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Naltrexone: Uses and Side Effects

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What is Naltrexone?

Naltrexone is a medication used to help manage alcohol and opioid dependence. It can be injected into muscle tissue or taken orally. 

Brand names for Naltrexone include Vivitrol, the injectable, and Revia, the pill.

Naltrexone is an FDA-approved drug commonly used as part of medication-assisted treatment (MAT) programs for those with opioid or alcohol use disorders (AUDs).

The medication blocks the effects of opioids when someone takes them. However, researchers and medical professionals are less knowledgeable on exactly how Naltrexone treats alcoholism.

Naltrexone can’t cure addiction and should not be prescribed with that intent. Instead, doctors will prescribe it as part of a comprehensive treatment program. These treatment plans also include counseling and social support.

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Who Should Use Naltrexone?

Naltrexone helps people with alcohol use disorder (AUD) stay sober. It’s also suitable for those who are dependent on narcotics.

Side Effects of Naltrexone

Naltrexone may cause some side effects.

Speak with your doctor immediately if you experience any of the following:1

  • Skin rash
  • Severe abdominal or stomach pain
  • Blurred vision
  • Aching, burning, or swollen eyes
  • Chest pain
  • Confusion
  • Discomfort while urinating or frequent urination
  • Fever
  • Hallucinations
  • Itching
  • Depression or other mood changes
  • Ringing or buzzing in the ears
  • Shortness of breath
  • Swelling of the face, feet, or lower legs
  • Weight gain

Some side effects of Naltrexone don’t usually require medical attention. These side effects may lessen during treatment as you adjust to the medicine. Additionally, your doctor may advise you on how to prevent or reduce side effects.

Speak with your doctor if any of the following side effects persist or are bothersome:

  • Abdominal or stomach cramping/pain
  • Anxiety, nervousness, restlessness, or trouble sleeping
  • Headache
  • Joint or muscle pain
  • Nausea or vomiting
  • Tiredness
  • Chills
  • Constipation
  • Cough
  • Hoarseness
  • Runny or stuffy nose
  • Sinus issues
  • Sneezing
  • Sore throat
  • Diarrhea
  • Dizziness
  • Fast or pounding heartbeat
  • Increased thirst
  • Irritability
  • Loss of appetite
  • Sexual problems (in men) 

Other side effects not listed may also occur. If you notice any, speak with a healthcare professional.

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Naltrexone Warnings & Interactions 

Naltrexone causes severe liver disease in rare cases. This risk increases if you take larger doses. Be sure to discuss these risks with your doctor.

Stop using Naltrexone and tell your doctor immediately if you develop symptoms of liver disease, which include:

  • Persistent nausea or vomiting
  • Severe stomach or abdominal pain
  • Dark urine
  • Yellowing eyes and skin

A serious allergic reaction to Naltrexone is rare. 

Still, seek medical help immediately if you notice any symptoms of a severe allergic reaction, including:

  • Skin rash
  • Itching or swelling, especially of the face, tongue, or throat
  • Severe dizziness
  • Trouble breathing

Naltrexone may not interact well with certain medications. If you plan to take Naltrexone, let your doctor know if you’re taking any other medicines. 

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Is Naltrexone Addictive?

Some people fear that medication-assisted treatment causes one addiction to replace another. Methadone is an example of this.

Some people with opioid use disorder who start a methadone treatment program become addicted to the medication. The use of methadone and similar opioid treatments is carried out in a supervised manner. Yet, drug misuse and addiction are still possible.

Naltrexone isn’t addictive because it doesn’t cause people to feel high or euphoric. Instead, Naltrexone blocks the effects of alcohol or opioids to reduce cravings and relapse risk.

Can You Overdose on Naltrexone?

Becoming addicted to Naltrexone is unlikely. However, the risk of overdose is still possible.

Using opioids while taking Naltrexone can be a deadly combination. Naltrexone blocks the euphoric effects of opioid drugs. So if you take them on Naltrexone, you won’t experience any of these pleasurable effects.

As a result, some people try to increase the dose to experience the high they crave. This is what can lead to overdose or even death.

Often, if someone relapses, they’ll take the same dosage before becoming sober. This can also lead to overdose.

Other Treatment Options for AUD

Most people with alcohol use disorder (AUD) benefit from professional treatment.

Treatments include medications and behavioral therapies. For many, using both types of treatment provides the best results. 

People receiving treatment for AUD may also find it beneficial to attend a support group like Alcoholics Anonymous (AA).

If you have an AUD and a mental disorder, it’s essential to seek treatment for both. 

People with severe AUDs require intensive treatment. They will need to attend a residential treatment program, which is highly structured. It typically includes several types of behavioral therapies and detox medications for alcohol withdrawal.

Medication

Aside from Naltrexone, there are other medications to treat AUD. 

The following are FDA-approved to treat AUD:2

  • Disulfiram: This drug causes unpleasant symptoms such as nausea and skin flushing when you drink alcohol. Associating drinking with these effects can encourage people to avoid alcohol. 
  • Acamprosate: This medication helps people avoid alcohol after they’ve stopped drinking. It works on various brain systems to reduce cravings, especially just after someone has quit drinking.

Your doctor can help you determine whether Naltrexone or one of these other medicines is right for you. These medications aren’t addictive, so you don’t need to worry about transitioning from one addiction to another.

AUD medications are also not a cure for addiction. Rather, they can help manage withdrawal symptoms and reduce cravings. 

Behavioral Therapies

Another term for behavioral therapies for AUD is alcohol counseling. This treatment involves working with healthcare professionals to pinpoint and change behaviors that contribute to alcoholism.

Some behavioral therapies include:2

Cognitive Behavioral Therapy (CBT)

CBT helps identify feelings and situations that result in heavy drinking. In CBT sessions, you learn coping skills, like managing stress and adjusting the thoughts that make you want to drink.

You may receive CBT one-on-one with a therapist or in small groups. 

Motivational Enhancement Therapy (MET)

This treatment helps you build and strengthen the motivation to shift your drinking behavior. Motivational enhancement therapy typically includes four sessions over a short period. 

Treatment begins with identifying the pros and cons of seeking treatment. Then, you and your therapist work on creating a plan to change your drinking habits. 

The following sessions involve building your confidence and developing the skills you need to stick to the program. 

Marital and Family Counseling

This type of counseling includes partners and other family members in sessions. It repairs and enhances family relationships. Strong family support through therapy can help you avoid drinking. 

Brief Interventions

These are short, one-on-one or small-group counseling sessions. This therapy includes one to four sessions. 

The counselor provides you with information about your drinking behavior and potential risks. Then, they work with you to set goals and provide advice to help you change.

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Updated on March 27, 2022
6 sources cited
  1. Naltrexone (Oral Route), Mayo Clinic, February 2021.
  2. Alcohol Use Disorder (AUD) Treatment, MedlinePlus, August 2021.
  3. Singh D, Saadabadi A. Naltrexone. [Updated 2022 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
  4. Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies Into Medical Practice. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2009. 
  5. Srivastava, A Benjamin, and Mark S Gold. “Naltrexone: A History and Future Directions.” Cerebrum : the Dana forum on brain science. 1 Sep. 2018.
  6. Toljan, Karlo, and Bruce Vrooman. “Low-Dose Naltrexone (LDN)-Review of Therapeutic Utilization.” Medical sciences (Basel, Switzerland). Sep. 2018.

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