Medicine & USMLE

Naltrexone

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Substance Use Disorder Treatments
  1. Buprenorphine
  2. Methadone
  3. Naltrexone
  4. Nicotine Replacement Therapies
  5. Naltrexone (Old)

Summary

Naltrexone is a medication that works as an opioid antagonist. It is long-acting, with effects lasting 24 to 72 hours after a single dose. Clinically, naltrexone is used to reduce opioid cravings, which can help prevent relapse in those with opioid use disorder. It may also help with alcohol and smoking cessation. A notable side effect of naltrexone is weight loss. It is typically given orally as a tablet or capsule.

Key Points

  • Naltrexone
    • Mechanism
      • Opioid Antagonist
        • Blocks opioid receptors
        • Long acting
          • Depending on the dose, the duration is between 24-72 hours
    • Clinical Use
      • Prevents opioid cravings (Prevents relapse)
        • When taking naltrexone, opioids won’t provide the pleasurable “high” feeling that makes people want to take them
      • May help alcohol cessation
        • Reduces alcohol cravings
      • May help smoking cessation
        • Limited evidence, but may reduce cravings and reward from smoking
    • Side Effects
      • Causes weight loss
      • Naltrexone should not be given within 7 days after last opioid/alcohol use
        • Can precipitate severe withdrawal symptoms in opioid-dependent individuals
    • Administration
      • Given orally
        • The most common form of administration is oral tablets