naltrexone

General information

• Class: Adjunctive therapy
• Common US brands: Revia, Depade
• Typical dose range: Alcohol dependence: 50 mg once daily was used in placebo-controlled outpatient trials for up to 12 weeks as an adjunct to psychosocial methods (label).
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2026-02-12

Dosing & forms

• Forms/strengths: Tablets: 50 mg (label/manufacturer-dependent).
• Frequency: Alcohol dependence: 50 mg once daily was used in placebo-controlled outpatient trials for up to 12 weeks as an adjunct to psychosocial methods (label).
• Typical range: Alcohol dependence: 50 mg once daily was used in placebo-controlled outpatient trials for up to 12 weeks as an adjunct to psychosocial methods (label).

Mechanism (brief)

Opioid receptor antagonist used for alcohol dependence and for opioid dependence relapse prevention via opioid blockade; requires an opioid-free period to avoid precipitated withdrawal and has hepatotoxicity cautions at higher doses.

Metabolism & Half‑life

• Metabolism: Extensive hepatic metabolism (first pass)
• Half‑life: Single-dose mean 4 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Liver function testing (baseline and follow-up), especially with alcohol-related liver disease (label/clinical).
• Opioid exposure screening and documentation of opioid-free verification strategy (label/clinical).
• Monitoring for nausea, dizziness, and fatigue that can affect adherence and function (clinical).
• Perioperative/acute pain planning because opioid analgesia may be ineffective while naltrexone is active (clinical).

Sources

• Naltrexone hydrochloride tablets prescribing information — DailyMed (2026)
• Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis — JAMA (2014)
• AGNP TDM Consensus — Pharmacopsychiatry (2018)
• The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management — Journal of Addiction Medicine (2020)