
naltrexone
Naltrexone (ReVia) is an opioid antagonist. It's used to treat opioid use disorder and alcohol use disorder in adults. Naltrexone (ReVia) is just one part of a comprehensive treatment plan that should also involve psychotherapy and support groups. Naltrexone (ReVia) is a tablet that's taken by mouth, typically once daily. Some common side effects of naltrexone (ReVia) include nausea, headache, and trouble sleeping. Brand name ReVia has been discontinued; naltrexone tablet is only available as a generic medication.
What is Naltrexone (ReVia)?
What is Naltrexone (ReVia) used for?
How Naltrexone (ReVia) works
Drinking alcohol or taking opioids can trigger the body to release dopamine, a chemical in the body that makes you feel good. Taking these substances repeatedly to feel pleasure can cause the body to become dependent on them.
Naltrexone (ReVia) is an opioid antagonist that blocks the body's opioid receptors. In doing so, naltrexone (ReVia) blocks the rewarding effects of alcohol or opioids. This can help lower cravings for alcohol or opioids.
Drug facts
| Common Brands | ReVia |
|---|---|
| Drug Class | Opioid antagonist |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
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Side effects of Naltrexone (ReVia)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Alcohol use disorder
- Nausea or vomiting (up to 10%)
- Headache (7%)
- Dizziness (4%)
- Nervousness or anxiety (up to 4%)
- Tiredness (4%)
- Trouble sleeping (3%)
Opioid use disorder Reported by 10% or more people during clinical trials:
- Trouble sleeping
- Anxiety
- Nervousness
- Stomach pain or cramps
- Nausea and vomiting
- Low energy
- Joint and muscle pain
- Headache
Less Common Side Effects
- Dry mouth
- Feeling less hungry
- Feeling thirsty
- Skin rash
- Depression
- Feeling irritable
- Diarrhea
- Constipation
- Sexual problems
Naltrexone (ReVia) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or actions
- Liver injury: dark urine, feeling very tired, sudden nausea and vomiting, stomach pain on the upper right side, clay-colored stool, yellowing of the skin or whites of the eyes
- Opioid withdrawal: anxiety, suicidal thoughts, restlessness, runny nose, yawning, sweating, chills, wide pupils, irritability
More on Naltrexone (ReVia) side effects
The following Naltrexone (ReVia) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Skin rash
Rare
Abdominal or stomach pain (severe)
blurred vision, aching, burning, or swollen eyes
confusion
discomfort while urinating or frequent urination
hallucinations or seeing, hearing, or feeling things that are not there
mental depression or other mood or mental changes
ringing or buzzing in the ears
shortness of breath
swelling of the face, feet, or lower legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Abdominal or stomach cramping or pain (mild or moderate)
anxiety, nervousness, restlessness or trouble sleeping
headache
joint or muscle pain
nausea or vomiting
unusual tiredness
Less common
Chills
cough, hoarseness, runny or stuffy nose, sinus problems, sneezing, or sore throat
dizziness
fast or pounding heartbeat
increased thirst
irritability
loss of appetite
sexual problems in males
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Naltrexone (ReVia)
Pros
- Taken by mouth
- Taken once daily
- Available as a lower-cost generic
Cons
- Makes you more sensitive to the effects of opioids
- Can cause sleep problems
- Hasn't been studied in people younger than 18 years old
Pharmacist tips for Naltrexone (ReVia)
- You can take naltrexone (ReVia) with or without food. If it's upsetting your stomach, try taking it with food to help.
- Naltrexone (ReVia) isn't meant to be the only treatment for opioid use disorder and alcohol use disorder. It works best when taken as a part of a comprehensive treatment plan that also involves psychotherapy and support groups. Have a discussion with your healthcare team about what your full treatment plan looks like.
- Before starting naltrexone (ReVia), your healthcare team will work with you to safely stop all opioid medications, including certain cough medications and antidiarrheal medications, for at least 7 to 10 days. Otherwise, you might experience opioid withdrawal symptoms, such as nausea, vomiting, and diarrhea. If you experience these symptoms, contact your prescriber right away.
- Wear a medical alert identification (ID) if you're taking naltrexone (ReVia). If you're ever in a medical emergency, the ID lets medical responders know that they should avoid giving you opioid medications.
- If you get any medical procedures or surgeries after you've completed naltrexone (ReVia) treatment, let your healthcare team know that you've taken naltrexone (ReVia) in the past. This is important because people who've been treated with naltrexone (ReVia) are more sensitive to opioid medications and are at higher risk for an opioid overdose. Your healthcare team might consider non-opioid options to treat or prevent pain.
- Naltrexone (ReVia) can make you feel sleepy or dizzy. Avoid performing any activity that requires a lot of attention (such as driving) until you know how this medication affects you.
- Let your healthcare team know if you're pregnant or would like to become pregnant. There isn't much research about the safety of taking naltrexone (ReVia) during pregnancy. But a study suggests that this medication might be an option.
- Talk to your healthcare team about the risks and benefits of taking naltrexone (ReVia) while breastfeeding. Limited information suggests that naltrexone (ReVia) is unlikely to cause harm to breastfed babies.
More on Naltrexone (ReVia) tips
Risks and warnings for Naltrexone (ReVia)
Naltrexone (ReVia) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
More sensitive to opioids (risk of opioid overdose)
- Risk factors: Restarting opioid medications after naltrexone (ReVia) therapy
When you take naltrexone (ReVia) for opioid use disorder, your body becomes more sensitive to opioids after you finish treatment. If you take opioids again, you can experience life-threatening side effects, even at doses that didn't cause harm before.
If you have or develop a condition where your healthcare team is considering treating you with opioid medications, let them know that you've received naltrexone (ReVia) treatment in the past. They might need to prescribe non-opioid alternatives. Or they might prescribe a much lower dose of opioid along with naloxone in case you experience life-threatening side effects.
Call 911 right away if you experience symptoms of an opioid overdose, such as extremely slowed breathing, extreme sleepiness, slow heartbeat, and cold or clammy skin.
Opioid withdrawal
- Risk factors: Having taken opioid medications before or while taking naltrexone (ReVia)
If you've been taking opioid medications, starting naltrexone (ReVia) can cause serious withdrawal symptoms, including nausea and vomiting, sweating, and agitation. These symptoms can start within 5 minutes after you take naltrexone (ReVia) and last for 2 days or longer, depending on what type of opioid you've been taking.
To lower the risk of opioid withdrawal, your healthcare team will work with you to safely stop all opioid medications for 7-10 days before starting naltrexone (ReVia). If needed, they might ask you to start naltrexone (ReVia) in a hospital setting so that a care team can monitor and treat you for any severe withdrawal symptoms. If you experience withdrawal symptoms at home, go to the hospital right away to get appropriate treatment.
If you're taking naltrexone (ReVia) for alcohol use disorder, it's important that you let your healthcare team know if you've taken any opioid medications before starting naltrexone (ReVia).
Liver injury
Though rare, it's possible that naltrexone (ReVia) might cause liver problems. Make sure to discuss your entire medical history with your healthcare team before starting this medication. They might want to monitor your liver enzymes more closely if you have a history of liver problems. Call a healthcare professional right away if you notice any symptoms of liver damage. These symptoms can include tiredness, dark urine, upset stomach, stomach pain, or yellowing of the skin or whites of the eyes.
Risk of depression and suicidal thoughts
Some people have reported feeling depressed or having thoughts of suicide or self-harm while taking naltrexone (ReVia). But it's unclear whether these changes in mood are caused by naltrexone (ReVia) or by other factors. Let your healthcare team know right away if you or a loved one notices a change in your mood. Get medical attention right away if you experience severe depression or have any thoughts of hurting yourself.
Naltrexone (ReVia) dosage
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg | 30 tablets | $37.22 | $1.24 |
Typical dosage for Naltrexone (ReVia)
- Alcohol use disorder: The typical dose is 50 mg by mouth once daily for up to 3 months.
- Opioid use disorder: The typical starting dose is 25 mg by mouth once daily. If you don't experience signs of withdrawal, your healthcare team will raise the dose to 50 mg by mouth once daily.
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Interactions between Naltrexone (ReVia) and other drugs
More on Naltrexone (ReVia) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Alfentanil
- Alphaprodine
- Anileridine
- Benzhydrocodone
- Buprenorphine
- Butorphanol
- Codeine
- Diacetylmorphine
- Difenoxin
- Dihydrocodeine
- Diphenoxylate
- Ethylmorphine
- Fentanyl
- Hydrocodone
- Hydromorphone
- Ketobemidone
- Levorphanol
- Meperidine
- Methadone
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nicomorphine
- Opium
- Opium Alkaloids
- Oxycodone
- Oxymorphone
- Papaveretum
- Paregoric
- Piritramide
- Propoxyphene
- Remifentanil
- Sufentanil
- Tapentadol
- Tilidine
- Tramadol
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bremelanotide
- Naldemedine
- Naloxegol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Lofexidine
- Yohimbine
How much does Naltrexone (ReVia) cost?
$37.22
Naltrexone (ReVia) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Naltrexone (ReVia) will not be safe for you to take.
- Taking opioids for pain or are still dependent on them and are taking maintenance opioids (e.g., methadone, buprenorphine)
- Actively going through an opioid withdrawal
- A failed naloxone challenge test
What are alternatives to Naltrexone (ReVia)?
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