Naltima

Why it is prescribed (Indications) :

This medication is an opioid antagonist, prescribed for management of alcoholism and addiction to opioid drugs. Naltrexone is prescribed either alone or with other medications. It blocks the receptors in the brain in order to terminate the action of opioids.

When it is not to be taken (Contraindications) :

Contraindicated in patients who are concurrently dependent on opioids, acute liver inflammation or liver failure, acute opioid withdrawal and patients on therapeutic opioid analgesics.

When it is to be taken :

Adult: PO Opioid dependence Initial: 25 mg, then up to 50 mg/day if no withdrawal signs. Maintenance: 350 mg/week given as 50 mg/day or divided in 3 doses (given on 3 days of the week) for improved compliance. Adjunct in alcohol dependence 50 mg/day. IM Adjunct in alcohol dependence 380 mg 4 weekly

How it should be taken :

It comes as a tablet to take by mouth, with or without food.

Special Instruction :

Caution should be exercised in patients with history of liver or kidney impairment, bleeding disorder, patient under treatment with disulfiram and thioridazine, pregnancy, breastfeeding, elderly, and in children.
Monitor liver functions regularly.
Patient may develop with suicidal thoughts.
Strictly avoid the usage of heroin or opioid drugs, otherwise it will cause death.
Patients should be free from opioid at least 10 days before the treatment with this medication.

Side Effects :

Most Common

Constipation, fatigue, abdominal, joint and muscle pain.

Respiratory

Nasal congestion, itching, runny nose, sneezing, sore throat, excess phlegm, sinus trouble, heavy breathing, hoarseness, cough and shortness of breath.

Heart

Nosebleeds, inflammation of veins, swelling, increased blood pressure, nonspecific ECG changes, palpitations, and fast heart rate.

Gastrointestinal

Nausea, vomiting, diarrhea, ulcer, excessive gas trouble and piles.

Musculoskeletal

Excess pain in the shoulders, legs or knee region, tremors and twitching.

Genitourinary

Increased urination frequency and decreased sexual interest.

Skin

Oily skin, rashes, itching, pimples, athlete’s foot, cold sores and hair loss.

Central Nervous System

Headache, dizziness, nervousness, fearful thought, fatigue, restlessness, drowsiness, confusion, depression, disorientation, hallucinations, nightmares and suicidal thoughts.

Eye and ENT

Blurred vision, burning, light sensitivity, ears "clogged", aching and ringing in the ear

Miscellaneous

Increased appetite, weight loss, weight gain, yawning, fever, dry mouth, head pounding, swollen glands and cold feet.

Other Precautions :

During reversal of this drug, if patient requires opioid painkillers, then the amount of opioid must be increased than the usual dose.
Monitor for injection-site reactions and bleeding disorders.

Storage Conditions :

Injection: Store it in refrigerator (2-8°C); do not freeze. Oral: Store it at room temperature (20-25°C).