Naltrexone is a drug used in the treatment of opioid addiction.
Release form and composition
Naltrexone is produced in the form of tablets (10 pcs. In blisters, 1, 2 or 5 packs per carton; 7 pcs in blister packs, 4 packs in a carton pack).
The composition of 1 tablet contains the active substance: naltrexone hydrochloride - 50 mg.
Indications for use
- Opioid addiction (as an auxiliary drug to prevent the pharmacological effects of exogenous opioids and to maintain a clean state of opioids);
- Alcohol dependence (simultaneously with other drugs).
- Acute hepatitis;
- Withdrawal syndrome;
- Liver failure;
- Positive test for the presence of opioids in the urine;
- Concomitant use with opiates;
- Pregnancy and lactation;
- Age up to 18 years;
- Hypersensitivity to the drug.
Dosing and Administration
Naltrexone is taken orally.
The drug is prescribed only after relief of withdrawal syndrome and prior detoxification.
Therapy begins in specialized drug treatment departments not earlier than 7-10 days after the last opioid drug intake. In the future, the patient should be under strict medical supervision, while the patient must have a positive setting for recovery.
In the treatment of alcoholism is usually prescribed 1 time per day, 1 tablet (50 mg). The use of the drug for 3 months with the consent of the patient, prevents relapses for 6 months.
Before starting treatment of drug addiction, it is necessary to refrain from using opioids for 7–10 days, which should be confirmed by a urine test for opioid content and a provocative test. The patient should be free from withdrawal symptoms and withdrawal syndrome. Therapy is not started until the provocative test with intravenous administration of naloxone in a dose of 0.5 mg is negative. The initial dose is 25 mg, after administration for 1 hour, it is necessary to monitor the patient's condition. In the absence of abstinence syndrome, naltrexone is administered 50 mg 1 time per day (the dose can block the intravenous administration of 25 mg heroin). Alternative treatment regimens are also possible:
- 5 days daily at 50 mg (weekdays), on Saturday - 100 mg;
- 100 mg every other day;
- After 2 days, 150 mg;
- Monday and Wednesday - 100 mg, Friday - 150 mg.
It must be borne in mind that these treatment regimens increase the risk of a hepatotoxic effect.
The duration of the therapeutic course is determined individually.
- Nervous system and sense organs: more often - unusual tiredness; rarely - blurred vision, hallucinations, confusion, ringing and a feeling of congestion in the ears, depression of the central nervous system, pain and burning sensation in the eyes, photophobia, drowsiness, irritability, disorientation in space and time;
- Urogenital system: increased urination, discomfort when urinating;
- Digestive system: rarely - dry mouth, increased appetite, flatulence, worsening symptoms of hemorrhoids, abdominal pain, erosive and ulcerative lesions of the gastrointestinal tract, increased activity of liver enzymes;
- Cardiovascular system: rarely - chest pain, non-specific ECG changes;
- Respiratory system: rarely - increased separation of mucous sputum, hoarseness, dry throat, hyperemia of the vessels of the nasal cavity (nasal congestion), shortness of breath, sneezing, sinusitis;
- Opioid withdrawal syndrome: general weakness, epigastric cramps, abdominal pain, anxiety, fatigue, nervousness, irritability, tremor, tachycardia, diarrhea, rhinorrhea, hyperthermia, sneezing, goose bumps, yawning, sweating, arthralgia, anorexia, milf, mildew, goose bumps, yawning, sweating, arthralgia, anorexia, milf, milf and / or nausea;
- Allergic reactions: less often - skin rash; rarely - pruritus, hyperthermia, increased secretion of the sebaceous glands;
- Other: rarely - an increase in lymph nodes, thirst, pain in the groin, loss or increase in body weight, lymphocytosis. A case of development of idiopathic thrombocytopenic purpura on the background of preliminary sensitization to Naltrexone is described.
Before using Naltrexone, it is necessary to exclude the presence of subclinical hepatic insufficiency, during therapy it is necessary to periodically monitor the level of transaminases. Simultaneous use with drugs with hepatotoxic properties is contraindicated.
In order to prevent the development of acute withdrawal symptoms, patients should stop taking opioids and preparations containing them for at least 7-10 days. If these conditions are not observed, withdrawal symptoms may develop 5 minutes after taking Naltrexone and last for 48 hours.
If emergency pain relief is necessary, caution should be taken to increase the dose of opiates (to overcome antagonism), since this can be more prolonged and more profound.
Before surgery, which requires the use of opioid analgesics, Naltrexone should be canceled no less than 48 hours.
Progressive weight loss and a persistent decrease in appetite require discontinuation of treatment.
Naltrexone is ineffective in the treatment of non-opioid and cocaine drug dependence.
When applying for medical care, patients should inform medical professionals about taking the drug.
If you experience pain in the abdomen, darkening of the urine, yellowing of the sclera, you need to interrupt therapy and consult a doctor.
When used in small doses of heroin and other drugs, there will be no effect from their use, and an increase in doses of narcotic drugs can lead to death (respiratory arrest).
With the simultaneous use of naltrexone with certain drugs, the following effects may occur:
- Hepatotoxic drugs: increased risk of liver damage;
- Thioridazine: increased drowsiness or lethargy;
- Drugs containing opioids (antitussive drugs, analgesics): reducing their effectiveness.
Terms and conditions of storage
Store in a dark, dry place inaccessible to children at temperature up to 25 ° C.
Shelf life - 3 years.