Naltrexone

Naltrexone is an opioid antagonist that is approved for the treatment of both opioid dependence and alcohol dependence.

Naltrexone for alcohol dependence

In people with alcohol dependence, it is believed that this blockade (opioid antagonism) diminishes craving for alcohol and leads to a greater ability to resist urges to drink excessively. Naltrexone is available in two forms: oral daily form (ReVia®, Depade®) and injectable monthly extended-release form (Vivitrol®). The later was approved by FDA for treatment of alcohol dependence in 2006.

Although the mechanism responsible for the reduction in alcohol consumption observed with treatment is not entirely understood, preclinical data suggests that occupation of the opioid receptors results in the blockade of the neurotransmitters in the brain that are believed to be involved with alcohol dependence. This blockade may result in the reduction in alcohol consumption observed in patients treated with naltrexone.

• Naltrexone for Extended-Release Injectable Suspension for Treatment of Alcohol Dependence.
• TIP 49, Chapter 4 (Oral Naltrexone), Chapter 5 (IM).
• Evidence for the Efficacy of Naltrexone in the Treatment of Alcohol Dependence (Alcoholism). (PDF, 686 KB)
  Forum: Naltrexone Clinical Update.
  

Naltrexone for opioid dependence

Naltrexone is a non-opioid medication that is approved for the treatment of opioid dependence. Naltrexone is an opioid receptor antagonist; it binds to opioid receptors, but instead of activating the receptors, it effectively blocks them. Through this action, it prevents opioid receptors from being activated by agonist compounds, such as heroin or prescription pain killers, and is reported to reduce craving and prevent relapse. As opposed to other medications used for opioid dependence (methadone and buprenorphine), naltrexone can be prescribed by any individual who is licensed to prescribe medicine (e.g., physician, doctor of osteopathic medicine, physician assistant, and nurse practitioner). Both the oral daily form and the monthly injectable monthly extended-release form (Vivitrol®) are FDA approved for treatment of opioid dependence. Vivitrol® was approved by FDA for this indication in 2010.

• The Fact About Naltrexone SAMHSA Publication.
• TIP 49, Chapter 4 (Oral Naltrexone).
• Vivitrol Medication Guide.
• Advisory: An Introduction to Extended-Release Injectable Naltrexone for the Treatment of People with Opioid Dependence .

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