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NaltrexoneAka: Trexan, Revia

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  1. Indications
    1. For relapsing Alcoholic
    2. Must be used with an aftercare program
  2. Contraindications
    1. Long-term Opioid use or heroin dependence
      1. Risk of severe withdrawal
    2. Hepatitis
    3. Liver failure
  3. Adverse effects
    1. Hepatotoxicity (dose dependent)
    2. Nausea (10%)
    3. Headache
    4. Anxiety
    5. Sedation
  4. Mechanism
    1. Reduces Alcohol craving
  5. Efficacy
    1. Initial studies showed relapse reduction by 50%
    2. Recent large DBPCT showed no benefit with Naltrexone
      1. Relapse rate: 38% at 13 weeks (44% with Placebo)
      2. Compliance rate low: 42-44% in all groups
      3. Krystal (2001) N Engl J Med 345:1734
  6. Adverse effects
    1. No toxicity if drinking with Naltrexone
      1. Not indicated to make them social drinkers
      2. Alcoholics tend to get less drunk on naltrexone
    2. Very broad safety profile with minimal adverse effects
      1. Hepatotoxicity, however is a risk
      2. Croop (1997) Arch Gen Psych 54:1130
  7. Monitoring
    1. Obtain serum liver transaminases periodically
      1. Monthly for first 3 months
      2. Then every 3 months
  8. Dosage
    1. Naltrexone 50 mg PO daily ($5/pill)
    2. May need to be used for 1 year or longer
  9. References
    1. Hartmann (1997) Am Fam Physician 55(5):1877
    2. Williams (2005) Am Fam Physician 72(9):1775

Naltrexone (C0027360)

Definition (MSH)Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.
Definition (CSP)synthetic congener of oxymorphone, chemically related to naloxone; a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction and alcohol dependence.
Definition (NCI)A noroxymorphone derivative with competitive opioid antagonistic property. Naltrexone reverses the effects of opioid analgesics by binding to the various opioid receptors in the central nervous system, including the mu-, kappa- and gamma-opioid receptors. This leads to an inhibition of the typical actions of opioid analgesics, including analgesia, euphoria, sedation, respiratory depression, miosis, bradycardia, and physical dependence. Naltrexone is longer-acting and more potent compared to naloxone.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009271
EnglishNaltrexone, NALTREXONE PREPARATION
Spanishnaltrexona
Parent Conceptsthebaine and derivatives (C0682977), Morphinans (C0026548), Narcotic Antagonists (C0027410), Naloxone (C0027358), [CN102] OPIOID ANTAGONIST ANALGESICS (C0973498), Drug allergen (C1320237), Drugs used to treat addiction (C1629845)
SourcesAOD, CSP, LNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


ReVia (C0591842)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009271
EnglishBristol Myers Squibb Brand of Naltrexone Hydrochloride, Bristol-Myers Squibb Brand of Naltrexone Hydrochloride, Du Pont Brand of Naltrexone Hydrochloride, Lamepro Brand of Naltrexone Hydrochloride, Nalorex, Nemexin, Orphan Brand of Naltrexone Hydrochloride, ReVia, Schering Plough Brand of Naltrexone Hydrochloride, Schering-Plough Brand of Naltrexone Hydrochloride, United Drug Brand of Naltrexone Hydrochloride
SourcesMSH, MTH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Trexan (C0729157)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD009271
EnglishTrexan
SourcesMSH
Derived from the NIH UMLS (Unified Medical Language System)



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