, 2001). By blocking craving, naltrexone may enhance the ability of patients to abstain from drinking. By blocking the pleasure from alcohol, naltrexone also may reduce the amount of heavy drinking in those who do drink.
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Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. For more information, ask your healthcare provider or pharmacist. Naltrexone tablets were first approved by the US Food and Drug Administration (FDA) in 1984. In 2006, the FDA also approved Vivitrol, the extended-release intramuscular injection form of naltrexone. Naltrexone comes as an extended-release intramuscular injection (Vivitrol) and as oral tablets. The branded versions of naltrexone tablets (Revia, Depade) have been discontinued, but generic versions are available.
People taking naltrexone need to have completely stopped taking all types of opioids seven to ten days before starting naltrexone. The Mainstreaming Addiction Treatment (MAT) Act provision updates federal guidelines to expand the availability of evidence-based treatment to address the opioid epidemic. The MAT Act empowers all health care providers with a standard controlled substance license to prescribe buprenorphine for opioid use disorder (OUD), just as they prescribe a beginners guide to doing drugs for the first time other essential medications. The MAT Act is intended to help destigmatize a standard of care for OUD and integrate substance use disorder treatment across healthcare settings. Naltrexone can precipitate a withdrawal syndrome in patients with opioid use disorder characterized by dysphoria, irritability, and signs of autonomic hyperactivity such as tachycardia, tremor, and sweating. Other rare but potentially serious effects include depression and suicidality.
