Getting the Right Naltrexone Dose For Alcohol Reduction

Naltrexone dosage is highly dependent on the patient, which is why a knowledgeable medical professional is needed to get the naltrexone dose for alcohol just right.

What You’ll Discover:

• Typical naltrexone alcohol dosage levels.
• Why the standard dose of naltrexone for alcoholism isn’t one-size-fits-all.
• What medical professionals consider to dial in naltrexone dosage.
• How frequency of use affects naltrexone dosage.
• What indicates that the dose of naltrexone needs to be adjusted.

With any prescription medication, dosage is crucial for getting the desired outcome as well as avoiding potential side effects. That’s why naltrexone is a controlled FDA-approved prescription medication and not simply sold over the counter. 

Before you start taking prescription naltrexone it’s helpful to get a better understanding of the dosage levels and how prescribing physicians determine the right naltrexone dose for alcohol reduction. Spoiler alert: it’s not solely based on how much you drink. 

Standard Naltrexone Dosage Levels 

The first thing to know is that naltrexone doses are measured in milligrams (mg). Currently, there are three dosage levels per pill:

• 25mg
• 50mg
• 100mg

The typical daily naltrexone dose for alcohol use disorder is 50mg, however, some patients may begin at just 25mg a day. Prescribing medical professionals err on the side of caution and start low because higher doses increase the risk of serious side effects like hepatotoxicity. Usually this is only a risk if the patient is taking 300mg of naltrexone daily.

*The naltrexone dosage information listed here is for the pill form of the medication only. There is also an extended-release intramuscular injectable form of naltrexone that is a higher dose.

What Medical Professionals Consider When They Prescribe a Naltrexone Dose For Alcohol Reduction

Before deciding on the proper dose of naltrexone for alcoholism, the prescribing medical professional will take a number of things into consideration, such as:

The Patient’s Medical History - The prescribing practitioner will look at the patient’s medical history to get a better idea of their overall health and potential risk factors. Allergies are a key consideration. 

The Patient’s Current Health - Current health matters just as much as a person’s medical history. Since naltrexone is metabolized by the liver, medical professionals will consider if any liver problems currently exist. If so, a lower dose will likely be recommended. The physician will also examine any medications that are currently being taken to watch out for adverse interactions.

The Patient’s Age - Often older patients start out with a low dose due to higher potential for side effects and underlying health issues.

The Patient’s Alcohol Use - Higher levels of alcohol consumption or consuming drinks with a high alcohol content can influence the naltrexone prescription. In general, if someone is a heavy drinker they may need a higher dosage to curb cravings.

Dose of Naltrexone For Alcoholism vs As Needed Consumption Control

Some patients use naltrexone to simply reduce the amount of alcohol they consume on a regular basis to avoid chronic drinking or binge drinking. Others take it to get a handle on alcohol use disorder and want to stop drinking entirely. 

One of the biggest differences between these two groups is the frequency with which they take naltrexone. Many people take naltrexone every day to ensure they are covered if they drink alcohol and to curb cravings as much as possible. Some people choose to take it as needed when they are most likely to consume alcohol while taking naltrexone.

So, does frequency affect naltrexone dosage? The short answer is no. The daily recommended dose is the same whether or not the medication is actually taken every day. 

Something to consider is that there is at least one study that tested the effects of combining daily naltrexone and targeted treatment simultaneously. The study found that taking a daily dose of 25mg and a targeted dose of 25mg as needed was more effective at reducing heavy drinking days compared to taking a daily 50mg dose. 

Adjusting Naltrexone Dosage to Get It Just Right

Another important reason why naltrexone is a prescription medication is because the dosage might need to be adjusted. Adjustments could be needed for a number of reasons. 

If someone is experiencing side effects the dosage may need to be reduced. On the other hand, if naltrexone isn’t as effective as expected the dose may need to be increased. Indications that the naltrexone dose needs to be higher include:

• The patient still has the same euphoric feelings while drinking alcohol.
• Alcohol cravings are still strong after having one or two drinks.
• There isn’t a reduction in alcohol consumption.

A major reason why the ideal naltrexone dose varies is metabolism. Some people metabolize naltrexone more efficiently. Usually, naltrexone stays in the system for 20-24 hours, but metabolites can remain for up to 72 hours. Rapid metabolizers are going to require a higher naltrexone dose to ensure the medication stays in their system for the intended length of time.

Find out what naltrexone dosage is recommended for you. Take the Alcohol Use Assessment to learn if naltrexone is an option and schedule an appointment to discuss ideal dosage with a physician. 

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