Naltrexone for drinking

What is naltrexone?

Naltrexone is a prescription tablet approved in Australia to help people who are dependent on alcohol. It can reduce cravings and the urge to keep drinking.

It isn't a sedative, it isn't addictive and it doesn't give a high.

How does naltrexone help with drinking?

Naltrexone blocks some of the pleasant, rewarding effects of alcohol in the brain. With less reward, cravings and the urge to keep drinking can ease.

Australian guidelines note it may be especially useful for helping people avoid going back to heavy drinking. It doesn't make you sick if you drink, and it doesn't sober you up or reduce the effects of alcohol you've already had.

Who might naltrexone suit?

It may suit people who are dependent on alcohol, are otherwise medically stable, and want help with cravings, whether they've already stopped or are working towards it.

Your GP will think about your goal, your liver health and the other medicines you take before suggesting it.

Who shouldn't take naltrexone?

Naltrexone isn't suitable for everyone. The most important thing is opioids, so tell your GP if you take any.

• People taking opioids, including some prescription painkillers and some cough and diarrhoea medicines. Naltrexone blocks opioids and can bring on sudden, severe opioid withdrawal.
• People on an opioid treatment program. Naltrexone isn't used alongside these treatments.
• People who may soon need strong pain relief, such as before planned surgery. Naltrexone stops opioid pain relief from working, so tell any doctor, dentist or hospital that you take it.
• People with serious liver problems, such as acute hepatitis or liver failure. Your GP will usually check your liver with a blood test before you start and from time to time while you take it.

If you're pregnant, planning a pregnancy or breastfeeding, talk to your GP first.

After you stop naltrexone, you may be more sensitive to opioids than before. Tell any doctor who prescribes for you that you've taken it.

What are the side effects of naltrexone?

Side effects are often mild. The common ones include:

• Feeling sick, vomiting, diarrhoea, constipation or stomach cramps.
• Headache or dizziness.
• Feeling tired, anxious or irritable.
• Trouble sleeping.

See a doctor promptly if you have stomach pain that lasts more than a few days, pale poo, dark urine, or yellowing of your skin or eyes, as these can be signs of a liver problem. Call 000 for swelling of the face, lips or throat, or trouble breathing.

How long do people take naltrexone?

There's no set length. People often take it for at least a few months, and you and your GP review how it's going and decide together when to stop.

It's usually taken as one tablet a day. For some people, a GP may suggest a different pattern, such as taking it on days when drinking is more likely. Don't change how you take it without talking to your GP.

How much does naltrexone cost, and is it on the PBS?

Naltrexone is on the Pharmaceutical Benefits Scheme (PBS) for alcohol dependence. That means you pay the standard PBS amount for each script, and less if you have a concession card.

The PBS listing has conditions: it's for people who are dependent on alcohol, as part of a comprehensive treatment program that includes regular GP review. Your GP will check whether you meet them. Outside those conditions it may be a private script, which costs more.

What should I ask my GP about naltrexone?

• Is naltrexone a good fit for my goal and my health?
• Do I need to stop drinking before I start?
• Do I need a blood test first, and how often after that?
• What should I do if I need pain relief or have an operation?
• Which side effects should I watch for, and what do I do if I get them?
• How long would I take it, and when will we review it?
• What other support should go with it?

This is general information. Your GP will explain what applies to you and how naltrexone compares with the other medicines that can help.