Naltrexone, an FDA-approved opioid antagonist, is one component of a treatment plan for managing opioid use disorder (OUD) and alcohol use disorder (AUD). This medication can help decrease the desire to consume alcohol or opioid drugs. Many people are concerned that medications used as part of treatment for substance use disorder are simply replacing one addiction with another. They may ask, “Can you become addicted to naltrexone? Is it possible to overdose on this medication?” Learning about the risks involved with naltrexone or any medication for OUD or AUD is important so you and your provider can find the safest course of treatment for your recovery with minimal side effects. 

If you would like support for decreasing urges to misuse opioids or alcohol, talk to the professionals of Confidant Health. We offer online medication-assisted treatment such as oral naltrexone to help you manage cravings so you can stay on track with your recovery goals. And if you need assistance managing withdrawal symptoms, we also offer Suboxone care through our convenient online Suboxone clinic. Get started today by scheduling an online assessment to determine if oral naltrexone is the right treatment for you.

The Dangers of Naltrexone Overdose

The risk of naltrexone overdose is low since most people do not consume enough of the drug to be harmful. This medication blocks the effects of opioids so that misusing alcohol or opioids does not produce the usual euphoria. Since naltrexone does not produce euphoria, people generally have no incentive to take more of the medication than prescribed. However, naltrexone overdose can happen if higher doses than prescribed are consumed, whether accidentally or intentionally.

The main concern regarding naltrexone overdose is that someone may try to overpower the medication's opioid and alcohol blocking effects by consuming larger amounts of these substances than usual. Because they will not feel intoxicated or high, they may feel comfortable taking larger quantities of the substances. This is primarily what leads to overdose when receiving naltrexone treatment.

Naltrexone Overdose Symptoms

The best way to protect yourself from a naltrexone overdose is to follow your provider's dosage instructions carefully. You should also be aware of the following naltrexone overdose symptoms:

  • Dizziness

  • Nausea

  • Seizures

  • Stomach pain

  • Extreme fatigue

You should seek emergency treatment if you think you may be experiencing a naltrexone overdose.

Who Is Most at Risk of Overdosing on Naltrexone?

When you take naltrexone as directed by your provider, the risk of overdose is very low. You would be most at risk of naltrexone overdose if you take larger doses than prescribed. If you forget to take your prescribed dose, it is safe to take it as soon as you remember. But if it is close to your next scheduled dose, it is better to wait and take your next regularly scheduled dose. You should never double up on doses of naltrexone as it can significantly increase the risk of overdose. If you have missed a dose of your naltrexone medication and aren’t sure if you should take your missed dose or wait for the next dose, you should reach out to your provider for guidance.

Another factor that can increase the risk of overdose is consuming large quantities of alcohol or opioids to overcome the blocking effects of naltrexone and achieve euphoria. Although naltrexone blocks the effects of alcohol and opioids, you can override this action by taking large amounts of these substances, potentially leading to an overdose. 

Discontinuing naltrexone treatment and resuming opioid use can also make you more vulnerable to overdose. Your opioid tolerance may drop, making you more susceptible to unintentionally overdosing.

The risk of precipitated withdrawal and overdose can increase if you begin a naltrexone regimen before you have completed opioid withdrawal. Be sure to inform your provider about the last time you consumed the opioids so they can determine when to start your initial dose of naltrexone. You should wait seven to 10 days after the last use of opioids before taking your first dose of naltrexone to prevent complications.

Naltrexone Administration

Naltrexone is administered as either a tablet or an injection.

Naltrexone Tablet

Naltrexone is available in 50 mg pills. Your initial dose will be 25 mg once daily, and your provider will monitor you closely for withdrawal symptoms. After this initial phase, the most common maintenance dosage is one 50 mg tablet daily, although your provider may modify your dosage and schedule as needed. Some other common naltrexone schedules are:

  • Two 50 mg pills every other day

  • Three 50 mg pills every third day

  • One 50 mg Monday through Friday and two 50 mg pills on Saturdays

You should always follow your provider's instructions and refrain from modifying your dosage schedule without guidance. Taking more naltrexone tablets than advised can increase the risk of adverse effects and overdose.

Naltrexone Injection (XR-NTX)

Injectable naltrexone is delivered as a 380 mg monthly injection. You would need to visit your provider's office once a month to receive the intramuscular injection.

Naltrexone FAQs

Can naltrexone be lethal?

Since naltrexone blocks the effects of opioids and alcohol, a person can experience a lethal overdose if they consume large amounts of opioids or alcohol to override the effects of naltrexone.

How many mg of naltrexone can I take?

The most common naltrexone dosage is 50 mg daily, but some people may be prescribed higher doses spread over a longer period. For example, your provider may have you take 100 mg of naltrexone every other day or 150 mg of naltrexone every three days. This schedule may not be appropriate for everyone, so you should only use your naltrexone medication as prescribed. 

Is 100 mg of naltrexone too much?

Many people are prescribed 100 mg of Naltrexone but usually take this dosage every other day during the maintenance phase. However, your provider may prescribe 100 mg of naltrexone daily if deemed necessary for your situation.

Can you take 75 mg of naltrexone?

You can take 75 mg of Naltrexone if your provider advises you to do so. Oral naltrexone comes in 50 mg tablets, which can be cut in half to allow for alternative dosages, such as 25 mg or 75 mg daily.

Is naltrexone addictive?

Naltrexone is not addictive because it does not have euphoric effects. 

Do you need a prescription for naltrexone?

Although naltrexone is not classified as a controlled substance, you will need a prescription to access this medication. However, you can receive a naltrexone prescription from your primary care provider or any medical professional with authority to prescribe medication.

Is naltrexone overdose possible?

Naltrexone overdose is possible if you take more of the medication than prescribed. Many overdoses involving naltrexone result from combining the medication with opioids or alcohol. Since naltrexone blocks the effects of opioids and alcohol, some people may take larger doses of these substances to override the blocking effects and achieve euphoria. The larger amount of narcotics needed to overcome naltrexone's effects can lead to overdose. Also, if you stop taking naltrexone and resume your previous dose of opioids, you can overdose due to decreased tolerance.

Confidant Health: Safe, Effective Naltrexone Treatment 

Although naltrexone is not addictive, it is still essential that you access this medication through a qualified provider. If you need help overcoming powerful opioid or alcohol cravings, contact the team at Confident Health. We can conduct a virtual assessment to determine if online medication-assisted treatment with naltrexone can help support your goals of decreasing opioid or alcohol use.