From the Guidelines
If you drink alcohol while taking naltrexone, you will still experience the physical effects of alcohol, but the pleasurable or rewarding feelings typically associated with drinking will be diminished. Naltrexone works by blocking opioid receptors in the brain, which are involved in the rewarding effects of alcohol 1. This medication is often prescribed at doses of 50mg daily to help reduce alcohol cravings and prevent relapse in people with alcohol use disorder.
Key Points to Consider
- Naltrexone does not prevent you from becoming intoxicated, and you should not drive or operate machinery after drinking alcohol, regardless of whether you're taking naltrexone.
- Naltrexone doesn't cause unpleasant reactions when combined with alcohol like disulfiram (Antabuse) does.
- You should continue taking naltrexone as prescribed even if you do drink, as it can still help reduce your desire to continue drinking.
- Some people may experience side effects such as nausea, headache, or dizziness when taking naltrexone, and these could potentially be intensified when combined with alcohol.
Important Considerations
- The most recent and highest quality study on this topic is from 2020, which provides guidance on the diagnosis and treatment of alcohol-associated liver diseases 1.
- According to this study, naltrexone is an FDA-approved medication for the treatment of alcohol use disorder, and it works by blocking opioid receptors in the brain.
- The study also notes that naltrexone has not been studied in patients with alcohol-induced liver disease, and therefore, its safety and efficacy in this population are not well established.
Recommendations
- If you are taking naltrexone and drink alcohol, you should be aware of the potential risks and benefits, and you should continue to take your medication as prescribed.
- You should also be aware of the potential side effects of naltrexone, and you should report any concerns to your healthcare provider.
- Additionally, you should not drive or operate machinery after drinking alcohol, regardless of whether you're taking naltrexone.
From the FDA Drug Label
Naltrexone hydrochloride is not aversive therapy and does not cause a disulfiram-like reaction either as a result of opiate use or ethanol ingestion.
The FDA drug label does not answer the question.
From the Research
Effects of Drinking Alcohol while Taking Naltrexone
- Naltrexone is a medication used to treat alcohol dependence by blocking the pleasurable effects of alcohol consumption 2.
- Studies have shown that naltrexone can reduce alcohol intake and relapse rates in alcohol-dependent patients when combined with behavioral treatment 2.
- However, the effects of drinking alcohol while taking naltrexone are not well-studied, and there is limited research on the safety of naltrexone in patients with liver disease.
Safety of Naltrexone in Patients with Liver Disease
- A 2022 study found that naltrexone is safe to use in patients with underlying liver disease, including those with compensated cirrhosis 3.
- Another study published in 2024 found that naltrexone is not associated with drug-induced liver injury in patients with cirrhosis, and may be safe to use in patients with both compensated and decompensated cirrhosis 4.
- Earlier studies have also shown that naltrexone is not hepatotoxic at recommended daily doses, and may even have beneficial effects on liver function 5, 6.
Potential Risks and Interactions
- While naltrexone is generally considered safe, there is a risk of adverse effects, including nausea and vomiting, particularly at high doses 2.
- Patients with liver disease should be monitored closely for signs of liver injury, and naltrexone should be used with caution in patients with decompensated cirrhosis 3, 4.
- The interaction between naltrexone and alcohol is not well-studied, and patients should be advised to avoid drinking alcohol while taking naltrexone to minimize potential risks.