Naltrexone is the common form of Vivitrol proprietary drug that is used to prevent drug abuse in people who are addicted to alcohol or opioid pain medications.
Examples of opioid analgesics include Norco (hydrocodone / acetaminophen), OxyContin (oxycodone), and codeine.
Some forms of this medication can also help those who suffer from tobacco dependence, certain developmental disorders (such as autism) or others, such as gambling.
Naltrexone is only part of a complete drug treatment program, which should also include lifestyle changes, counseling and support.
In addition, low doses of naltrexone have been shown to reduce the severity of symptoms in fibromyalgia, Crohn’s disease, multiple sclerosis, a complex regional pain syndrome and other chronic pain syndromes. Currently, this is a misuse.
The drug is in a class of drugs known as opiate antagonists. It works by blocking the action of narcotic drugs. It is available as a tablet and injection.
The Food and Drug Administration (FDA) approved naltrexone in 2010.
Low-dose naltrexone (LDN)
It has been shown that low doses of naltrexone reduce the severity of symptoms in multiple sclerosis, fibromyalgia, Crohn’s disease and other chronic pain.
Currently, this is a misuse.
Naltrexone and weight loss
The sustained-release naltrexone formulation was combined with a sustained-release bupropion drug (Contrave) to reduce weight in people who were diagnosed with obesity.
The FDA did not approve the combined form of naltrexone / burppion for this use because of problems with side effects associated with cardiovascular diseases.
If you are obese or overweight, ask your doctor if naltrexone is a good option for you.
Implants of naltrexone
Although primarily an oral drug taken in the form of tablets, naltrexone implants that are inserted into the lower abdominal wall under local anesthesia are used to treat opioid dependence and / or abuse / misuse.
Implants release a controlled amount of naltrexone into the body and last for three to six months.
Naltrexone implants block the effect of opiate preparations.
Naltrexone implants are currently not approved by the FDA and are only available in clinical settings offering 24-hour monitoring and surveillance, such as rehabilitation facilities for the treatment of drug and alcohol abuse.
Naltrexone may cause liver damage if taken in doses exceeding those recommended.
Immediately notify your doctor if you experience the following symptoms:
- Pain in the upper right side of the stomach, which lasts more than a few days
- Yellowing of the skin or eyes (jaundice)
- Excessive fatigue
- Unusual bleeding or bruising
- Loss of appetite
- Dark urine
Naltrexone should not be used by people who are still using opioids or drink a large amount of alcohol.
If you are taking naltrexone with high doses of opioid drugs, this can lead to serious injury, coma or death.
Your health care provider can order tests to determine if you have taken any opioid medications or used any opioid street drugs in the last seven to ten days before recommending naltrexone.
If you took opioids before naltrexone, you may be more sensitive to the effects of these pain relievers when you finish the treatment.
The medicine will help you avoid addiction and alcoholism, but it will not prevent and will not alleviate withdrawal symptoms. It can even worsen them.
You should not take naltrexone if you have recently stopped using opioids and are currently experiencing withdrawal symptoms.
Before taking naltrexone, you should tell your doctor if you have or have ever had:
- Liver disease
- Kidney disease
- Bleeding disorder, such as hemophilia
People who abuse drugs or alcohol often suffer from depression and may try to harm themselves. Naltrexone will not reduce this risk.
You should tell your doctor if you have any of the following symptoms:
- Suicidal thoughts or actions
- Extreme sadness
- Feelings of hopelessness
- Feeling of worthlessness
- Feeling helpless
- Anhedonia (inability to find pleasure in everything)
Tell your doctor that you are taking naltrexone before you undergo any surgery, including dental procedures.
If you take the injection form of this drug, you may notice pain, swelling, redness, bruising at the injection site. If you experience these symptoms, call your doctor.
Continue taking naltrexone, even if you feel good. Do not stop taking this medication without first talking to your doctor.
The drug is effective only if it is used as part of a dependence treatment program. You should attend all consultations, support group meetings and other treatment programs recommended by your doctor.
Pregnancy and Naltrexone
Naltrexone can harm an unborn baby. You should talk with your doctor about using this medication if you are pregnant or plan to become pregnant.
Also, it is not known whether naltrexone can harm a nursing baby. Talk with your doctor before breastfeeding while taking this medication.
Side Effects of Naltrexone
Common side effects
You should tell your doctor if any of the following side effects become serious or do not go away:
- Nausea, vomiting, diarrhea, or constipation
- Stomach pain or cramps
- Loss of appetite
- Nervousness, irritability or anxiety
- Increase or decrease in energy
- Difficulty falling asleep
- Pain in muscles or joints
- Light discomfort at the injection site (injection form)
Serious side effects
You should call your doctor immediately if you have any of the symptoms listed in the warning section, or any of the following serious side effects:
- Symptoms of an allergic reaction (rash, itching, shortness of breath, contraction in the chest, swelling of the mouth, face, lips or tongue)
- Blurred vision or problems with the eyes
- Cough, wheezing, or trouble breathing
- Severe vomiting or diarrhea
Before taking naltrexone, you should inform your doctor about all prescription, non-prescription, illegal, recreational, herbal, food and dietary preparations that you take, especially:
- Opioid (narcotic) drugs or street drugs, including levometasilate acetate (LAAM, ORLAAM) (not available in the US) or methadone (dolofin, methadose)
- Some medicines for diarrhea, cough or pain
- Disulfiram (Antabuse)
Naltrexone and alcohol
You should not drink alcohol while taking naltrexone.
In addition, talk to your doctor about any over-the-counter (OTC) medicines that you take that can contain alcohol.
Naltrexone and other interactions
Naltrexone can disrupt your thinking or reaction. Be careful when driving or doing anything that requires you to be vigilant.
Naltrexone is supplied as a tablet or as an injection.
If it is taken at home, the drug is usually taken once a day with or without food.
If this is done in the treatment center, naltrexone can be administered once a day or once every three days.
A typical dose of naltrexone is 50 milligrams (mg) per day. If it is given at the clinic, your doctor can increase the dose (up to 150 mg), which must be taken on different days.
You can take this medicine with or without food.
Take Naltrexone exactly as directed. You should not take more or less medicine than recommended.
Injectable naltrexone: a naltrexone injection is usually given once a month by a doctor or nurse in a clinic.
You should receive regular injections to get the most benefit.
Overdose with naltrexone
If you suspect an overdose, immediately contact a poison control center or an emergency room.
The missed dose of Naltrexone
If you miss a dose of oral naltrexone, take it as soon as you remember.
However, if it’s time for the next dose, skip it and continue with your usual dosing schedule.
If you miss a naltrexone injection, contact your health care provider.