Naltrexone is an FDA-approved opioid antagonist that may be used as part of medication-assisted treatment for alcohol use disorder (AUD). This medication can help reduce cravings for alcohol so that you can stay focused on your goals for an alcohol-free life. The naltrexone dosage prescribed for AUD is different for each person, so it is important to consult with your provider for proper dosing. Although naltrexone is not a controlled substance, you should only access naltrexone care under the guidance of a qualified provider.

If you are interested in online medication-assisted treatment to help support abstinence from alcohol, get in touch with the caring team at Confidant Health. We offer convenient virtual naltrexone and Suboxone treatment through our online Suboxone clinic. To experience the difference naltrexone can make in your recovery, download our app today and schedule an online assessment.

What Is Naltrexone?

Naltrexone is an opioid antagonist medication used to treat alcohol use disorder (AUD) and opioid use disorder (OUD). As an opioid antagonist, naltrexone binds to opioid receptors in the brain without creating a high. This prevents other opioids from interacting with these receptors, so they cannot produce euphoria. Without the euphoric high, the motivation to use opioids or alcohol is minimized, and cravings are reduced.

How Does Naltrexone Work for Alcohol Use Disorder?

Naltrexone works for alcohol use disorder by attaching to brain receptors and blocking alcohol from interacting with them. When you consume alcohol, it interacts with opioid receptors in the brain and affects gamma-aminobutyric acid (GABA), glutamate, and dopamine levels. This interaction is what produces feelings of euphoria and relaxation, which increases the motivation to drink alcohol. If you consume alcohol while on naltrexone, you will not experience a positive mood or sedation. The intention behind naltrexone is to decrease the motivation to drink by preventing the positive feelings associated with alcohol use. This helps to alleviate cravings so that you find it easier to abstain from drinking.

Naltrexone Dosing for Alcohol Use Disorder

Although naltrexone dosing for alcohol use disorder can be similar to that prescribed for opioid use disorder, your provider will determine the appropriate dosage for your needs. The medication is administered as either an oral tablet or an intramuscular injection. 

Oral Naltrexone 

For most people, the prescribed naltrexone dosage will be one 50 mg tablet daily. The tablet will help block the effects of alcohol and reduce cravings for approximately one whole day. In some cases, your provider may adjust your dosage, having you take a higher dose or spread your doses throughout the week. The most common alternative naltrexone dosage schedules for AUD are:

  • 100 mg every other day (two 50 mg tablets)

  • 150 mg every three days (three 50 mg tablets)

  • 50 mg on weekdays, 100 mg on Saturdays

Although most people are prescribed 350 mg of naltrexone over the course of a week, your provider will take into account your personal needs. Even if you are prescribed 350 mg of naltrexone per week, always take your medication exactly as instructed by your provider. Consult them before making any changes to your dosing schedule.

Injectable Naltrexone (XR-NTX)

The brand name for the naltrexone injection is Vivitrol. If your provider prescribes the naltrexone shot (Vivitrol), you will receive one 380 mg intramuscular injection every four weeks. This is the only dosage available for injectable naltrexone. The shot will help keep alcohol cravings at bay for up to one month. You will need to schedule monthly visits with your provider to receive your naltrexone injection, as it can only be administered in their office.

If you find that you experience intense cravings for alcohol before you are due for your next daily dose of naltrexone, talk to your provider. They may decide to modify your dosage or try a different medication. Never adjust your naltrexone dosage without consulting your provider first. Although the medication doesn't get you high or carry a high risk for addiction, taking too much naltrexone at once can lead to an overdose.

Dangers of Naltrexone Overdose

Naltrexone has a low risk for addiction or overdose. The main reason a person would overdose on this medication would be consuming more than the prescribed dosage accidentally or intentionally. However, since taking more naltrexone will not get you high, there's no incentive to do so.

Naltrexone can also lower your tolerance to alcohol or opioids, so if you stop taking naltrexone and consume your usual dose of these substances, you are more likely to overdose.

The most significant danger of naltrexone overdose comes from using large doses of alcohol or opioids to overcome the opioid-blocking effects of the medication. Naltrexone blocks the effects of alcohol on opioid receptors, but only to a certain extent. Since naltrexone blocks the buzz that typically comes with alcohol consumption, some people choose to drink larger amounts to try to recapture that feeling. Consuming high quantities of alcohol can override the effects of naltrexone, but doing so can lead to drinking enough to cause alcohol poisoning.

Naltrexone FAQs

What happens if you miss a naltrexone dose?

If you miss an oral naltrexone dose, you should take your medication as soon as you realize you've missed a dose. But if it is close to the time for your next dose, you should not double up. Instead, wait until it is time to take your next dose. Doubling up on naltrexone medication or taking two doses close together can increase the risk of naltrexone overdose. If you are ever unsure if it is a safe time to take your missed dose, call your provider for instructions.

Who prescribes naltrexone?

Naltrexone is not classified as a controlled substance, so it can be prescribed by any licensed physician, whether it's your primary care physician, a provider at an addiction treatment center, or any other medical professional authorized to write prescriptions. Although you can access naltrexone care through your primary care provider, the medication works best for alcohol use disorder when combined with counseling and support.

Can you drink on naltrexone?

Naltrexone is designed to reduce cravings for alcohol, but you may still experience urges to drink at times. If you drink while receiving naltrexone treatment, your medication will block the effects of alcohol, so you won't feel a buzz. However, you will still experience adverse side effects like impairment, hangovers, and withdrawal symptoms. And since you don't feel intoxicated, you may be at a higher risk for overconsumption and overdose.

For the safest and most effective naltrexone treatment, you should complete alcohol detoxification before your first dose. 

What is the half-life of naltrexone?

The half-life of a medication is the amount of time it takes for half the medication to leave your system. The half-life of naltrexone is dependent on which form is administered. Oral naltrexone has a half-life of four to 13 hours, while injectable naltrexone has a much longer half-life of five to 10 days.

Get Virtual Naltrexone Treatment for AUD at Confidant Health

At Confidant Health, we realize that it can take more than sheer willpower to resist urges to drink. With the help of online medication-assisted treatment with naltrexone, you can enjoy freedom from intense cravings, so you can eliminate alcohol from your life. Contact us today to schedule a virtual assessment to determine if naltrexone medication-assisted treatment for alcohol use disorder is right for you.