How Long Does It Take Naltrexone to Work

More than1 in 6 Americansstruggle with substance misuse. Like other chronic conditions,substance use disordersare treatable, often with medication.

Naltrexoneis one medication option that treatsopioid use disorder(OUD) andalcohol use disorder(AUD). It comes as a once-daily oral tablet and a once-monthly injection calledVivitrol.

When starting medication for OUD or AUD, it's best if it works quickly. But how long does it take naltrexone to work? And how long do you need to take it? We'll answer these questions and more.

EXPERT PICKS: WHAT TO READ NEXT

• Naltrexone side effects to watch for:Naltrexone side effects, such as nausea and headache, are usually mild. But rarely, severe risks like liver damage can occur.
• Comparing medications for opioid use disorder (OUD):Whenlooking at different medications that treat OUD, naltrexone isn't always the best choice.
• Comparing medications for alcohol use disorder (AUD):There are a fewmedication options for AUD. The best choice for you depends on several factors.

How long does naltrexone take to work?

How long naltrexone takes to work depends on which form you're taking. Each form of naltrexone is absorbed differently.

If you take naltrexone by mouth, it gets absorbed and starts workingwithin an hour. The intramuscular (IM) injection takes a little longer to start working -about 2 hours. Full effects from the IM injection may take a few days.

Once naltrexone starts working, it helps decrease alcohol and opioid cravings. This is because naltrexone is anopioid blocker. It blocksopioid receptors(binding sites) in the body. Thisdecreases the levelsof two substances in the body: natural opioid substances and a chemical calleddopamine. This makes opioids and alcohol less enjoyable, reducing cravings for them.

How do you know if naltrexone is working?

If you experience fewer opioid or alcohol cravings after starting naltrexone, it's working. Keep in mind, recovery from substance use disorders is alifelong process. And how long it takes to stop using a substance varies from person to person. If your recovery isn't progressing as you'd like, talk to your prescriber. They may suggest adding or changing treatments.

Naltrexoneisn't considered the most effectivemedication for OUD. It helps with opioid cravings, but it doesn't treat opioid withdrawal symptoms. Instead,first-choice medicationslikebuprenorphine,buprenorphine / naloxone(Suboxone, Zubsolv), andmethadone(Methadose) are better options for most people. They're more likely to help you quit opioids and prevent overdose.

But naltrexone still may be a good option for some people, especially those who can't - or don't want to - take methadone or a buprenorphine-containing medication. If naltrexone is used for OUD, the injection is the preferred form.

On the other hand, naltrexoneisafirst-choice medicationfor AUD. It can help you quit or reduce your drinking, depending on your goals. Either form is a reasonable option for AUD.

Are there factors that can affect how long naltrexone takes to work?

If your goal is to quit opioids or alcohol, taking your naltrexone doses consistently can help you experience its effects more quickly. Not taking it consistently makes it more likely for opioid or alcohol cravings to surface, increasing your chance of returning to substance use.

If you prefer to avoid taking an oral medication daily, the naltrexone injection may be a better option. The injection must be given by a healthcare professional every 4 weeks, often at the clinic where you're receiving treatment. So make sure to keep up with your appointments to get the most out of naltrexone.

It's important to note that some people don't take naltrexone tablets every day. In some cases, naltrexone is prescribed to help reducebinge drinking. This is referred to as "targeted naltrexone" therapy. If you think you may be tempted to drink too much before an event, you can take oral naltrexone. This is instead of taking naltrexone on a daily basis.

Using other nonmedication treatments along with naltrexone can help boost your chances of successfully quitting opioids or alcohol. This includes engaging intalk therapyorsupport groups.

Everyone has a differentrecovery process. If naltrexone doesn't seem to be working for you, tell your prescriber. They may suggest trying another medication.

What to expect when starting naltrexone

Below, we discuss several important points to remember before starting naltrexone.

Tell healthcare professionals that you're using naltrexone Naltrexone can block opioid effects. If you're in an emergency situation that requires pain medications, tell the emergency healthcare professionals that you're taking naltrexone. Keeping apatient safety cardon your person is one way to do this. This will help them come up with a plan to best manage your pain.

You can usually manage side effects at home Naltrexone has been used to treat substance use disordersfor 40 years. This long track record shows that naltrexone is usually well-tolerated. But like all medications,naltrexone side effectscan still occur.

Common side effects like nausea, headaches, and dizziness are usually mild and improve within a few days. With the IM injection, injection site reactions include mild redness, itching, and swelling.

Rarely, liver damage can occur. So if you experience symptoms like swelling in the abdominal area, jaundice (yellow skin or eyes), or dark-colored urine, seek emergency care.

You might need to wait before starting naltrexone Naltrexone strongly attaches to opioid receptors. In fact, it binds so strongly that it can bump off typical opioids that are bound to these receptors. So if any opioids are in your system when you start naltrexone, uncomfortableopioid withdrawal symptomscan occur since their effects are quickly blocked.

After you stop opioids, a7- to 10-day waiting periodmay be recommended before starting naltrexone. But if you're being closely monitored, your care teammight recommendstarting naltrexone sooner. In some cases, your prescriber may test your blood to make sure opioids are fully out of your system.

There are other treatment options if naltrexone doesn't work If naltrexone doesn't seem to be helping you - or is causing bothersome side effects - tell your healthcare team. They may suggest switching to another medication or recommend additional treatment options. For example, many people with substance use disorders also havemood disorders, like anxiety or depression. So they might recommend additional medications or treatment options to improve these conditions.

If your prescriber recommends switching you to methadone or Suboxone for OUD, you can start either of these as soon as the majority of your last naltrexone dose iscleared from your body. This is typically about 1 day after naltrexone tablets or 30 days after the injectable form.

Be aware of overdose risk after starting naltrexone Your body loses tolerance to opioids after you stop taking them. This can make you more sensitive to opioid effects if you return to opioid use. This is especially true if you take more opioids to try toovercome naltrexone's opioid-blocking effects.

Returning to opioid use after using naltrexone can result in a life-threateningopioid overdose. That's why it's important to speak with your prescriber immediately if you feel you're at risk for relapse or if you've already relapsed. They can offer support and talk about how to proceed.

Good to know:Other opioid blockers callednaloxone(Narcan, Zimhi) andnalmefene(Opvee, Zurnai) are used to quickly reverse the effects of an opioid overdose. But naltrexonedoesn't have the same effect. It shouldn't be used in an emergency overdose situation. Since relapse is oftenpart of the recovery process, always keep analoxone or nalmefene medicationon hand if you're diagnosed with OUD. Naloxone nasal spray can befound over the counter. You can also get a prescription from your prescriber. Injectable naloxone and nalmefene are available with a prescription.

How long do you need to take naltrexone?

There'sno universal recommendationfor how long you'll need to take naltrexone for AUD and OUD. Studies of naltrexone for AUD and OUD typicallylast 3to12 months. But the optimal length of treatment will depend on how severe your condition is, your personal preferences, and whether naltrexone is causing any side effects. Treatment for AUD and OUD is often a long-term process. And some people may take naltrexone indefinitely.

There's no risk of naltrexone withdrawal if you stop taking it abruptly, but you should talk to your care team first if you're interested in stopping naltrexone. They can help you come up with a plan to make sure you haveadequate supportin place before you stop it. This decreases your risk of returning to alcohol or opioid use.

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" data-qa="ContentCalloutH2Title" The bottom line

Naltrexone (Vivitrol) is a first-choice medication for moderate-to-severe alcohol use disorder (AUD). It's also FDA approved for opioid use disorder (OUD) Naltrexone usually isn't a first-choice medication for OUD, but it is one of the best options for AUD.

How long it takes naltrexone to work depends on what form you're using. Naltrexone comes as an oral tablet or a monthly injection. The oral form works within about an hour, and the injection works within about 2 hours. But the injection lasts a month and needs to be administered only every 4 weeks; the oral form is typically taken every day.

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