Back نالتريكسون Arabic نالتروکسان AZB Налтрексон Bulgarian Naltrexon Czech Naltrecson Welsh Naltrexon German Naltrexona Spanish نالتروکسان Persian Naltreksoni Finnish Naltrexone French

Naltrexone

Not to be confused with Naloxone or Nalmexone.
"Revia" redirects here. For the cantillation mark, see Revia (Hebrew cantillation mark).

Naltrexone
Clinical data
Pronunciation/ˌnælˈtrɛksoʊn/
Trade namesRevia, Vivitrol, Depade, others
Other namesEN-1639A; UM-792; ALKS-6428; N-cyclopropylmethylnoroxymorphone; N-cyclopropylmethyl-14-hydroxydihydromorphinone; 17-(cyclopropylmethyl)-4,5α-epoxy-3,14-dihydroxymorphinan-6-one
AHFS/Drugs.comMonograph
MedlinePlusa685041
License data
Pregnancy
category
  • AU: B3
Routes of
administration		By mouth, intramuscular, subcutaneous implant
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability5–60%[6][7]
Protein binding20%[6][3]
MetabolismLiver (non-CYP450)[11]
Metabolites6β-Naltrexol, others[6]
Onset of action30 minutes[8]
Elimination half-lifeOral (Revia):[3]
• Naltrexone: 4 hours
• 6β-Naltrexol: 13 hours
Oral (Contrave):[4]
• Naltrexone: 5 hours
IMTooltip Intramuscular injection (Vivitrol):[5]
• Naltrexone: 5–10 days
• 6β-Naltrexol: 5–10 days
Duration of action>72 hours[6][9][10]
ExcretionUrine[3]
Identifiers
  • (4R,4aS,7aR,12bS)-3-(cyclopropylmethyl)-4a,9-dihydroxy-2,4,5,6,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline-7-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.036.939 Edit this at Wikidata
Chemical and physical data
FormulaC20H23NO4
Molar mass341.407 g·mol−1
3D model (JSmol)
Melting point169 °C (336 °F)
  • O=C4[C@@H]5Oc1c2c(ccc1O)C[C@H]3N(CC[C@]25[C@@]3(O)CC4)CC6CC6
  • InChI=1S/C20H23NO4/c22-13-4-3-12-9-15-20(24)6-5-14(23)18-19(20,16(12)17(13)25-18)7-8-21(15)10-11-1-2-11/h3-4,11,15,18,22,24H,1-2,5-10H2/t15-,18+,19+,20-/m1/s1 checkY
  • Key:DQCKKXVULJGBQN-XFWGSAIBSA-N checkY
  (verify)

Naltrexone, sold under the brand name Revia among others, is a medication primarily used to manage alcohol use or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder.[8] It has also been found effective in the treatment of other addictions and may be used for them off-label.[12] An opioid-dependent person should not receive naltrexone before detoxification.[8] It is taken orally or by injection into a muscle.[8] Effects begin within 30 minutes,[8] though a decreased desire for opioids may take a few weeks to occur.[8]

Side effects may include trouble sleeping, anxiety, nausea, and headaches.[8] In those still on opioids, opioid withdrawal may occur.[8] Use is not recommended in people with liver failure.[8] It is unclear if use is safe during pregnancy.[8][13] Naltrexone is an opioid antagonist and works by blocking the effects of opioids, including both opioid drugs as well as opioids naturally produced in the brain.[8]

Naltrexone was first made in 1965 and was approved for medical use in the United States in 1984.[8][14] Naltrexone, as naltrexone/bupropion (brand name Contrave), is also used to treat obesity.[15] It is on the World Health Organization's List of Essential Medicines.[16] In 2021, it was the 254th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[17][18]

  1. ^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Retrieved 30 March 2024.
  2. ^ Anvisa (31 March 2023). "RDC Nº 784 – Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 16 August 2023.
  3. ^ a b c d "Revia (naltrexone hydrochloride tablets USP50 mgOpioid Antagonist". DailyMed. 24 April 2015. Archived from the original on 14 June 2022. Retrieved 13 June 2022.
  4. ^ a b "Contrave Extended-Release – naltrexone hydrochloride and bupropion hydrochloride tablet, extended release". DailyMed. 4 November 2021. Archived from the original on 4 June 2020. Retrieved 13 June 2022.
  5. ^ a b "Vivitrol- naltrexone kit". DailyMed. 10 March 2021. Archived from the original on 30 May 2022. Retrieved 13 June 2022.
  6. ^ a b c d Cite error: The named reference pmid2836152 was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference pmid19537999 was invoked but never defined (see the help page).
  8. ^ a b c d e f g h i j k l "Naltrexone Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 9 November 2017. Retrieved 9 November 2017.
  9. ^ Cite error: The named reference ColasantiLingford-HughesNutt2013 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference pmid2839637 was invoked but never defined (see the help page).
  11. ^ Sevarino KA, Kosten TR (2009). "Naltrexone for Initiation and Maintenance of Opiate Abstinence". In Dean RL, Bilsky EJ, Negus SS (eds.). Opiate Receptors and Antagonists. Humana Press. pp. 227–245. doi:10.1007/978-1-59745-197-0_12. ISBN 978-1-58829-881-2.
  12. ^ Cite error: The named reference pmid27401883 was invoked but never defined (see the help page).
  13. ^ Tran TH, Griffin BL, Stone RH, Vest KM, Todd TJ (July 2017). "Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women". Pharmacotherapy. 37 (7): 824–839. doi:10.1002/phar.1958. PMID 28543191. S2CID 13772333.
  14. ^ Sadock BJ, Sadock VA, Sussman N (2012). Kaplan & Sadock's Pocket Handbook of Psychiatric Drug Treatment. Lippincott Williams & Wilkins. p. 265. ISBN 978-1451154467. Archived from the original on 5 December 2017.
  15. ^ "Naltrexone/bupropion for obesity". Drug and Therapeutics Bulletin. 55 (11): 126–129. November 2017. doi:10.1136/dtb.2017.11.0550. PMID 29117992. S2CID 547660.
  16. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list. Geneva: WHO. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  17. ^ "The Top 300 of 2021". ClinCalc. Archived from the original on 15 January 2024. Retrieved 14 January 2024.
  18. ^ "Naltrexone - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.

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