What to avoid when taking naltrexone?

Official answer

by Drugs.com

You should not use naltrexone treatment if:

Tell your doctor or other health care provider of any recent use of opioids or any history of opioid dependence before starting naltrexone to avoid having an opioid withdrawal. Your doctor may require that you pass a naloxone challenge test and/or a urine screen for opioids prior to naltrexone use.

What is naltrexone used for?

Naltrexone blocks euphoric actions only (meaning it can't lead to addiction or a "high"). It also may block the "high'' feeling that may make you want to consume alcohol. Naltrexone is not a cure for addiction to opioids or alcohol.

It is available by prescription as a long-acting intramuscular injection (brand name: Vivitrol) or as a 50 mg oral tablet (a generic).

Naltrexone treatment is started after you are no longer dependent on opioids. Naltrexone use for either opioid use disorder or alcohol use disorder can lead to withdrawal symptoms if you are still using narcotics (opioids).

Naltrexone should not be used before you complete a medically-supervised opioid withdrawal lasting at least 7 to 14 days. This will help you to avoid an opioid withdrawal that may require hospitalization. If you have been using a more long-acting opioid such as methadone or buprenorphine, your detoxification period may need to be longer.

Which opioids should I avoid with naltrexone?

People using naltrexone should not:

If you attempt to self-administer opioids, in small doses while on naltrexone, you will not perceive any effect. Naltrexone blocks the euphoric and sedative effects of the abused drug and prevents feelings of euphoria (“high”). However, using large doses of any opioid to try to bypass the opioid-blocking effect of naltrexone may lead to serious injury, overdose, coma, or death. You may be more sensitive to smaller doses of opioids once you stop using them, so taking any dose of an opioid can be dangerous.

What if I miss a dose of naltrexone?

If you miss taking your oral naltrexone tablet, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

If you miss your naltrexone injection appointment, contact your doctor’s office immediately to reschedule another appointment as soon as possible.

What if I take too much naltrexone?

Follow your doctor’s instruction exactly. The risk of liver injury is higher with single oral naltrexone doses above 50 mg.

Naltrexone use should be avoided in people who are currently using opioids, in people with certain types of liver disease or with chronic pain who rely on opioids for pain control.

Never give or sell naltrexone to anyone else, especially someone who is using opioids. Naltrexone will cause withdrawal symptoms in people who are using opioids.

Naltrexone Use and Alcohol Dependence

For the treatment of alcohol dependence, you should not be actively drinking at the time you start naltrexone treatment. You should be able to abstain from alcohol in an outpatient setting (for example: at home, work and in your community) prior to initiation of treatment with naltrexone.

You should use naltrexone as part of a treatment program that includes counseling, support groups, and other behavioral methods as recommended by your doctor, for both alcohol use disorder and opioid use disorder.

Who can use naltrexone?

Naltrexone can be prescribed by any health care professional who is licensed to prescribe medications. It comes as a tablet (generic) and long-acting injection (Vivitrol). The tablets may be administered with or without food. Administration with food or after meals may help to lessen any stomach side effects.

Injectable naltrexone is only given by a health care provider. The injection will be shipped directly to your doctor and you will receive the injection at their office.

Do not attempt to give yourself an injection of naltrexone. Injectable naltrexone has been associated with serious injection site problems and skin reactions. If you experience any of these reactions after a naltrexone injection, contact your doctor immediately

Tell your doctor if you have kidney (renal) disease before you start naltrexone treatment. Extra caution may be needed when you receive naltrexone.

If you have bleeding problems, low blood platelets, or a lung condition, tell your doctor before you start naltrexone treatment.

Naltrexone can cause depression in some patients. Tell your doctor if you have a history of depression, attempted suicide, or other mental health disorders before you start naltrexone treatment. Tell your family members or other people close to you that you are taking naltrexone. They should call a doctor right away if you become depressed or experience symptoms of depression.

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 dangerous side effects.

You should not use naltrexone if you are allergic to the drug, any vehicle or any inactive ingredients in the medication. Tell your doctor if you have ever had an allergic reaction to this medicine or any other substance.

If you are pregnant, breastfeeding or planning a pregnancy, be sure to tell your doctor before you start naltrexone treatment.

Is naltrexone the same as naloxone?

Are there drug interactions with naltrexone?

There is the possibility of many different drug interactions with naltrexone. You should not start taking any new prescription medicine, over-the-counter (OTC) medication, vitamin, herbal or dietary supplement until you have had a drug interaction review completed by your doctor or pharmacist.

Naltrexone will also block the effects of other opioid-containing medicines, such as cough and cold remedies and antidiarrheal preparations. While taking naltrexone, you may not benefit from these medicines or opioid analgesics. Always use a non-narcotic medicine to treat pain, diarrhea, or a cough. Ask your doctor about the best medicine to use.

Do I need a naltrexone identification card?

Yes, carry your naltrexone identification card with you at all times.

The naltrexone injection may cause an allergic-type of pneumonia. Patients should immediately notify their physician if they develop signs and symptoms of pneumonia, including trouble breathing, shortness-of-breath, coughing, or wheezing.

Bottom line

This is not all the information you need to know about naltrexone for safe and effective use. Review the full naltrexone prescribing information here, and discuss this drug with your doctor or other health care provider.