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NERVOUS SYSTEM › OTHER NERVOUS SYSTEM DRUGS › DRUGS USED IN ADDICTIVE DISORDERS › Drugs used in alcohol dependence
naltrexone
N07BB04
Forms & Strengths
- Oral tablet: 50 mg
- Extended-release intramuscular suspension (Vivitrol): 380 mg/vial
Adult Dosing
- Alcohol dependence: Oral 50 mg once daily
- Alcohol dependence: IM 380 mg once every 4 weeks or once a month
- Opioid dependence: Oral induction 25 mg, then 50 mg once daily; or targeted dosing schedules
- Opioid dependence: IM 380 mg once every 4 weeks or once a month
Pediatric Dosing
- Safety and efficacy not established in pediatric patients under 18 years of age
Indications
- Management of alcohol dependence
- Prevention of relapse to opioid dependence, following opioid detoxification
Mechanism of Action
- Competitive opioid receptor antagonist with highest affinity for mu receptors
- Blocks the subjective reinforcing effects of alcohol and exogenous opioids
- Hypothesized to reduce alcohol consumption by blunting endogenous opioid system activation
Contraindications
- Patients receiving opioid analgesics
- Patients currently dependent on opioids due to risk of precipitating acute withdrawal
- Acute opioid withdrawal
- Failed naloxone challenge test or positive urine drug screen for opioids
- Known hypersensitivity to naltrexone or any component
Adverse Reactions
- Nausea and vomiting
- Headache
- Dizziness
- Fatigue and insomnia
- Anxiety and nervousness
- Abdominal pain and cramping
- Injection site reactions (with IM formulation)
- Hepatotoxicity (dose-related elevations in hepatic transaminases)
Drug Interactions
- Opioid analgesics and agonists: antagonism of analgesic effect, risk of acute severe withdrawal
- Thioridazine: potential for increased somnolence and lethargy
- Cough and cold preparations, antidiarrheals containing opioids: therapeutic efficacy blocked by naltrexone
Curated Content: Needs Vetting Before Put to Clinical Use