Recent trends in substance use during pregnancy are concerning. Research shows a 130% increase in opioid-misuse-related diagnoses in pregnant women over the past decade. In addition, every one in seven women reports using alcohol while pregnant. 

Drug misuse has severe consequences for the mother and her unborn baby. These include slow fetal growth, intrauterine fetal death, and stillbirths. 

Fortunately, medication-assisted treatments (MAT) can reduce drug misuse and the risk of pregnancy complications. Here we discuss if naltrexone — a part of MAT — is safe to take while pregnant.

What is Naltrexone, And How Does it Work?

Naltrexone is an opioid antagonist available in oral and injectable formulations. It binds to opioid receptors in the brain without activating them. As a result, it blocks the addictive and euphoric effects of opioids while also reducing cravings for alcohol.

Is Naltrexone FDA-Approved for Pregnancy?

The FDA (Food and Drug Administration) classifies naltrexone as a 'category C' drug in pregnancy. This implies that the medication can cause considerable harm to the unborn child and the expecting mother.

Why is Naltrexone a ‘Category C’ Drug in Pregnancy?

The FDA justifies this recommendation based on the following:

  • Animal studies show that naltrexone can cause intrauterine fetal deaths and stillbirths.

  • Owing to the lack of data, naltrexone's long-term effects on pre-and postnatal development are not well-known.

  • The opioid system is active during fetal development, and the long-term effects of antagonizing (naltrexone is an opioid antagonist) this system during development are not well known

Recent Developments

Several trials are currently underway to determine naltrexone safety in human pregnancies. Initial data suggests no dangerous consequences of using either formulation of naltrexone. Similarly, experimental studies conducted by Boston University show no adverse effects of using naltrexone in pregnant women.

At this stage, however, given the limited data, we can not recommend naltrexone use in pregnancy. This may change in the future.

Can You Take Low Dose Naltrexone During Pregnancy?

Low-dose naltrexone refers to using about 1/10th of the usual naltrexone dose. This is equal to about 4.5 mg per day. Studies show that low-dose naltrexone has anti-inflammatory properties and can treat many conditions, including:

  • Fibromyalgia

  • Chronic fatigue syndrome

  • Chronic pain

  • Autoimmune conditions such as rheumatoid arthritis, multiple sclerosis, and Crohn's disease

  • Obesity

  • Cholestatic pruritus

  • Depression

  • Post-traumatic stress disorder (PTSD)

  • Cancer

Despite its safe profile, we can not recommend using low-dose naltrexone during pregnancy, given the limited available data. It is always recommended that you speak with your medical provider to discuss your options further. 

We Can Help You Overcome Substance Misuse During Your Pregnancy!

At Confidant Health, we combine medications with behavioral and psychological therapies to help you combat substance-use disorders — even if you are pregnant. 

Our trained virtual providers can work with  your pregnancy to help you achieve your desired results. Get in touch with us today!