Naltrexone Hydrochloride

Naltrexone is an FDA-approved medication primarily used to treat opioid use disorder and alcohol dependence in adults. Available in both oral tablet and injectable forms, Naltrexone works by blocking the effects of opioids and reducing the desire for alcohol. It is essential for patients to be opioid-free for 7-14 days before starting treatment to prevent severe withdrawal symptoms. If you are considering treatment options, you can buy Naltrexone online to treat opioid use disorder or buy Naltrexone online from Canada for alcohol dependence, ensuring access to this potentially life-changing medication.

Naltrexone is a versatile medication approved by the FDA to manage opioid and alcohol use disorders. It is available as a 50 mg oral tablet and as a 380 mg injectable solution administered intramuscularly once a month. The drug functions by occupying opioid receptors in the brain, blocking the euphoric effects of opioid drugs and the cravings associated with alcohol, thereby aiding in recovery and relapse prevention.

For alcohol dependence, the standard dosage is 50 mg orally daily, continued over 12 weeks to achieve the best outcomes. For opioid dependence, treatment begins with a lower dose of 25 mg to ensure tolerability, then increased to 50 mg daily as a maintenance dose. Intramuscular injections are given every four weeks, providing a steady state of medication ideal for those who struggle with daily compliance. Patients must avoid opioids for at least 7 to 14 days before starting Naltrexone to avoid precipitated withdrawal—a severe reaction that can occur if opioids are still in the body when treatment begins. Common side effects include nausea, headache, dizziness, and muscle cramps, which generally subside over time.

For those unable to access it locally, options to buy Naltrexone online to treat opioid use disorder or buy Naltrexone online from Canada for treating alcohol dependence are available. This accessibility can be crucial for those seeking recovery in areas where treatment options are limited. Always consult with a healthcare provider before starting Naltrexone to ensure it’s the right fit for your treatment needs, considering any potential interactions with other medications you may be taking.

Naltrexone is a medication that has received FDA approval for the treatment of two specific conditions in adults:

• Opioid Use Disorder: Commonly referred to as opioid dependence, this condition involves the compulsive use of opioid drugs, even when they cause harm. 
• Alcohol Use Disorder: Also known as alcohol dependence or alcoholism, this is a medical condition characterized by an uncontrollable need to consume alcohol despite negative consequences.

What Are the Forms & Strengths of Naltrexone?

Naltrexone is available in the following formulations:

• Oral Tablet:
  • Naltrexone is offered as an oral tablet, which is taken by mouth.
  • The standard strength for the oral tablet is 50 milligrams (mg).
• Injectable Solution: This form of naltrexone is a liquid that is administered by injection directly into a muscle.

What Is the Recommended Dosage of Naltrexone?

Adult Dose for Alcohol Dependence

• Oral Administration:
  • Average Dose: 50 mg taken orally once daily.
  • Duration of Therapy: Recommended for 12 weeks.
• Intramuscular Administration:
  • Dose: 380 mg administered intramuscularly every 4 weeks, or once a month.
• Additional Guidance:
  • Transitioning from Other Medications: There is limited data on switching directly from opioid agonists like buprenorphine or methadone to naltrexone. Some patients have experienced severe withdrawal symptoms, known as precipitated withdrawal, when transitioning from an opioid agonist to an opioid antagonist like naltrexone.
  • Risk of Withdrawal: Patients may be at risk of precipitated withdrawal for up to two weeks after switching from buprenorphine or methadone to naltrexone.
  • Managing Withdrawal: Be prepared to manage withdrawal symptoms using non-opioid medications to alleviate discomfort.
  • Enhancing Treatment Compliance: For the best outcomes, apply strategies to enhance treatment adherence, particularly regarding medication compliance, to ensure consistent therapeutic effects.

Usual Adult Dose for Opiate Dependence

• Oral Administration:
  • Initial Dose: 25 mg taken orally once daily.
  • Maintenance Dose: If there are no withdrawal symptoms at 25 mg/day, increase to 50 mg taken orally once daily.
• Intramuscular Administration:
  • Dose: 380 mg administered intramuscularly every 4 weeks, or once a month.
• Additional Guidance:
  • Transitioning from Other Medications: There is no specific data on switching from opioid agonists like buprenorphine or methadone to naltrexone. It is important to note that some patients might experience severe withdrawal symptoms, known as precipitated withdrawal, when making this transition.
  • Risk of Withdrawal: Those switching from buprenorphine or methadone to naltrexone could face precipitated withdrawal symptoms for up to two weeks.
  • Managing Withdrawal: Prepare to treat withdrawal symptoms with non-opioid medications to alleviate discomfort effectively.
  • Comprehensive Treatment Plan: Naltrexone should be used as part of a broader management strategy that includes ensuring patient compliance with the medication. This holistic approach is crucial for achieving the best outcomes in treating opiate dependence.

Renal and Liver Dose Adjustments for Naltrexone

• Renal Dose Adjustments:
  • No adjustments are necessary for patients with mild renal impairment.
  • However, caution is advised when prescribing to patients with renal issues.

• Liver Dose Adjustments: No adjustments are required for patients with mild to moderate hepatic impairment.

• Dose Adjustments and Alternative Dosing Schedules:
  • To accommodate supervised administration, alternative dosing schedules can be utilized:
    • 50 mg every weekday with a 100 mg dose on Saturdays.
    • 100 mg administered every other day.
    • 150 mg given every third day.
  • Note: These extended dosing intervals may result in a reduced effect of the blockade.
  • Caution: The risk of liver damage increases with single doses exceeding 50 mg.
• Naloxone Challenge Test:
• Intravenous Administration:
  • Inject 0.2 mg of naloxone and observe the patient for 30 seconds for any withdrawal signs.
  • If no withdrawal is evident, administer an additional 0.6 mg and observe for 20 minutes.

• Subcutaneous Administration: Administer 0.8 mg of naloxone and monitor for 20 minutes for withdrawal symptoms.

• General Comments:
  • Determining an adequate opioid-free interval before starting naltrexone can be challenging.
  • The naloxone challenge test may assist in identifying hidden opioid dependence.
  • If opioid withdrawal symptoms appear during the test, naloxone treatment should not be initiated.
  • The naloxone challenge should not be conducted on patients who already exhibit opioid withdrawal signs or whose urine tests positive for opioids.
  • Withdrawal symptoms can include nausea, vomiting, anxiety, depression, muscle aches, fever, and changes in heart rate, among others.
  • If the test results are uncertain, withhold naltrexone and repeat the naloxone challenge after 24 hours.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

Important Precaution: If you have used opioids in the 7 to 14 days before starting naltrexone, it may trigger sudden opioid withdrawal symptoms. To prevent this, avoid using short-acting opioids for at least 7 to 10 days before beginning naltrexone treatment.

How to Take Naltrexone Tablets:

• Always follow your doctor’s instructions carefully when taking this medication. If you are unsure, ask your doctor or pharmacist for clarification.
• Take naltrexone once a day by mouth, as directed by your doctor.
• Your doctor will determine how long you should take naltrexone, as extended treatment may be beneficial in certain cases.

How to Receive a Naltrexone Injection:

• Naltrexone injections are administered by a healthcare provider every 4 weeks or once a month.
• To get the full benefit of the treatment, make sure to receive your injections regularly. Keep your doctor informed of the date of your last injection.
• Do not try to inject yourself with this medication, as serious reactions may occur, potentially requiring hospitalization.
• The injection is given into a muscle in your buttocks using a special needle that comes with the medication.
• After receiving the injection, you may experience some pain, redness, itching, swelling, bruising, or a hard lump at the injection site. Contact your doctor if these reactions persist or worsen after 2 weeks.
• Once injected, the medication lasts in your body for a month and cannot be removed.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

This medication works by blocking endorphins & opioids from attaching to the opioid receptors present in your brain. These receptors are responsible for creating feelings of pleasure and reward when you use opioids or alcohol. By preventing these substances from activating the receptors, naltrexone helps reduce the desire to use opioids or drink alcohol, making it easier to avoid these substances.

Common Side Effects of Naltrexone: This medication may cause some side effects, which are usually temporary and can last from a few days to weeks. If these side effects persist, become bothersome, or worsen, it is important to speak with your doctor or pharmacist. Common side effects of Naltrexone may include:

• Muscle cramps
• Drowsiness
• Joint pain
• Cold symptoms such as:
  • sore throat
  • Sneezing
  • stuffy nose
  • feeling nervous or anxious
• Nausea
• Tooth pain
• Dizziness
• Vomiting
• Sleep problems (insomnia)
• Headache
• Loss of appetite

Serious Side Effects of Naltrexone: This medication can also cause more serious side effects. The following list does not cover all possible serious side effects. If you experience any of these, contact your doctor immediately. If the side effects are life-threatening or if you suspect a medical emergency, call 911 or your local emergency number right away. Call your doctor at once if you experience:

• Weak or shallow breathing
• Cough that does not go away
• New or worsening respiratory symptoms:
  • Cough
  • Wheezing
  • Trouble breathing
• Severe gastrointestinal symptoms:
  • Nausea
  • Vomiting
  • Diarrhea
• Injection site reactions:
  • Severe pain
  • Swelling
  • Blistering
  • Skin changes
  • Dark scab
  • Hard lump
• Liver problems:
  • Stomach pain (upper right side)
  • Dark urine
  • Tiredness
  • Vomiting
  • Loss of appetite
  • Clay-colored stools
  • Jaundice (yellowing of the skin or eyes)
• Symptoms of depression:
  • Unusual mood or behavior changes
  • Crying
  • Loss of interest in things you once enjoyed
  • New sleep problems
  • Thoughts about hurting yourself

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Naltrexone?

• Risk of Opioid Overdose: Taking Naltrexone can increase the risk of an opioid overdose in two ways:
  • Naltrexone blocks the effects of opioids. If you try to overcome this by taking large amounts of opioids (such as heroin or prescription pain medications), it can lead to serious harm, coma, or even death.
  • After receiving the extended-release injection, the blocking effect gradually wears off. If you take opioids in the same amounts you used before starting Naltrexone treatment, you are at higher risk of overdose and death. You may be more sensitive to opioids in the following situations:
    • After completing detoxification
    • When your next injection is due
    • If you miss a dose
    • After stopping Naltrexone treatment
• Injection Site Reactions: Some people may experience severe reactions at the injection site, including tissue death, which may require surgery. Always have Naltrexone injections administered by a healthcare professional. Contact your healthcare provider immediately if you notice any of the following at the injection site:
  • Severe pain
  • Hardening of the area
  • Large swelling, lumps, blisters, or open wounds
  • A dark scab
• Sudden Opioid Withdrawal: Naltrexone can cause sudden opioid withdrawal if opioids were used in the 7 to 14 days before starting treatment. Withdrawal can be severe and may require hospitalization. Ensure you are opioid-free before starting Naltrexone unless your doctor decides otherwise and administers it in a medical facility where sudden withdrawal can be managed.
• Liver Damage or Hepatitis: Naltrexone can cause liver damage or hepatitis. Contact your doctor if you experience:
  • Abdominal pain lasting several days
  • Dark urine
  • Yellowing of the eyes (jaundice)
  • Unexplained fatigue

If you show signs of serious liver problems, your doctor may stop the medication. If you choose to buy Naltrexone online from Canada, ensure you have consulted with your healthcare provider to understand the correct use and potential risks involved.

What Is the Black Box Warning for Naltrexone?

• Oral Naltrexone Black Box Warning: Naltrexone is not known to cause liver toxicity when taken at the recommended doses. However, patients should be aware of the potential risk of liver damage. If you experience any symptoms of acute hepatitis, such as stomach pain, dark urine, yellowing of the eyes, or extreme tiredness, you should stop using Naltrexone and seek medical help immediately.

• Pregnancy: Tell your doctor if you are pregnant or planning to become pregnant. It’s not known if Naltrexone could harm an unborn baby. The medication should only be used during pregnancy if the benefits outweigh the potential risks to the fetus.
• Medical History: Inform your doctor if you have or have ever had:
  • Bleeding disorders, such as hemophilia.
  • Liver or kidney disease.
  • Alcohol dependence while also using opioids.
• Breastfeeding: If you are breastfeeding, talk to your doctor. It’s unclear if Naltrexone, when given by injection, passes into breast milk, and its effect on a baby is unknown. However, Naltrexone taken in tablet form can pass into breast milk. Discuss with your healthcare provider whether you should breastfeed or take Naltrexone, as doing both is not recommended.

Naltrexone should not be used if:

• You are hypersensitive or allergic to any of the ingredients.
• You are currently taking opioid medications.
• You have an active opioid dependence.
• You are experiencing acute opioid withdrawal.
• You fail the naloxone challenge test or have a positive urine screen for opioids.

• For Tablets: If you forget to take a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for the missed one.
• For Injections: If you miss your scheduled naltrexone injection, make an appointment with your healthcare provider as soon as possible to receive your next dose.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

• Do Not Exceed Recommended Dose: Taking more naltrexone than prescribed may result in unwanted side effects or overdose.
• What to Do in Case of Overdose: If you think you’ve taken too much naltrexone, contact your doctor immediately. You can also call America’s Poison Centers at 800-222-1222 or use their online tool for guidance. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

[Note: If you consumed more than recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

• Store naltrexone in a tightly sealed container at room temperature, away from heat, moisture, and direct sunlight. Do not allow it to freeze.
• Keep the medicine out of reach of children.
• Dispose of any outdated or no longer needed medication. Ask your healthcare provider for instructions on proper disposal.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

What Medications Interact with Naltrexone?

Naltrexone can interact with several medications, supplements, and possibly certain foods. It’s important to talk to your doctor or pharmacist about all the medications you take, including prescription, over-the-counter, vitamins, herbs, and supplements. This helps avoid any potential interactions.

Medications That Can Interact with Naltrexone:

• Diarrhea Medications Containing Opioids: Like loperamide (Imodium). These may not work properly when taken with naltrexone.
• Opioid Pain Relievers: Such as oxycodone (OxyContin) and tramadol (Ultram). These medications should not be taken with naltrexone as naltrexone blocks the effects of opioids.
• Cough and Cold Medications Containing Opioids: Such as codeine or dextromethorphan (Delsym), which may interact with naltrexone and reduce their effectiveness.

What Are the Other Naltrexone Interactions?

• Alcohol Interaction: Alcohol itself does not directly interact with naltrexone, but both alcohol and naltrexone can affect the liver. Drinking alcohol while on naltrexone may increase the risk of liver problems. Additionally, if you’re taking naltrexone for alcohol use disorder, the medication is designed to reduce your desire to drink. It is advisable to avoid alcohol during treatment. If you are concerned about managing alcohol use while taking naltrexone, discuss this with your doctor.
• Supplements and Food: While naltrexone hasn’t been reported to interact with any supplements or foods, it’s still important to discuss any concerns with your doctor or pharmacist. Potential interactions can still occur, so it’s best to be cautious.
• Other Naltrexone Interactions: Certain medications may interact with food, alcohol, or tobacco. While there are no known direct food interactions with naltrexone, you should talk to your healthcare provider about any potential interactions between your medication and food, alcohol, or tobacco.

[Note: This isn’t a complete list, and there could be other drugs that interact with Naltrexone. Make sure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

There are other medications available that may treat your condition and could be a better option for you. If you’re considering alternatives to naltrexone, it’s important to consult with your doctor, who can recommend the best treatment based on your needs.

Alternatives for Opioid Use Disorder

• Brixadi (buprenorphine)
• Sublocade (buprenorphine)
• Suboxone (buprenorphine/naloxone)
• Zubsolv (buprenorphine/naloxone)
• Methadose (methadone)
• Vivitrol (naltrexone injection)

Alternatives for Alcohol Use Disorder:Acamprosate

• Disulfiram
• Horizant (gabapentin)
• Neurontin (gabapentin)
• Vivitrol (naltrexone injection)
• Topamax (topiramate)
• Qudexy XR (topiramate)

Each of these medications works differently, and your doctor can help determine which alternative is most appropriate based on your condition and health history.

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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