Is drowsiness a potential side effect of low-dose Naltrexone (opioid receptor antagonist)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 7, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Drowsiness is not a commonly reported side effect of low-dose naltrexone (LDN) in the provided evidence, but it may still occur in some patients. When considering the potential side effects of LDN, it is essential to look at the most recent and highest quality studies. According to the study published in 2017 1, common side effects of LDN include headache, tachycardia, and vivid dreams, but drowsiness is not explicitly mentioned. However, the study published in 2022 1 discusses the use of naltrexone-bupropion ER for obesity and mentions that the second dose should not be taken late in the day to minimize the risk of insomnia, implying that naltrexone may have some impact on sleep patterns. Key points to consider when evaluating the potential for drowsiness as a side effect of LDN include:

  • The dosage and administration schedule of LDN, as taking it at bedtime may help minimize potential drowsiness
  • The individual patient's response to the medication, as some may be more prone to drowsiness than others
  • The potential for LDN to influence sleep-wake cycles and energy levels due to its action on opioid receptors. It is crucial for patients to discuss any concerns about drowsiness or other side effects with their healthcare provider, who can provide personalized guidance and recommendations.

From the FDA Drug Label

Although no causal relationship with naltrexone hydrochloride is suspected, physicians should be aware that treatment with naltrexone hydrochloride does not reduce the risk of suicide in these patients In an open label safety study with approximately 570 individuals with alcoholism receiving naltrexone hydrochloride, the following new-onset adverse reactions occurred in 2% or more of the patients: ... somnolence (2%) The following events occurred in less than 1% of subjects: ... Psychiatric: ... somnolence Postmarketing ExperienceData collected from postmarketing use of naltrexone hydrochloride show that most events usually occur early in the course of drug therapy and are transient... Events that have been reported include ... somnolence

Drowsiness is a potential side effect of naltrexone, as somnolence (which is another term for drowsiness) has been reported in patients taking the medication, including at a rate of 2% in an open-label safety study in individuals with alcoholism, and in less than 1% of subjects in other studies 2.

From the Research

Drowsiness as a Potential Side Effect of Low-Dose Naltrexone

  • Drowsiness has been reported as a side effect of low-dose naltrexone in several studies 3, 4, 5.
  • In a study evaluating the effectiveness of low-dose naltrexone for chronic pain management, 32% of patients reported adverse effects, including drowsiness 3.
  • Another study examining the side effects of low-dose naltrexone in patients with gastrointestinal disorders found that 61.2% of patients experienced side effects, with 32.4% having short-lived symptoms, including drowsiness 4.
  • A study on the dose-ranging kinetics and behavioral pharmacology of naltrexone and acamprosate reported somnolence (drowsiness) as a side effect of naltrexone administration 5.
  • However, it is essential to note that the frequency and severity of drowsiness as a side effect may vary depending on the individual, dosage, and specific condition being treated.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Evaluation of Low-Dose Naltrexone for Chronic Pain Management.

Journal of pain & palliative care pharmacotherapy, 2025

Research

Low dose naltrexone: side effects and efficacy in gastrointestinal disorders.

International journal of pharmaceutical compounding, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.