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Naltrexone Brand Names
Depade | ReVia | Vivitrol
What is Naltrexone
Naltrexone is an oral opiate receptor antagonist. It is derived from thebaine and is very similar in structure to oxymorphone.
Like parenteral naloxone, naltrexone is a pure antagonist (i.e., agonist actions are not apparent), but naltrexone has better oral bioavailability and a much longer duration of action than naloxone.
Clinically, naltrexone is used to help maintain an opiate-free state in patients who are known opiate abusers.
Naltrexone is of greatest benefit in patients who take the drug as part of a comprehensive occupational rehabilitative program or other compliance-enhancing program.
Unlike methadone or LAAM, naltrexone does not reinforce medication compliance and will not prevent withdrawal. Naltrexone has been used as part of rapid and ultrarapid detoxification techniques. These techniques are designed to precipitate withdrawal by administering opiate antagonists. These approaches are thought to minimize the risk of relapse and allow quick initiation of naltrexone maintenance and psychosocial supports.
Ultrarapid detoxification is performed under general anesthesia or heavy sedation. While numerous studies have been performed examining the role of these detoxification techniques, a standardized procedure including appropriate medications and dose, safety, and effectiveness have not been determined in relation to standard detoxification techniques.
Naltrexone supports abstinence, prevents relapse, and decreases alcohol consumption in patients treated for alcoholism.
Naltrexone is not beneficial in all alcoholic patients and may only provide a small improvement in outcome when added to conventional therapy. The FDA approved naltrexone in 1984 for the adjuvant treatment of patients dependent on opiate agonists.
FDA approval of naltrexone for the treatment of alcoholism was granted January 1995.
The FDA approved Vivitrol, a once-monthly intramuscular naltrexone formulation used to help control cravings for alcohol in April 2006, and then in October 2010, the FDA approved Vivitrol for the prevention of relapse to opioid dependence after opioid detoxification.
Indications
- alcohol dependence
- opiate agonist dependence
- opiate agonist withdrawal induction
- pruritus
- tobacco cessation
Side Effects
- abdominal pain
- acne vulgaris
- agitation
- alopecia
- anaphylactoid reactions
- angina
- angioedema
- anorexia
- anxiety
- appetite stimulation
- arthralgia
- asthenia
- atrial fibrillation
- back pain
- bleeding
- blurred vision
- chest pain (unspecified)
- chills
- cholecystitis
- cholelithiasis
- colitis
- confusion
- conjunctivitis
- constipation
- cough
- dehydration
- dental pain
- depression
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dyspnea
- dysuria
- ecchymosis
- edema
- ejaculation dysfunction
- elevated hepatic enzymes
- eosinophilia
- eosinophilic pneumonia
- epistaxis
- euphoria
- fatigue
- fever
- flatulence
- gastroesophageal reflux
- GI bleeding
- hallucinations
- headache
- heart failure
- hematoma
- hemorrhoids
- hepatitis
- hoarseness
- hot flashes
- hyperbilirubinemia
- hypercholesterolemia
- hyperhidrosis
- hyperkinesis
- hypertension
- ileus
- increased urinary frequency
- infection
- influenza
- injection site reaction
- insomnia
- irritability
- laryngitis
- lethargy
- libido decrease
- libido increase
- lymphadenopathy
- malaise
- migraine
- muscle cramps
- myalgia
- myocardial infarction
- nasal congestion
- nausea
- night sweats
- nightmares
- ocular inflammation
- ocular irritation
- otalgia
- palpitations
- pancreatitis
- paranoia
- paresthesias
- peptic ulcer
- phlebitis
- photophobia
- polydipsia
- pruritus
- pulmonary embolism
- purpura
- rash
- restlessness
- rhinorrhea
- seizures
- sinus tachycardia
- sinusitis
- sneezing
- stroke
- suicidal ideation
- syncope
- thrombosis
- tinnitus
- tissue necrosis
- tremor
- urticaria
- visual impairment
- vomiting
- weight gain
- weight loss
- withdrawal
- xerostomia
- yawning
Monitoring Parameters
- LFTs
Contraindications
- acute opioid withdrawal
- breast-feeding
- children
- coagulopathy
- depression
- driving or operating machinery
- females
- hemophilia
- hepatic disease
- hepatitis
- infants
- intravenous administration
- neonates
- obesity
- potential for overdose or poisoning
- pregnancy
- renal impairment
- respiratory depression
- subcutaneous administration
- suicidal ideation
- surgery
- thrombocytopenia
- tissue necrosis
Interactions
- Acamprosate
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Alfentanil
- Alvimopan
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Bremelanotide
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Butorphanol
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disulfiram
- Dronabinol
- Fentanyl
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Ibuprofen; Oxycodone
- Levomethadyl
- Levorphanol
- Lofexidine
- Meperidine
- Meperidine; Promethazine
- Methadone
- Methylnaltrexone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Naldemedine
- Naloxegol
- Opiate Agonists-Antagonists
- Oxycodone
- Oxymorphone
- Pentazocine
- Pentazocine; Naloxone
- Phenothiazines
- Propoxyphene
- Remifentanil
- Sufentanil
- Tapentadol
- Tramadol
