Naloxone vs. Naltrexone: Prescription, Uses, Administration, and More

47,000 Americans lost their lives to opioid overdose in 2017. Unfortunately, these numbers have since increased. In 2020, the CDC reported 68,630 opioid overdose deaths, while projections for 2021 stand at 75,673 deaths.

FDA-approved opioid antagonists can reverse an opioid overdose and potentially save thousands of lives. While both naloxone and naltrexone are opioid antagonists, their duration of action, intended uses, doses, and formulations differ. In this article, we discuss all these differences and more. 

What is Naloxone, and How Does it Work?

Naloxone is a short-acting opioid antagonist. This means it dislodges opioids from their receptors and can reverse an opioid overdose within two minutes.

Naloxone Formulations and How Are They Administered?

What is Naloxone Used For?

Naloxone is an FDA-approved treatment for opioid overdose. A systematic review shows that naloxone can effectively reverse opioid overdose. In addition, using naloxone can help diagnose suspected opioid overdose. This is because naloxone can only displace opioids. Thus if a patient improves with naloxone, an opioid overdose is most likely.

Doctors also use naloxone off-label to treat conditions other than opioid overdose. These include:

• Septic shock. Studies show naloxone can improve blood pressure in 50% of septic shock patients.
• Clonidine overdose. In isolated cases, naloxone has been able to reverse clonidine overdose.
• Opioid-induced constipation. Constipation can affect up to 81% of opioid users. Studies show naloxone can relieve symptoms in patients and reduce laxative requirements.

‍

What is Naltrexone, and How Does it Work?

Like naloxone, naltrexone is an opioid antagonist. But it takes longer to act and thus can't immediately reverse an opioid overdose. Instead, it is FDA-approved for use in opioid use disorder (OUD) and alcohol use disorder. 

Naltrexone Formulations and How Are They Administered?

What is Naltrexone Used For?

Naltrexone is an FDA-approved treatment for OUD and alcohol use disorder.

Studies show naltrexone can also treat many other conditions. These include:

• Obesity
• Cholestatic pruritus
• Chronic pain
• Fibromyalgia
• Chronic fatigue syndrome
• Crohn's disease
• Connective tissue diseases such as Sjogren's syndrome
• Depression
• Post-traumatic stress disorder (PTSD)
• Cancer

Can You Use Naloxone & Naltrexone at the Same Time?

Using naloxone and naltrexone together makes them less effective because they reduce each other's concentration in blood.

In a study where researchers administered naloxone and naltrexone together, naltrexone concentration was 62% lower than expected. This meant naltrexone took twice the standard time to achieve its effects.

However, suppose patients are already on naltrexone for OUD and suffer from an opioid overdose. In that case, physicians should administer naloxone for rapid overdose reversal.

Frequently Asked Questions

Is Naloxone the Same as Narcan?

Naloxone is available as part of many formulations. One such formulation is the nasal spray (4 mg/spray): Narcan.

In other words, naloxone is the same as Narcan when referring to its nasal spray formulation.

Is Naltrexone the Same as Naloxone?

Naltrexone and naloxone are not the same.

Naltrexone is a long-acting opioid antagonist, while naloxone is a quicker-acting opioid antagonist. 

Is Suboxone the same as Naltrexone?

Suboxone is not the same as naltrexone.

Suboxone is a brand-name formulation containing two active ingredients: buprenorphine and naltrexone. In other words, naltrexone is an opioid antagonist part of Suboxone.

Is Naltrexone Available Over the Counter?

Naltrexone is not available OTC (over-the-counter). Only a licensed practitioner can prescribe it.

Is Naloxone Available Over the Counter?

No. All formulations of naloxone are prescription products.

Given the state of the opioid epidemic, the FDA is trying to increase access to naloxone. But at present only licensed providers can prescribe it.

Medication-Assisted Treatment (MAT) at Confidant Health

At Confidant Health, we combine FDA-approved medications with holistic behavioral therapy to help you overcome substance use disorders. Our virtual providers go above and beyond, providing you with the best care.

Connect with us today!