Naltrexone is a medication used specifically for the treatment of drug addiction and alcohol dependence, primarily functioning to block the activity of opioid receptors. By inhibiting dopamine release, it effectively reduces cravings for opioids or alcohol in addicts and alleviates withdrawal symptoms. In clinical practice, naltrexone is regarded as an important adjunct in behavioral therapy and psychological counseling, often used in conjunction with a professional medical team.
The generic name of this medication is Naltrexone. Common brand names include:
Naltrexone is classified as an "opioid receptor antagonist" with a mechanism that involves inverse regulation of the central nervous system. This classification is characterized by its ability to selectively block μ, κ, and σ opioid receptors without inducing withdrawal reactions, which is markedly different from traditional detoxification drugs.
The main indications include:
Mild side effects include:
Serious side effects require immediate medical attention:
Contraindications include:
Pregnancy is classified as Category C, and the drug should only be used when potential benefits outweigh risks. It should be avoided during breastfeeding as it may inhibit lactation. Elderly patients require close monitoring of liver function tests.
Concurrent use with opioid analgesics (such as morphine, fentanyl) can trigger acute withdrawal reactions, potentially causing hypotension and respiratory depression. Combining with CYP450 enzyme inducers (like carbamazepine) may reduce efficacy, requiring dose adjustments.
Using with anticoagulants (such as warfarin) may increase bleeding risk; INR levels should be monitored regularly. Alcohol consumption should be avoided during treatment as it may exacerbate liver damage.
Oral formulations typically start at 50 mg once daily, with severe cases possibly increasing to 100 mg. The injectable form is 380 mg administered monthly via intramuscular injection by healthcare professionals. Taking medication at a fixed time, preferably after meals, can reduce gastrointestinal discomfort.
Patients with liver impairment may require dose adjustments, with initial doses possibly reduced to 25 mg daily. Regular blood tests for liver enzymes are recommended during early treatment to ensure safety.
If a dose is missed, take it as soon as remembered, but if less than 6 hours remain until the next scheduled dose, skip the missed dose. Do not double doses to compensate for missed ones, to avoid liver overload.
If a missed injection occurs, contact the healthcare team immediately to schedule a catch-up injection; do not attempt to adjust the next injection cycle independently.
Overdose may cause drowsiness, respiratory depression, and liver failure. Immediate medical attention is required. There is no specific antidote; supportive care includes gastric lavage, dialysis, and monitoring of liver function. If other hepatotoxic drugs are being used concurrently, special attention should be paid to drug accumulation, and healthcare providers should be informed of all medications being taken.
Naltrexone can be taken with or without food. If gastrointestinal discomfort occurs after taking the medication, it is recommended to take it with a small snack to reduce stomach irritation. The absorption of the drug is not significantly affected by food, but individual tolerance may vary. Adjust meal timing based on personal response. Taking the medication at a consistent time each day helps maintain stable blood drug levels.
What should I do if I miss a dose to ensure the effectiveness of treatment?If the missed dose is within 6 hours, take it as soon as possible and adjust the next dose accordingly; if more than 6 hours have passed, skip the missed dose. Do not take extra to make up for the missed dose. Irregular dosing can affect treatment efficacy. Setting reminders or using a pill organizer can help prevent missed doses.
How should I monitor and respond to potential liver function abnormalities caused by naltrexone?Naltrexone may cause elevated liver enzymes. Liver function tests (such as GOT, GPT) should be checked every 4-8 weeks during early treatment. If abnormal results or symptoms such as jaundice or fatigue occur, discontinue the medication and seek medical evaluation. Mild abnormalities may lead to dose adjustments or temporary discontinuation. Patients should avoid using other hepatotoxic drugs concurrently.
Can I take painkillers or antidepressants while using naltrexone?Naltrexone antagonizes opioid analgesics (such as morphine), which can trigger withdrawal symptoms; they should not be used together. SSRIs (such as fluoxetine) generally do not have direct interactions but should be reported to the physician to avoid metabolic pathway conflicts or increased liver burden.
How should long-term users of naltrexone deal with potential fatigue or dizziness?Initial side effects like mild dizziness or fatigue usually diminish within a few weeks as the body adjusts. If symptoms are severe, consider dividing doses or discussing dose adjustments with a doctor. Avoid sudden position changes, increase hydration, and engage in gentle exercise to improve circulation. Activities requiring high concentration should be avoided until symptoms subside.
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