Naltrexone
Administration
- Type: Opioid antagonist
- Dosage Forms:
- Routes of Administration: PO, IM
- Common Trade Names: ReVia, Vivitrol, Depade
Adult Dosing
- Opioid dependence (prevention of relapse after opioid-free x 7-10d), ETOH dependence: 25-50mg PO daily OR 380mg IM q4w
Pediatric Dosing
Safety/efficacy not established
Special Populations
Pregnancy Rating
- Category C
Lactation risk
- Minimally excreted in breastmilk
Renal Dosing
- Use caution
Hepatic Dosing
- Use caution
Contraindications
- Allergy to class/drug
- Patients who are on opioid analgesics/partial agonists, are opioid-dependant, or in acute opioid withdrawal
Adverse Reactions
Serious
- Depression, suicide, and suicidality
- Vulnerability to opioid overdose: Patients should be alerted that they may be more sensitive to opioids, even at lower doses, after discontinuance of naltrexone
- Hepatotoxicity
- Severe injection-site reactions (e.g. necrosis, cellulitis, hematoma)
Common
- Injection site reaction
- Nausea/vomiting, diarrhea, decreased appetite, dry mouth
- LFT abnormalities,
- Elevated CPK
- Headache, dizziness, anxiety, insomnia, somnolence
- URI, pharyngitis
- Arthralgia, muscle cramps, back pain
- Rash
Pharmacology
- Half-life: PO- 4-13h;IM- 5-10 days
- Metabolism: Hepatic
- Excretion: Urinary
Mechanism of Action
- Potent nonselective opioid competitive receptor antagonist
- Reduces the rewarding effects of alcohol consumption by inhibiting the activity of endogenous opioids in the mesolimbic system. [1]
Comments
See Also
References
- ↑ Anderson, E., Chamberlin, M., Zuluaga, M., Ullal, M., & Hawk, K. (2021). Annals of emergency medicine. Annals of Emergency Medicine, 78(6), 752–758.