Naltrexone and Vivitrol for Alcohol Use Disorder

Apr 26

Alcohol use disorder (AUD) presents a significant challenge in the realm of addiction treatment, yet there is a growing list of promising pharmacological agents. Among these, Naltrexone stands out as a well-tolerated medication that has shown significant promise in reducing alcohol consumption. In this discussion, we delve into the dosing guidelines, potential side effects, and the mechanism of action of Naltrexone, as well as exploring Vivitrol, a once-monthly injectable alternative that could enhance compliance and treatment effectiveness.

What is Naltrexone?

Naltrexone is a medication approved to help reduce heavy drinking and prevent relapse in individuals recovering from alcohol dependence. It works by blocking the mu-opioid receptors in the brain. This action is crucial because these receptors are part of the pathway that mediates the rewarding and reinforcing effects of alcohol. By blocking these receptors, naltrexone reduces the euphoria and pleasurable sensations associated with alcohol consumption, which can help decrease the desire to drink and prevent relapse in individuals recovering from alcohol use disorder.

Note About Naltrexone And Pain Relief in Emergencies

If you're on Naltrexone, which blocks pain relief from opiates, it's crucial to be ready for any emergency that requires pain treatment. To stay safe:
Wear a medical alert bracelet indicating you're taking Naltrexone. It's easier for emergency staff to spot than necklaces or cards. Add a message on it to check your wallet for more info.
Carry a wallet card with details about Naltrexone and its impact on emergency care. This helps medical workers understand your needs quickly.

Dosage Considerations

The initial recommended dose for oral Naltrexone is 50 mg daily.
Depending on individual response, the dose may be increased to 100 mg daily, although this should be done under close medical supervision.
There is also a once per month injection available, called Vivitrol.

Vivitrol: An Alternative to Oral Naltrexone

Vivitrol is the brand name for naltrexone extended-release injectable. It is administered once a month and can be a good alternative for those who have difficulty with daily medication adherence. By avoiding the liver's first-pass metabolism, Vivitrol provides a more consistent and reliable level of medication in the body.

Clinical Recommendations

If oral Naltrexone does not lead to a significant reduction in alcohol use or cravings, increasing the dose to 100 mg daily, or switching to Vivitrol may be considered. Many patients who did not respond to oral Naltrexone have benefited from the injectable form, according to clinical experiences shared by addiction experts.

Side Effects & Contraindications

Regular monitoring, especially liver function tests, is recommended when using higher doses. In rare cases, patients can develop hepatitis (liver inflammation) from naltrexone.

That being said, research examining the use of naltrexone in patients with severe liver disease typically indicates an enhancement in liver health while on naltrexone, likely due to reduced alcohol consumption.

Side effects are rare and in most studies naltrexone is as well tolerated as a placebo (sugar pill). But they can occur:

The most common side effects of naltrexone are nausea, vomiting, headaches, dizziness, anxiety, nervousness, and variations in sleep patterns such as insomnia or sleepiness.
Other, more rare side effects include abdominal pain or cramps, fatigue, joint and muscle pain, loss of appetite, increased thirst, diarrhea, sexual side effects such as erectile dysfunction and delayed ejaculation, mild allergic reactions, chills, constipation, cough, hoarseness, runny or stuffy nose, sinus problems, sneezing, sore throat, and rash.

Finding a Provider for Vivitrol

If you and your healthcare provider decide that Vivitrol might be right for you, finding a provider is an important next step. The manufacturer of Vivitrol offers a tool to locate healthcare providers who can administer the injection. Visit Vivitrol's provider locator for more information.

Conclusion

For those interested in exploring treatment options or discussing how Naltrexone or Vivitrol might fit into your recovery plan, please don't hesitate to reach out. You can contact us directly by texting or calling at 610-999-6414. We are here to support your journey towards recovery and are eager to help you take the next steps towards a healthier, alcohol-free life.