Naltrexone

Sold under the brand names ReVia and Vivitrol among others, is a medication primarily used to manage alcohol or opioid dependence.

Naltrexone

Naltrexone; 16590-41-3; Vivitrex; ReVia; N-Cyclopropylmethylnoroxymorphone

Naltima, Nodict

(1S,5R,13R,17S)-4-(cyclopropylmethyl)-10,17-dihydroxy-12-oxa-4-azapentacyclo[9.6.1.0¹,¹³.0?,¹?.0?,¹?]octadeca-7(18),8,10-trien-14-one

Although well absorbed orally, naltrexone is subject to significant first pass metabolism with oral bioavailability estimates ranging from 5 to 40%.

NA

• Initial: 25 mg for Opioid dependence as PO. 
• 50 mg/day for adjunct in alcohol dependence. 
• IM- Adjunct in alcohol dependence- 380 mg 4 weekly.

• Used as an opiate cessation
• Also used for the management of alcohol dependence in conjunction with a behavioural modification program.

Abdominal pain, nausea, vomiting; anxiety, insomnia, lethargy, headache, musculoskeletal pain; anorexia, diarrhoea, constipation; increased thirst; chest pain; chills, dizziness; sexual dysfunction; rash, liver function abnormalities and reversible idiopathic thrombocytopenia. Inj-site reactions.

• With thioridazine increased risk of naltrexone-induced lethargy and somnolence.
• May reduce effects of opiate-containing preparations e.g. those used for cough and cold, diarrhoea and pain.
• Potentially increased hepatotoxic effects with disulfiram.
• Decreased or increased serum levels with drugs that alter hepatic metabolism.
• May increase insulin requirements.

Patients concurrently dependent on opioids; acute hepatitis or hepatic failure; acute opioid withdrawal; patients on therapeutic opioid analgesics.

Store at 20-25°C

Molecular weight

341.4009

Molecular formula

C20H23NO4

CAS number

16590-41-3

Precautions

• Hepatic or renal impairment.
•  Monitor LFTs regularly.
• Pregnancy, lactation.
• Monitor for inj-site reactions.
• History of bleeding disorders (including thrombocytopenia).