What is Naltrexone: Uses, Dosage, Side Effects and More

Naltrexone is a prescription medication that helps people overcome alcohol and opioid dependence by blocking the rewarding effects of these substances. Think of it as a protective shield that prevents your brain from feeling the "high" that typically comes from alcohol or opioids, making it easier to stay committed to your recovery journey.

This medication has been helping people reclaim their lives from addiction for decades. It works differently from other addiction treatments because it doesn't replace one substance with another. Instead, it simply removes the pleasurable feelings that make substances so hard to resist.

What is Naltrexone Used For?

Naltrexone is primarily prescribed to treat alcohol use disorder and opioid use disorder in adults who have already stopped drinking or using opioids. It's designed to help you maintain sobriety once you've taken that crucial first step of getting clean.

For alcohol dependence, naltrexone reduces cravings and the rewarding effects of drinking. Many people find that alcohol simply doesn't feel as appealing or satisfying when they're taking this medication. It's like having a constant reminder that helps reinforce your commitment to sobriety.

When it comes to opioid dependence, naltrexone blocks opioid receptors in your brain completely. This means that if someone tries to use heroin, prescription painkillers, or other opioids while taking naltrexone, they won't experience the typical euphoric effects. This protection can be lifesaving during vulnerable moments in recovery.

Some doctors also prescribe naltrexone for other conditions like compulsive behaviors, though these are considered off-label uses. Your healthcare provider will discuss whether naltrexone is appropriate for your specific situation.

How Does Naltrexone Work?

Naltrexone works by blocking opioid receptors in your brain, which are the same receptors that alcohol and opioids target to create pleasurable feelings. When these receptors are blocked, substances can't attach to them and produce their typical effects.

This is considered a moderately strong medication in terms of its blocking action. Once naltrexone occupies these receptors, it holds onto them tightly for about 24 hours. This means you're protected around the clock with just one daily dose.

For alcohol, the blocking effect is somewhat different. While alcohol doesn't directly target opioid receptors, it does trigger the release of natural opioids in your brain that contribute to the pleasurable feelings of drinking. By blocking these receptors, naltrexone reduces the rewarding aspects of alcohol consumption.

The medication doesn't make you feel sick if you drink or use opioids. Instead, it simply removes the positive reinforcement that keeps the cycle of addiction going. Many people describe it as making substances feel "pointless" or "not worth it."

How Should I Take Naltrexone?

Naltrexone is typically taken once daily as a tablet, usually in the morning with or without food. Taking it at the same time each day helps maintain consistent levels in your system and makes it easier to remember.

You can take naltrexone with milk, water, or juice. Some people find that taking it with food helps reduce stomach upset, especially during the first few days of treatment. If you experience nausea, try taking it with a light meal or snack.

Before starting naltrexone, it's crucial that you've been completely free from opioids for at least 7 to 10 days. Taking naltrexone too soon after opioid use can trigger severe withdrawal symptoms. Your doctor will likely perform a test to make sure opioids have cleared your system.

For alcohol treatment, you don't need to wait after your last drink. However, your doctor will want to make sure you're medically stable and not experiencing severe withdrawal symptoms before starting the medication.

How Long Should I Take Naltrexone For?

The length of naltrexone treatment varies greatly from person to person, but most people take it for at least three to six months. Some continue for a year or longer, depending on their individual recovery needs and circumstances.

Your doctor will work with you to determine the right duration based on your progress, stability in recovery, and personal risk factors. There's no standard "one size fits all" timeline because everyone's journey with addiction recovery is unique.

Many people find that staying on naltrexone for an extended period gives them the confidence and stability they need to build strong recovery habits. The medication can serve as a safety net while you develop coping strategies and rebuild your life.

It's important never to stop naltrexone suddenly without discussing it with your healthcare provider first. They can help you create a plan for discontinuing the medication when you're ready, which might include additional support or monitoring.

What Are the Side Effects of Naltrexone?

Most people tolerate naltrexone well, but like all medications, it can cause side effects. The good news is that many side effects are mild and tend to improve as your body adjusts to the medication.

Here are the most common side effects you might experience during the first few weeks of treatment:

• Nausea and stomach upset
• Headaches
• Dizziness or lightheadedness
• Fatigue or feeling tired
• Difficulty sleeping
• Anxiety or nervousness
• Muscle or joint pain
• Decreased appetite

These symptoms usually fade within the first two weeks as your body adapts. Taking naltrexone with food can help reduce nausea, and staying well-hydrated may help with headaches.

Less common but more serious side effects require immediate medical attention. These include severe stomach pain, persistent nausea and vomiting, dark urine, yellowing of the skin or eyes, or unusual fatigue. These could indicate liver problems, which are rare but serious.

Some people experience mood changes, including depression or suicidal thoughts. If you notice significant changes in your mood or mental health, contact your healthcare provider right away. This is especially important during the early stages of recovery when emotions can be particularly intense.

Who Should Not Take Naltrexone?

Naltrexone isn't suitable for everyone, and your doctor will carefully review your medical history before prescribing it. Understanding who shouldn't take this medication helps ensure your safety and treatment success.

You should not take naltrexone if you're currently using opioids, including prescription pain medications, heroin, or opioid-based cough medicines. Taking naltrexone while opioids are in your system can cause severe withdrawal symptoms that require emergency medical care.

People with acute hepatitis or liver failure cannot safely take naltrexone because the medication is processed through the liver. Your doctor will perform blood tests to check your liver function before starting treatment and monitor it regularly while you're taking the medication.

If you're pregnant or breastfeeding, naltrexone may not be appropriate. While studies haven't shown definitive harm, there isn't enough research to confirm its safety during pregnancy. Your doctor will weigh the benefits against potential risks in your specific situation.

Those with severe kidney disease may need dose adjustments or alternative treatments. People with a history of severe depression or suicidal thoughts require extra monitoring, as naltrexone can sometimes affect mood.

Naltrexone Brand Names

Naltrexone is available under several brand names, with ReVia being the most common oral formulation. This is the standard tablet form that most people take daily for alcohol or opioid dependence.

Vivitrol is another well-known brand, but it's given as a monthly injection rather than a daily pill. Both contain the same active ingredient but are delivered differently. The injection might be preferred for people who have difficulty remembering daily medications.

Generic naltrexone is also widely available and works exactly the same as brand-name versions. Many insurance plans prefer generic medications, which can make treatment more affordable while providing the same therapeutic benefits.

Your pharmacist can help you understand which formulation you're receiving and answer any questions about the specific brand or generic version you're prescribed.

Naltrexone Alternatives

Several other medications can help with alcohol and opioid dependence, and your doctor might consider these alternatives based on your specific needs and medical history.

For alcohol dependence, acamprosate (Campral) and disulfiram (Antabuse) are two other FDA-approved options. Acamprosate helps reduce cravings and works well for people who have already stopped drinking. Disulfiram creates unpleasant reactions when combined with alcohol, serving as a deterrent.

For opioid dependence, buprenorphine (Suboxone, Subutex) and methadone are medication-assisted treatment options. Unlike naltrexone, these are opioid medications themselves but work by satisfying cravings in a controlled way while blocking the effects of other opioids.

The choice between these medications depends on many factors, including your addiction history, medical conditions, lifestyle, and personal preferences. Some people do better with blocking medications like naltrexone, while others benefit from replacement therapies.

Is Naltrexone Better Than Buprenorphine?

Naltrexone and buprenorphine are both effective medications for opioid dependence, but they work in fundamentally different ways. Neither is universally "better" than the other because the best choice depends on your individual circumstances and recovery goals.

Naltrexone is a complete blocker that prevents you from feeling any effects from opioids. This makes it ideal for people who want complete abstinence and have already successfully detoxed from opioids. It requires no special prescribing licenses and doesn't carry addiction potential itself.

Buprenorphine is a partial opioid that satisfies cravings while blocking other opioids. It can be started while you're still experiencing withdrawal symptoms, making the transition to treatment easier. However, it requires special prescribing requirements and has some addiction potential.

Your doctor will help you choose based on factors like your readiness for complete abstinence, previous treatment experiences, social support, and medical history. Some people even transition from buprenorphine to naltrexone as their recovery progresses.