Naltrexone Dose For Alcohol: The Naltrexone Alcohol Dosage Details Everyone Should Know

One of the first things to understand about naltrexone is the dosage details because the dose level, duration and timing really matter. 

What You’ll Discover:

• Naltrexone doses available for reducing or quitting alcohol
  
  • Typical naltrexone starting dose
  • Naltrexone max dose for alcohol use
  • LDN and alcohol use
• The recommended naltrexone dose for The Sinclair Method
• The safety and efficacy of a naltrexone daily dose
• Safety of taking high dose naltrexone for an alcohol use disorder
• How long to take naltrexone to end alcohol cravings
• How long a dose of naltrexone stays in your system
• Timing a naltrexone dose for maximum effectiveness
• What to consider to get the naltrexone dose right

Naltrexone was first developed for opioid use disorder in 1963, and then taking naltrexone for alcohol use disorder was approved in 1994. Since that time hundreds of studies have been done reviewing naltrexone alcohol dosage levels, including low dose naltrexone alcohol treatments. The research has led to the best practices that are followed today to maximize the efficacy while minimizing the risk of side effects. 

Our team has compiled all of the most essential information regarding the ideal naltrexone dose for alcohol use, which you’ll find here. We encourage anyone who is considering the use of naltrexone to cut back on alcohol, curb alcohol cravings or stop drinking entirely to use it as a resource for discussing a prescription with a qualified clinician. 

Common Naltrexone Dose Levels For Alcohol Use

Naltrexone comes in two forms: intramuscular injection and oral tablets. Both have doses that are measured in milligrams. 

The intravenous method is a much higher dose level of 380mg and is given once a month in a medical clinic. The naltrexone tablets come in various dose levels that can be taken at home. For alcohol treatment the common oral naltrexone dosages are:

• 25 mg
• 50 mg
• 100 mg 
• 150 mg

All of these doses could be prescribed for alcohol reduction depending on a variety of factors. 

Naltrexone 50mg Tablets - The “Normal” Dose of Naltrexone

Many people take a naltrexone 50 mg pill on a daily basis, and that is how the medication is normally compounded. The goal is to block the opioid receptors that release dopamine when alcohol is consumed, but to do so at the lowest dosage level possible. 

Research has shown that for many people 50 mg is a good starting point. Of course, that isn’t always the case, which is why the prescribing clinician will monitor the patient in the initial phases to ensure that a 50 mg dose is providing the intended results. If the patient experiences side effects the dose may be lowered, and if the effects of alcohol are still felt the dosage may be increased. 

The Minimum and Maximum Dose of Naltrexone For Alcohol Use

As noted above, there’s a range of naltrexone dose levels for alcohol use. What works for one person may not be ideal for another. You may find that low dose naltrexone provides the support you need or a higher dose has to be taken initially.  

Alcohol and LDN

Low dose naltrexone (LDN) isn’t a specific milligram level. Some would consider a 25 mg naltrexone dose to be low dosage since it’s half of the naltrexone normal dosage of 50 mg. If you’re looking for a more concrete measurement, many experts have cited low dose naltrexone as 10% of the regular dose. For alcohol treatment that would work out to be 5 mg. 

Low dose naltrexone and alcohol use is still being studied today. While this may not be an adequate starting dose for alcohol use, it could be effective over time after the alcohol cravings have subsided. 

Max Dose Naltrexone

Since the average dose of naltrexone is 50mg, anything over that could technically be considered a naltrexone high dose prescription. 

The highest dose of naltrexone for alcohol use is 150 mg. Naltrexone 150 mg tablets can be taken:

• Daily
• Every other day
• Every three days
• Split in half to create two 75 mg doses

There are a number of reasons why the naltrexone highest dose is needed. People who have been chronic heavy drinkers over an extended period will often find that the standard 50mg naltrexone starting dose isn’t enough to kill the buzz and curb alcohol cravings. 

The Sinclair Method Naltrexone Dose Recommendations

The Sinclair Method (TSM) is one of the most effective programs for overcoming alcohol use disorder, especially for people who find abstinence-based programs difficult to maintain. The use of naltrexone is a core component of TSM. While the dosing can vary, naltrexone 50mg tablets is the typical protocol.

The Safety and Efficacy of Taking a Naltrexone Daily Dose

Something that patients also question is how safe it is to take naltrexone daily. As with any prescription medication, the safety of naltrexone has been scrutinized in many studies. In particular, researchers look at the safety and efficacy of taking naltrexone daily at different dose levels. 

Taking Naltrexone 50 mg Daily

Many people take a naltrexone 50 mg pill on a daily basis from the beginning of treatment. It is a highly tolerable dose level that is also effective for the majority of people. 

Taking Naltrexone 100 mg Daily

Taking a dose of naltrexone 100 mg per day is actually fairly common, particularly for people with higher alcohol tolerance levels. The risk of hepatotoxicity does become an issue with doses of 100+ mg, but the risk is still very low. In one study, liver enzyme testing showed that 11 of 614 patients that took 100 mg naltrexone daily had elevated enzyme levels. 

Taking Naltrexone 150 mg Daily

Taking the naltrexone max daily dose has also been found to be safe even when taken over the course of months, and is a treatment option for people with a high degree of alcohol cravings.

The Duration of Naltrexone Dosing to Curb Alcohol Cravings

Another factor in dosing is how long naltrexone will be taken to curb alcohol cravings. Research has shown that a daily dose of naltrexone should be taken at least three months to curb alcohol cravings. But longer term use of 6+ months is more effective. 

For those who are taking naltrexone for alcohol use disorder, the duration is typically longer since it takes 1-5 years to reach stable remission. The long-term use can be critical since drinking alcohol just once without naltrexone in the system can lead to a relapse. Before discontinuing use, the patient should be fully recovered with very little risk of using alcohol.

How Long a Dose of Naltrexone Stays in the System

One of the reasons that naltrexone dosage matters so much is because it impacts how long the medication is effective in their system. As already mentioned, just one occurrence of drinking alcohol without naltrexone can reestablish the cravings and cause a person to lose the progress they have made. 

How long a dose of naltrexone stays in the system is dependent on the dose level. Part of the reason that it’s highly recommended people take naltrexone daily is because the standard 50mg naltrexone dose is effective for approximately 24 hours. If the dosage is increased, that extends the effective period. A 100mg dose will last around 48 hours, and a 150mg dose lasts 72 hours.

Why Timing a Naltrexone Dosage For Alcohol Really Matters

Now that you understand more about naltrexone dose levels and how long the medication is active, it’s time to talk about timing your naltrexone dose. When you take naltrexone matters. The medication needs to be in your system for an hour prior to drinking alcohol in order to be effective. It reaches peak concentration levels around the 1-hour mark. It’s then most potent for the first 4-6 hours.

Someone who takes naltrexone daily should take the medication at the same time each day. For those who take naltrexone as needed, it’s ideal to take the medication an hour before drinking and discontinue alcohol use within six hours.

Considerations For Getting the Naltrexone Dose Right For You

There are some key considerations that a clinician is going to factor in when they are prescribing naltrexone. Getting the naltrexone dose right is based on:

Current health - The reason why naltrexone isn’t sold over the counter is because a clinician needs to evaluate your current health to determine the best dose level. 

Reason for taking naltrexone - A great aspect of naltrexone is the control that it gives the patient. Some people take naltrexone to treat alcohol use disorder, but others simply want to reduce how much they drink. The goal can impact how naltrexone is taken, and current consumption can affect the dose level. For example, if you’ve been binge drinking once a week then last six months and want to cut back that’s a very different scenario compared to someone who has been drinking five days a week for years. 

Potential for side effects - Naltrexone side effects are rare, but they are possible. If someone experiences side effects, reducing the dose level can often correct the issue. 

Our Alcohol Use Assessment is the first step in finding out if taking naltrexone for alcohol reduction is an option. 

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