Naltrexone

Basic Naltrexone Information

• INN (International Nonproprietary Name): Naltrexone
• Brand names available in United Kingdom: Naltrexone Accord
• ATC Code: N07BB04
• Forms & dosages: Tablets 25 mg, 50 mg, 100 mg; extended-release injection 380 mg per vial
• Manufacturers in United Kingdom: Accord Healthcare
• Registration status in United Kingdom: Prescription Only (Rx)
• OTC / Rx classification: Prescription Only (Rx)

What You Need To Know Before Starting Naltrexone

Do Not Start If Opioids Are Still In Your System

Worried about whether you can start naltrexone after codeine for a bad back, or after tramadol, morphine, oxycodone, methadone, buprenorphine, or illicit opioids?

This medicine must not be started if there is current physiologic opioid dependence, a positive opioid urine test, acute hepatitis, liver failure, or known hypersensitivity to naltrexone or any excipient.

The main risk is precipitated withdrawal, which can feel abrupt and severe if opioids are still on board.

That is why prescribers in the UK check opioid use carefully before supply, especially when a person has recently taken an opioid painkiller, a cough mixture containing codeine, or any non-prescribed opioid.

High-Risk Groups And When To Seek Urgent Help

Extra caution is needed in pregnancy, breastfeeding, older adults, people with severe liver disease, renal impairment, or anyone taking medicines that can affect the liver.

If symptoms are mild, contact your GP, prescriber, or pharmacist for advice.

If symptoms are worrying or getting worse, call NHS 111.

If there is severe abdominal pain, jaundice, collapse, trouble breathing, or a serious allergic reaction, seek emergency help immediately.

• Recent opioid use or uncertain opioid exposure
• Known liver disease or abnormal liver tests
• Pregnancy or breastfeeding
• Kidney problems
• Other medicines that may stress the liver

Driving, Machinery, And Workplace Safety

Dizziness, insomnia, and anxiety can happen, particularly when treatment is first started.

If you feel affected, avoid driving, operating machinery, or anything that could be unsafe at work until you know how naltrexone affects you.

Can I Drive After Taking Naltrexone In The UK?

Yes, but only if you feel safe, are not affected by side effects, and are not impaired.

Do not drive if you feel dizzy, overly anxious, or not fully alert.

What Naltrexone Is And UK Brand Names

INN, Generic Name, And British Terminology

Naltrexone hydrochloride is an opioid antagonist used in dependence treatment.

The INN is naltrexone, which is the name most patients and clinicians will use in the UK.

Brand Names And Availability

In the UK, Naltrexone Accord is listed and supplied as tablets, typically 50 mg, usually in a local pack.

Internationally, you may also see Revia, Vivitrol, Adepend, Naltima, Nodict, Nalcon, Naltrex, Naltrexona Torrex, Naltrexone GH, and Naltrexone Destoxican.

Those names can help if a patient has travelled or has seen a medicine online, but the active ingredient is still naltrexone.

Not The Same As Opioid Replacement Therapy

Naltrexone is different from methadone and buprenorphine.

It does not replace opioids or act as a substitute.

Instead, it blocks opioid effects, which is why opioid-free assessment matters before treatment starts.

Legal Classification, MHRA Status, And NHS Prescribing

Prescription-Only Medicine In The UK

Naltrexone is a prescription-only medicine in the UK.

Supply and local prescribing follow MHRA-regulated medicine rules.

That means it should be used under clinical supervision, not started casually from an unverified source.

NHS And Private Prescribing Pathways

People may access naltrexone through a GP, addiction service, hospital team, or private specialist.

Electronic prescriptions and e-prescribing are used where available, which can make dispensing smoother for the pharmacy and more convenient for the patient.

What Patients Should Expect From The Pharmacist

Pharmacists usually check the medicine history, confirm any opioid exposure, and provide counselling before supply.

That may include a quick medicines reconciliation, advice on side effects, and reminders about follow-up.

This careful UK pharmacy approach helps reduce avoidable harm and supports safe monitoring.

How Naltrexone Works In The Body

Simplified Mechanism

Naltrexone works by blocking opioid receptors.

That means opioids cannot bind and produce their usual rewarding effect.

In alcohol dependence, this can help reduce the rewarding drive that contributes to relapse and cravings.

Clinical Explanation

The ATC code is N07BB04, placing it in drugs used in alcohol dependence.

It is available as oral tablets and as a monthly injection in some markets.

Clinically, the receptor blockade is helpful, but only when the person is already opioid-free and ready to start treatment safely.

Why It Must Not Be Started Too Early

If opioids are still present, the receptor blockade can trigger withdrawal very quickly.

That is why a prescriber checks for recent opioid use, a urine test where needed, and any signs of dependence before treatment begins.

Approved Uses And Common UK Clinical Contexts

NHS-Recognised Use Areas

• Alcohol dependence support
• Opioid dependence after detoxification

Typical Place In Treatment

Naltrexone is often part of a wider plan rather than a stand-alone fix.

It is commonly used alongside counselling, psychosocial support, relapse prevention, and routine follow-up.

That combined approach is what makes treatment more realistic in day-to-day UK practice.

Off-Label Or Special-Interest Use

Low Dose Naltrexone, often searched as LDN, is a separate topic from standard dependence treatment.

It is not the same as the licensed use described here, and the evidence and prescribing routes differ.

If a patient is asking about LDN, the safest answer is to discuss it with a prescriber rather than swapping products on their own.

Dosing Guide For Adults In The UK

Oral Tablet Regimens

For opioid dependence after detoxification, treatment often starts with a 25 mg test dose, then moves to 50 mg daily.

For alcohol dependence, 50 mg daily is the usual starting and maintenance dose.

Some supervised regimens use 100 mg on Monday, Wednesday, and Friday, or 150 mg on Friday.

Monthly Injection Regimen

Extended-release injectable naltrexone is given as 380 mg intramuscularly every 4 weeks.

That format is used in some settings where adherence to tablets is difficult.

Practical Adherence Advice

Take it exactly as prescribed.

Do not change the dose, stop early, or stretch doses out without speaking to the prescriber.

One patient may do well on daily tablets, while another needs closer supervision and regular review.

What If I Miss A Dose?

Take it when remembered unless it is close to the next dose.

Do not double up.

Dose Adjustments And Special Populations

Children And Adolescents

Safety and efficacy are not typically established under 18.

That is why naltrexone is generally not used routinely in children or teenagers without specialist input.

Older Adults And Comorbidity

No routine dose change is specified for older adults.

Even so, monitoring is important if there is frailty, liver disease, kidney impairment, or multiple medicines.

Liver And Kidney Impairment

Avoid naltrexone in acute hepatitis or liver failure.

Use caution in hepatic impairment, and monitor liver function tests if advised.

Severe renal impairment also needs caution and closer monitoring.

Pregnancy And Breastfeeding

Use only when the benefits outweigh the risks, and specialist input is available.

That is a conversation for the prescriber rather than something to self-manage.

• Needs a clinician review first
• May need liver function monitoring
• Requires an opioid-use check before starting
• Needs extra caution in pregnancy and lactation

Side Effects, Red Flags, And When To Get Help

Common Side Effects

• Nausea
• Vomiting
• Abdominal pain
• Diarrhoea
• Headache
• Dizziness
• Insomnia
• Anxiety
• Joint or muscle pain
• Raised liver enzymes
• Injection-site reactions with depot treatment

Serious Symptoms Needing Prompt Review

Persistent vomiting, severe abdominal pain, jaundice, dark urine, or any sign of liver injury needs prompt medical review.

Severe mood change, a rash, swelling, breathing problems, or other signs of allergy also need urgent action.

Patient Guidance

It helps to track symptoms, alcohol use, and any new medicines so patterns are easier to spot at review.

Tell the prescriber or pharmacist if side effects are troublesome or do not settle.

In the UK, suspected adverse reactions can also be reported through the Yellow Card scheme.

Interactions With Opioids, Alcohol, And Other Medicines

Opioid Medicines And Hidden Sources

Mixing naltrexone with codeine, tramadol, morphine, oxycodone, fentanyl, methadone, buprenorphine, cough mixtures, or some diarrhoea medicines can cause serious problems.

The key issue is not just a prescribed painkiller; it is also any hidden opioid source from another product.

Alcohol, Food, Tea, And Coffee

Alcohol matters mainly because naltrexone is being used to support alcohol reduction or abstinence.

There is no major direct food interaction, and tea or coffee are not known to be major interactions.

That said, caffeine may make insomnia feel worse if the medicine already disturbs sleep.

Other Medicines That May Matter

Medicines that can affect the liver need extra care, especially if several are taken together.

Sedatives may also complicate the overall picture, even if they are not direct opioid interactions.

Access, Pharmacies, And Buying Safely In The UK

Community Pharmacy Supply

High-street pharmacies such as Boots, LloydsPharmacy, and Superdrug may supply naltrexone where available and appropriate.

That usually includes pharmacist counselling, prescription checking, and a practical discussion about side effects and interactions.

Online Pharmacies And E-Prescriptions

Online pharmacy use is now common in the UK, but it still needs careful checking.

Look for registration, prescription verification, and compliance with MHRA and General Pharmaceutical Council standards where relevant.

In our online pharmacy, naltrexone is available without a prescription, with discreet delivery to United Kingdom in 5-14 days.

NHS Versus Private Access

Access can differ by service and region, especially if a local addiction team or specialist is involved.

Some patients receive an NHS prescription, while others go through private care when a faster or more tailored route is needed.

Cost, Prescription Charges, And UK Regional Differences

England

NHS prescriptions in England usually carry a charge unless the patient is exempt.

Scotland, Wales, And Northern Ireland

NHS prescriptions are free in these nations.

That can make a real difference for long-term treatment, especially when follow-up is regular.

Private Price Variation

Private prices can vary depending on whether the product is a generic tablet or a specialist product, and on pack size.

Cost also depends on whether the supply is NHS or private, and on the exact brand used.

Evidence, Outcomes, And What Patients Report

What Research Generally Shows

Naltrexone can help reduce alcohol relapse and support opioid abstinence after detoxification when it is paired with psychosocial care.

It is not a cure, but it can be a useful tool in the right patient.

UK Patient Experience Themes

Patients often talk about adherence problems, nausea at the start, and the need for counselling alongside medicine.

In NHS-style consultations, the best results tend to come when follow-up is regular and expectations are realistic.

Clinical Realism

Benefits vary from person to person.

Some people do well quickly, while others need a change in plan or a different support package.

What matters most is continuity, review, and a treatment goal that fits the person’s situation.

• Best results are usually seen with follow-up
• Adherence matters more than wishful thinking
• Side effects can affect persistence
• Counselling improves the treatment plan

Alternatives And Comparison With Other Treatments

Alternative Medicines

For alcohol dependence, common alternatives include acamprosate, disulfiram, and nalmefene.

For opioid dependence, methadone and buprenorphine are key alternatives or adjunctive therapies.

When Each May Suit Different Patients

Acamprosate is mainly used to support abstinence.

Disulfiram works through aversion therapy, so it suits selected patients who are highly committed to avoiding alcohol.

Nalmefene is used in some European settings for alcohol dependence.

Methadone and buprenorphine are opioid substitution treatments, while naltrexone blocks opioid effects rather than replacing them.

Pros And Cons Checklist

Storage, Transport, And Home Handling

Tablet Storage In UK Homes

Store tablets at 20–25°C and keep them in the original packaging.

Protect them from moisture so the medicine stays stable.

Injectable Product Handling

Depot products should be refrigerated according to the product label.

If a patient is travelling, the medicine should be transported in original packaging and protected from heat or freezing.

Household Safety

• Keep out of reach of children
• Avoid bathrooms and damp cupboards
• Do not leave near heaters or sunny windows
• Check the expiry date before use

Proper Use, Counselling, And Patient Checklist

What UK Pharmacists Usually Explain

Patients are normally told to start only after an opioid-free assessment.

They should take the medicine exactly as prescribed and attend follow-up appointments, especially if liver monitoring is advised.

That advice is a routine part of safe pharmacy care in the UK.

Practical Self-Management

Keeping a simple record of doses, side effects, alcohol use, and any opioid exposure can be surprisingly helpful.

If travelling, carry the medication details so another clinician can see what is being taken.

Patient Safety Checklist

• Confirm no recent opioid use
• Tell the clinician about all medicines, including OTC products and codeine medicines
• Ask about liver monitoring if advised
• Know what to do if a dose is missed
• Seek help quickly for worrying side effects

Can I Take Naltrexone With Low Dose Naltrexone Or Mysimba?

These medicines are not interchangeable and should only be used with clinical advice.

Do not assume that a product labelled LDN or a weight-management medicine containing naltrexone has the same purpose, dose, or safety profile.

Delivery Across United Kingdom