Naltrexone often makes you less likely to crave opioid drugs and alcohol. It’s one of the three FDA-approved medications for alcohol use disorder (AUD), and patients who take it report a 75% reduction in alcohol consumption.

However, some people may react differently to the drug and experience unpleasant side effects. Read ahead as we explore these effects, how naltrexone makes you feel, and answer other common questions about the drug.

How Does Naltrexone Work?

Naltrexone blocks opioid receptors in the brain, preventing narcotics and alcohol from taking effect. This eliminates the pleasurable sensations associated with narcotics (such as pain relief and feelings of well-being), which can help you eventually wean off them.

It also eliminates the physical effects of opioids, such as a slower breathing rate, pupil constriction, and drowsiness.

There are three opioid receptors in the brain — µ, κ, and δ. Naltrexone binds the most strongly to μ receptors and is nine times stronger than naloxone (a drug used to reverse opioid overdose).

You might think this would cause people to become addicted to naltrexone, but studies show it does not lead to physical or psychological dependence.

How Does Naltrexone Make You Feel?

It’s difficult to predict how naltrexone will make you feel. If you’ve started taking it after the recommended seven-day opioid-free period, you may feel a reduction in drug and alcohol cravings.

If you still have opioids in your system when starting naltrexone, you may develop withdrawal syndrome. This can be characterized by bone or joint pains, skin crawling sensations, irritability, cramps, and tremors.

Your risk of withdrawal syndrome increases if you’re switching from methadone or buprenorphine, and symptoms may last as long as 14 days.

Some people can also experience other side effects from taking naltrexone.

Common Side Effects of Naltrexone

Common side effects of naltrexone include:

  • Headache
  • Nausea
  • Vomiting
  • Loss of appetite
  • Joint and muscle pain
  • Low/high energy
  • Irritability
  • Feeling down
  • Difficulty sleeping
  • Increased thirst
  • Dizziness
  • Nervousness
  • Skin rash
  • Gastrointestinal irritation, such as abdominal cramps and diarrhea

While naltrexone is generally well-tolerated, it has been shown to cause these side effects in one in every ten patients.

Severe Side Effects of Taking Naltrexone

Naltrexone rarely causes severe side effects. If you experience the following, you should get medical attention right away:

  • Seizures
  • Feeling sleepy
  • Noising breathing
  • Shortness of breath and slow breathing
  • Passing out
  • Feeling confused, tired, or weak
  • Constipation
  • Bloody stools
  • Severe stomach pain

You may also be at a higher risk for liver disease if you use larger doses. It’s important to discuss the risks with your doctor before starting on naltrexone and contact them right away if you notice the following symptoms:

  • Yellowing of eyes or skin
  • Severe abdominal pain
  • Nausea or vomiting that doesn’t stop

You should also contact 911 right away if you experience the following allergic reaction symptoms.

  • Rash
  • Itching
  • Red, swollen, or peeling skin with or without fever
  • Swelling in the tongue, face, or throat
  • Trouble breathing, talking, or swallowing
  • Chest tightness
  • Severe dizziness

An allergic reaction to naltrexone is rare but possible.

How Is Naltrexone Administered?

Naltrexone is available in three forms:

1. Injectable

Naltrexone injections release a 30-day dose and are administered by a healthcare professional in an outpatient setting. They have been shown to decrease overall drinking days, increase abstinence rates, and reduce heavy drinking days.

After the injection, you may experience bruising, swelling, pain, or redness at the injection site. This is common and goes away within two weeks.

If you still experience these symptoms and develop open wounds, blisters, dark scabs, lumps, skin hardness, or extreme pain at the injection site after two weeks, you should immediately notify your healthcare provider.

2. Implant Device

Naltrexone implants are pellet-like devices inserted into the lower belly under anesthesia. They release a fixed amount of naltrexone for 10 to 12 weeks.

Over time, many implants are completely absorbed into the body and don’t need to be removed. But some might break up instead of dissolving, in which case they would have to be surgically removed.

While naltrexone implants are safe, patients may experience surgical site infections and, more rarely, allergic reactions.

3. Tablet

Tablet naltrexone is taken once daily by mouth. It may be a part of a medication regimen, in which case naltrexone may be taken once every two or three days.

The dosage of oral naltrexone is based on your treatment response and medical condition. For instance, if you’re at risk of kidney or liver disease, your doctor may lower your dose or stop you from taking it entirely.

Are There Any Alternatives to Naltrexone?

Although naltrexone is the first-line drug for helping patients quit alcohol, some people can’t tolerate it. In these cases, doctors can use:

  • Disulfiram: It worsens the symptoms of alcohol intoxication, such as nausea, vomiting, and low blood pressure. This acts as a deterrent to alcohol consumption. It’s used only in patients who show a strong motivation for abstinence.
  • Acamprosate: This drug works by blocking glutamate receptors in the brain, reducing alcohol cravings.
  • Gabapentin: This is an anti-seizure drug that works by blocking brain calcium channels. It’s used as a last resort.

For opioid addiction, buprenorphine plus naloxone is a commonly used alternative regimen.

Precautions to Take When Using Naltrexone

When you start using naltrexone, you should take the following precautions:

Do Not Self-Administer Opioids

Naltrexone blocks the sedative effects of opioids and alcohol and stops you from getting “high.” Some patients try to bypass this blocking effect by using larger doses of narcotics. This can lead to opioid overdose, coma, or even death.

Try Not to Miss a Dose

You should not miss a dose of naltrexone even if you feel better unless advised otherwise by your doctor. If you forget to take your naltrexone pill or miss your injection appointment, do not take a double dose to make up for the one you missed. Instead, try to take the missed dose as soon as possible.

Don’t Double Dose on Naltrexone

Naltrexone doses above 50 mg can lead to severe liver injury. You should ensure you don’t take too much by separating your daily doses or having someone do it for you.

If you accidentally overdose and develop symptoms like yellowing in the whites of your eyes, dark urine, stomach pain, or white stools, you should contact your doctor immediately. These are signs of liver injury.

Don’t Perform Dangerous Activities

You should not climb ladders, hike to tall places, drive vehicles, or use heavy machinery until you know how naltrexone affects you. This is important because the drug can cause you to feel sleepy, dizzy, or breathless when you start on it.

Don’t Increase the Dosage of Any Other Drug

Naltrexone may reduce the effectiveness of some cold, cough, diarrhea, and pain medications. If you feel your other medications aren’t working as well as they used to, avoid the urge to take larger doses because that can cause severe side effects. Instead, talk to your doctor. They’ll help you understand your options.

Take Your First Step to Recovery With Curednation

While naltrexone therapy blocks the sedative and euphoric effects of opioids and alcohol, it does not “cure” your dependence on these narcotics.

Instead, it gives you a pathway to a better version of yourself. To make the most of it, it’s important to combine it with long-term therapy and hold yourself accountable. Every day you resist the urge is a day you win.

That’s where Curednation comes in.

Our experts have helped hundreds of people kick their addiction to the curb as safely as possible. If you’ve got any questions or just want to know how to use naltrexone the right way, we’ve got the answers. Book an appointment to get started.

Frequently Asked Questions

Do You Need to Be Sober Before Starting Naltrexone?

No, you do not need to be sober before starting naltrexone. Continued use of alcohol when on naltrexone can induce pharmacologic extinction, which is a process that reduces the association between the pleasurable effects of alcohol and its consumption.

This may significantly decrease the desire to drink alcohol.

Does Naltrexone Reduce Cravings?

Naltrexone may not stop cravings 100% of the time, which may lead to overdose. It is given to people who have detoxified and are motivated to recover from their alcohol or opioid use disorders.

Does Naltrexone Cause Withdrawal When You Stop Taking It?

While naltrexone reduces your desire to use opioids and alcohol, it doesn’t cause withdrawal symptoms once you stop taking it.

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