{"id":52159,"date":"2023-09-20T09:29:31","date_gmt":"2023-09-20T09:29:31","guid":{"rendered":"https:\/\/medsname.com\/naltima\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"naltima","status":"publish","type":"product","link":"https:\/\/medsbase.com\/el\/naltima\/","title":{"rendered":"Naltima"},"content":{"rendered":"

<\/p>\n

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⚡ Quick Answer — Naltima — naltrexone 50 mg for alcohol or opioid use disorder<\/h3>\n

Naltima is naltrexone 50 mg, a long-acting μ-opioid receptor antagonist. In alcohol use disorder<\/strong> it dampens the rewarding feeling of drinking; in opioid use disorder<\/strong> it blocks the effect of any opioid taken. You must be opioid-free for 7–10 days<\/strong> before starting for OUD, otherwise it precipitates withdrawal. A 50 mg once-daily oral course is typical, often paired with counselling and medical management.<\/p>\n<\/div>\n

\n\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong> \u03a0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae\u03c2 WHO-GMP \u00b7 \u0394\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u00b7 \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae \u00b7 1,400+ \u03b5\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03b5\u03c2 \u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b5\u03bb\u03b1\u03c4\u03ce\u03bd<\/a>\n<\/div>\n

\ud83d\udce6 \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7\u03c2 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2<\/strong><\/a> \u2014 \u03b5\u03ac\u03bd \u03c4\u03bf \u03b4\u03ad\u03bc\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03b5\u03bd\u03c4\u03cc\u03c2 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03c9\u03bd \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd, \u03c4\u03bf \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5.<\/p>\n

\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n

\u03a4\u03b1 \u03b3\u03b5\u03bd\u03cc\u03c3\u03b7\u03bc\u03b1 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03ac \u03bc\u03b1\u03c2 \u03c0\u03c1\u03bf\u03ad\u03c1\u03c7\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ad\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd WHO-GMP \u03ba\u03b1\u03b9 \u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03bd\u03c4\u03b1\u03b9 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c3\u03b5 \u03b4\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae, \u03b1\u03c0\u03bb\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u2014 \u03c7\u03c9\u03c1\u03af\u03c2 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5 \u03c3\u03c4\u03bf \u03b5\u03be\u03c9\u03c4\u03b5\u03c1\u03b9\u03ba\u03cc \u03c4\u03bf\u03c5 \u03b4\u03ad\u03bc\u03b1\u03c4\u03bf\u03c2. \u039f\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u03b4\u03c1\u03bf\u03bc\u03bf\u03bb\u03bf\u03b3\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03bc\u03ad\u03c3\u03c9 \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf\u03c5 \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae (\u03bf\u03b9 \u03c0\u03b5\u03c1\u03b9\u03b3\u03c1\u03b1\u03c6\u03ad\u03c2 \u03b5\u03ba\u03ba\u03b1\u03b8\u03ac\u03c1\u03b9\u03c3\u03b7\u03c2 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ce\u03bd \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u2014 \u03c0\u03bf\u03c4\u03ad \u201cMedsBase\u201d \u03ae \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5). \u0393\u03af\u03bd\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b4\u03b5\u03ba\u03c4\u03ad\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03c1\u03c5\u03c0\u03c4\u03bf\u03bd\u03bf\u03bc\u03af\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03c4\u03c1\u03b1\u03c0\u03b5\u03b6\u03b9\u03ba\u03ae \u03bc\u03b5\u03c4\u03b1\u03c6\u03bf\u03c1\u03ac SEPA. \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2 \u0395\u03be\u03b1\u03c3\u03c6\u03b1\u03bb\u03af\u03c3\u03b5\u03ce\u03c2 \u03bc\u03b1\u03c2.<\/p>\n

Opioid-free precondition.<\/strong> If naltrexone is started while opioids are still in the system — including methadone (longer washout: 14 days), buprenorphine, codeine, tramadol, oxycodone, fentanyl, heroin — it precipitates a severe acute withdrawal syndrome that can require hospital admission. The patient must be at least 7–10 days opioid-free<\/strong> (longer for methadone), and most prescribers run a naloxone challenge test<\/strong> before the first naltrexone dose.<\/div>\n

What is Naltima?<\/h2>\n

Naltima is a medication containing naltrexone hydrochloride 50 mg<\/strong> (tablets), supplied by Intas Pharmaceuticals. Naltrexone is a long-acting, orally active opioid-receptor antagonist with high affinity at μ-receptors (and partial activity at κ- and δ-receptors). It is one of the two first-line oral pharmacotherapies (alongside acamprosate) for alcohol use disorder in modern guidelines, and a non-controlled alternative to opioid agonist therapy for opioid use disorder.<\/p>\n

How naltrexone works<\/h2>\n

In alcohol use disorder:<\/strong> alcohol-induced dopamine release in the nucleus accumbens is partly opioid-mediated; blocking μ-receptors with naltrexone attenuates that reward signal. Patients describe drinking as “less satisfying” rather than aversive — importantly, naltrexone does not produce a disulfiram-like reaction, so it is safe if the patient slips. The COMBINE study (2006) established naltrexone’s effectiveness, particularly when paired with medical management.<\/p>\n

In opioid use disorder:<\/strong> naltrexone occupies μ-receptors with such high affinity that subsequent opioid use produces no euphoria. The deterrent is total — injection of heroin while on naltrexone is essentially a wasted dose. This makes adherence the entire problem: a patient who skips two days of naltrexone has a clear window to relapse, and the relapse risk after stopping is high because there is no agonist effect to fall back on.<\/p>\n

How Naltima is used<\/h2>\n

The standard adult dose for both indications is 50 mg \u03bc\u03af\u03b1 \u03c6\u03bf\u03c1\u03ac \u03b7\u03bc\u03b5\u03c1\u03b7\u03c3\u03af\u03c9\u03c2<\/strong>:<\/p>\n\n\n\n\n\n\n\n\n
\u0395\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/th>\nStandard regimen<\/th>\n\u03a3\u03b7\u03bc\u03b5\u03b9\u03ce\u03c3\u03b5\u03b9\u03c2<\/th>\n<\/tr>\n<\/thead>\n
Alcohol use disorder<\/td>\n50 mg \u03bc\u03af\u03b1 \u03c6\u03bf\u03c1\u03ac \u03b7\u03bc\u03b5\u03c1\u03b7\u03c3\u03af\u03c9\u03c2<\/td>\nCan be started while still drinking; cessation not required for first dose<\/td>\n<\/tr>\n
Opioid use disorder<\/td>\n50 mg \u03bc\u03af\u03b1 \u03c6\u03bf\u03c1\u03ac \u03b7\u03bc\u03b5\u03c1\u03b7\u03c3\u03af\u03c9\u03c2<\/td>\nMust be opioid-free 7–10 days<\/strong> (14 for methadone); naloxone-challenge test confirms<\/td>\n<\/tr>\n
Targeted use (selected AUD patients)<\/td>\n50 mg 1–2 hours before drinking events<\/td>\nSinclair Method; useful in patients pursuing controlled drinking rather than abstinence<\/td>\n<\/tr>\n
Three-times-weekly schedule (selected patients)<\/td>\n100 mg Mon, 100 mg Wed, 150 mg Fri<\/td>\nImproves observed-dose adherence in OUD<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Take with or without food. If a dose is missed, take it as soon as remembered, but skip it if it is nearly time for the next — do not double-dose. Treatment duration is at least 3 months<\/strong>, often 6–12 months<\/strong> in AUD and longer in OUD<\/strong>; relapse risk is highest in the first 90 days after stopping.<\/p>\n

\u03a0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b5\u03c2<\/h2>\n
    \n
  • \u039d\u03b1\u03c5\u03c4\u03af\u03b1<\/strong> (most common, ~10–15%, abates within 1–2 weeks; take after food)<\/li>\n
  • Headache, dizziness<\/strong><\/li>\n
  • Insomnia, anxiety, low mood, anhedonia (occasional — some patients describe a flattening of pleasure that resolves on stopping)<\/li>\n
  • Fatigue, somnolence<\/li>\n
  • Abdominal pain, diarrhoea or constipation<\/li>\n
  • Hepatotoxicity<\/strong> — the original FDA black-box was based on liver injury in obese patients on 300 mg\/day for non-AUD indications. At 50 mg\/day the signal is much weaker. Baseline LFTs and re-check at 6 and 12 weeks then 3-monthly is reasonable.<\/li>\n
  • Injection-site reactions if extended-release IM formulations are used (not applicable to this oral product)<\/li>\n<\/ul>\n

    Critical safety: surgical and emergency analgesia<\/h2>\n
    Opioid analgesia is largely blocked while on naltrexone.<\/strong> If you need surgery, dental work, or might attend an emergency department, tell every clinician you are on naltrexone and carry a wallet card<\/strong>. For elective surgery, naltrexone is usually stopped 72 hours before. For emergency analgesia, non-opioid options (paracetamol, NSAIDs, ketamine, regional anaesthesia) are preferred; if opioid analgesia is essential, much higher-than-usual doses of a short-acting agent under monitoring may be needed — this is a specialist anaesthetic decision because of the risk of respiratory depression once receptor blockade wanes.<\/div>\n

    \u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n
    \u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf \/ \u03ba\u03b1\u03c4\u03b7\u03b3\u03bf\u03c1\u03af\u03b1<\/th>\n\u0391\u03c0\u03bf\u03c4\u03ad\u03bb\u03b5\u03c3\u03bc\u03b1<\/th>\nAction<\/th>\n<\/tr>\n<\/thead>\n
    Opioid analgesics (codeine, tramadol, morphine, oxycodone, fentanyl, etc.)<\/td>\nAnalgesia blocked; high-dose attempts risk respiratory depression once blockade wanes<\/td>\nUse non-opioid analgesia where possible; tell every prescriber<\/td>\n<\/tr>\n
    Opioid agonist OUD therapy (methadone, buprenorphine)<\/td>\nPrecipitated withdrawal<\/td>\nCannot be co-prescribed; choose one strategy<\/td>\n<\/tr>\n
    Antidiarrhoeals (loperamide, diphenoxylate)<\/td>\nReduced effect<\/td>\nUse bismuth or non-opioid alternatives<\/td>\n<\/tr>\n
    Antitussives (dextromethorphan, codeine cough syrups)<\/td>\nReduced effect<\/td>\nHoney, simple linctus, guaifenesin alternatives<\/td>\n<\/tr>\n
    Disulfiram<\/td>\nTheoretical hepatotoxicity stacking; combination is sometimes used in AUD with extra LFT monitoring<\/td>\nSpecialist decision<\/td>\n<\/tr>\n
    Thioridazine<\/td>\nLethargy and somnolence<\/td>\nAvoid combination<\/td>\n<\/tr>\n
    Yohimbine<\/td>\nMay precipitate panic in vulnerable patients<\/td>\n\u0391\u03c0\u03bf\u03c6\u03cd\u03b3\u03b5\u03c4\u03b5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Contraindications and special populations<\/h2>\n