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naltrexone

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Brand names: Vivitrol, ReVia

Opioid Antagonist Rx

Naltrexone is a medicine that can help treat alcohol and opioid dependence. It works by blocking the effects of opioids in your body.

Drug Pricing (NADAC)

Brand Price

$1578.75/unit

Generic Price

$0.98/unit

Generic Savings

100%

Generic Available

Yes (5 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Naltrexone is used to treat alcohol dependence and to block the effects of opioid drugs.

Common side effects

Nausea, Headache, Fatigue

Key warnings

Naltrexone can cause serious withdrawal symptoms if you are still using opioids.

How It Works

Naltrexone blocks the effects of opioids by attaching to opioid receptors in the brain. This prevents opioids from having their usual effects, like pain relief or feelings of euphoria. By blocking these effects, naltrexone can help reduce cravings for alcohol or opioids.

How to Take It

If you are dependent on opioids, you must be opioid-free for 7 to 10 days before starting naltrexone. The usual dose for alcoholism is 50 mg once a day. To treat opioid dependence, you may start with 25 mg, then increase to 50 mg a day if you have no withdrawal symptoms. Take naltrexone exactly as prescribed by your doctor.

Pregnancy & Breastfeeding

It is not known if naltrexone is safe to use during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if naltrexone passes into breast milk, so talk to your doctor if you are breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store naltrexone at room temperature, away from moisture and heat.

Side Effects (from patient reports)

Based on 21,218 FDA adverse event reports.

Reaction at the injection site
4,407
Pain at the injection site
3,111
Feeling sick to your stomach
2,094
Alcohol addiction
1,942
Lump at the injection site
1,895
Feeling tired
1,781
General pain
1,626
The medicine is not working
1,498
Head pain
1,479
Feeling strange or not like yourself
1,385

FDA Adverse Event Report Analysis

Detailed analysis of 29,813 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

29,813

Death-Related Reports

1,301

Hospitalization Reports

3,715

Top Indication

Alcoholism

Gender Distribution

Female 11,958 (47%)
Male 13,161 (52%)

Age Distribution

0–17 343
18–44 9,536
45–64 6,269
65–74 705
75+ 139

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 INJECTION SITE REACTION 4,407
2 INJECTION SITE PAIN 3,111
3 NAUSEA 2,094
4 ALCOHOLISM 1,942
5 INJECTION SITE MASS 1,895
6 FATIGUE 1,781
7 PAIN 1,626
8 DRUG INEFFECTIVE 1,498
9 HEADACHE 1,479
10 FEELING ABNORMAL 1,385
11 OFF LABEL USE 1,383
12 DRUG DEPENDENCE 1,369
13 MALAISE 1,239
14 INSOMNIA 1,141
15 ANXIETY 1,083

Reactions in Death Reports

DEATH 556
OVERDOSE 321
COMPLETED SUICIDE 155
DRUG DEPENDENCE 74
TOXICITY TO VARIOUS AGENTS 63
DRUG ABUSE 44
OFF LABEL USE 32
DRUG DOSE OMISSION 31
TREATMENT NONCOMPLIANCE 24
PRODUCT DOSE OMISSION 20

Reactions in Hospitalization Reports

HOSPITALISATION 437
ALCOHOLISM 261
NAUSEA 231
INJECTION SITE REACTION 226
PAIN 225
VOMITING 191
INJECTION SITE PAIN 181
DRUG INEFFECTIVE 168
DRUG DEPENDENCE 156
ANXIETY 144

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Naltrexone can cause serious withdrawal symptoms if you are still using opioids. Make sure you are opioid-free for at least 7 to 10 days before starting naltrexone. If you experience severe withdrawal symptoms, seek medical help right away.

Known Drug Interactions

Lethargy and somnolence have been reported following doses of naltrexone hydrochloride and thioridazine.

Mechanism: Taking these two drugs together can cause an additive effect that makes you feel very sleepy and tired. Both medications impact the brain in a way that increases drowsiness.

What to do: Tell your doctor if you feel unusually sleepy or sluggish. They may need to monitor your symptoms or adjust your medications.

The safety and efficacy of concomitant use of naltrexone hydrochloride and disulfiram is unknown, and the concomitant use of two potentially hepatotoxic medications is not ordinarily recommended unless the probable benefits outweigh the known risks.

Mechanism: Both of these medications can be hard on the liver. Using them at the same time may increase your risk of developing liver problems.

What to do: This combination is usually avoided unless your doctor decides the benefits are worth the risk. Your doctor should check your liver function regularly.

The pharmacokinetics of acamprosate are not affected by alcohol, diazepam, or disulfiram, and clinically important interactions between naltrexone and acamprosate were not observed [ see Clinical Pharmacology (12.3) ].

Mechanism: These two drugs do not significantly change how the other works in your body.

What to do: You can take these medicines together as no major issues have been found.

There is insufficient information to make a recommendation regarding the concomitant use of naltrexone with MAVYRET.

Mechanism: There is not enough research yet to know exactly how these two drugs affect each other in the body.

What to do: Talk to your doctor before taking these together because the safety of this combination is not yet known.

CONCOMITANT DRUG CLINICAL EFFECT(S) Amphetamines, cocaine, other sympathomimetic agents Additive hypertension, tachycardia, possibly cardiotoxicity Atropine, scopolamine, antihistamines, other anticholinergic agents Additive or super-additive tachycardia, drowsiness Amitriptyline, amoxapine, desipramine, other tricyclic antidepressants Additive tachycardia, hypertension, drowsiness Barbiturates, benzodiazepines, ethanol, lithium, opioids, buspirone, antihistamines, muscle relaxants, other CNS depressants Additive drowsiness and CNS depression Disulfiram A reversible hypomanic reaction was r...

Mechanism: These drugs can have a combined effect that slows down your central nervous system, leading to increased sleepiness.

What to do: Use caution when taking these together and report any excessive drowsiness to your healthcare provider.

Common Questions

Can I take naltrexone if I am taking pain medicine?
You should not take naltrexone if you are taking opioid pain medicines.
How long will I need to take naltrexone?
Your doctor will determine how long you need to take naltrexone.
Will naltrexone cure my addiction?
Naltrexone is not a cure, but it can help you manage your addiction as part of a complete treatment plan.
Can I drink alcohol while taking naltrexone?
Naltrexone can help reduce cravings for alcohol, but it is important to avoid alcohol while taking this medicine.
What should I do if I experience side effects?
Talk to your doctor if you experience any side effects while taking naltrexone.
Can I take naltrexone if I am allergic to naloxone?
Tell your doctor if you are allergic to naloxone before taking naltrexone.
Will naltrexone show up on a drug test?
Naltrexone itself will not show up on a standard drug test, but it can affect the results of opioid tests.
Can I stop taking naltrexone suddenly?
Talk to your doctor before stopping naltrexone, as they may want to monitor you for any withdrawal symptoms.
Does naltrexone have any effect on my liver?
High doses of naltrexone can cause liver problems. Your doctor may check your liver function while you are taking naltrexone.
What is a naloxone challenge test?
A naloxone challenge test is used to check if you are opioid-free before starting naltrexone. If you have opioids in your system, naloxone can cause withdrawal symptoms.
What are the common side effects of naltrexone?
The most commonly reported side effects of naltrexone include Nausea, Headache, Fatigue, Insomnia, Anxiety. Based on 21,218 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does naltrexone interact with other medications?
Yes, naltrexone has 5 known drug interactions. Notable interactions include thioridazine, disulfiram, acamprosate. Always inform your doctor about all medications you are taking.
What drug class is naltrexone?
naltrexone belongs to the Opioid Antagonist drug class. It requires a prescription (Rx). Naltrexone is used to treat alcohol dependence and to block the effects of opioid drugs.
Is there a generic version of naltrexone?
Yes, generic naltrexone is available from 5 manufacturers. The generic costs $0.98 per unit compared to $1578.75 for the brand version, saving approximately 100%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is naltrexone safe during pregnancy?
It is not known if naltrexone is safe to use during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

Related Medications in Opioid Antagonist

Other drugs grouped near naltrexone — same-class peers and common alternatives.

Compare naltrexone vs acamprosate side-by-side →

Medication Guides

Related Health & Safety Data

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What the FDA Data Shows for naltrexone

The FDA label for naltrexone (sold under brand names such as Vivitrol, ReVia) classifies it as a prescription-only medication in the Opioid Antagonist class. Naltrexone is used to treat alcohol dependence and to block the effects of opioid drugs. Official labeling lists 7 commonly reported side effects, including Nausea, Headache, Fatigue.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 21,218 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.98 versus $1578.75 for the brand — a 100% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: December 15, 2023

All federal data sources used on this page