Naltrexone is a medication used in the treatment of alcohol and opioid use disorders. It is available in oral tablet forms, such as ReVia and Depade, and as an extended-release injectable known as Vivitrol. This medication plays a role in recovery by helping to reduce cravings and preventing the euphoric effects associated with substance use. Naltrexone is a valuable part of medication-assisted treatment (MAT) programs, which address various aspects of addiction and dependence.
Nausea as a Common Side Effect
Nausea is a common side effect for individuals taking naltrexone, often accompanied by other gastrointestinal complaints like upset stomach, vomiting, stomach pain, or diarrhea. This symptom typically emerges early in treatment, often within the first few days or weeks. For many, the nausea is mild and tends to lessen as the body adjusts to the medication, usually subsiding within two to four weeks.
Understanding Why Nausea Occurs
Naltrexone functions as an opioid receptor antagonist, binding to and blocking opioid receptors in the brain. This mechanism helps reduce cravings and block the rewarding effects of opioids and alcohol. Its interaction with these receptors, particularly those in the gut and brain, can disrupt normal digestive processes. Opioid receptors regulate digestion, hormone release, and pain perception, and naltrexone’s action on them can lead to gastrointestinal upset, including nausea. Factors like recent alcohol consumption, drug interactions, or taking naltrexone on an empty stomach can also influence nausea.
Strategies for Managing Nausea
To manage naltrexone-induced nausea, consider taking the medication with food or a snack to reduce stomach discomfort. Eating smaller, more frequent meals throughout the day may also help, as can avoiding rich, fatty, or spicy foods. Staying hydrated by drinking plenty of fluids is important, as dehydration can worsen nausea.
Adjusting the dose timing, such as taking naltrexone at bedtime, can help individuals sleep through initial side effects like nausea or dizziness. Some healthcare providers may suggest starting with a lower dose (e.g., 25 mg per day) and gradually increasing it to the standard 50 mg dose, allowing the body to adapt slowly. Over-the-counter remedies like ginger tea, peppermint, or antacids may also provide relief, but always consult a doctor before using them or making any changes to your medication regimen.
When to Consult a Healthcare Provider
While naltrexone-induced nausea is often temporary and manageable, certain situations warrant contacting a healthcare provider. If nausea becomes severe, debilitating, or persists beyond the initial few weeks of treatment, medical advice should be sought. This is also true if nausea is accompanied by frequent vomiting that prevents keeping down food or liquids, as this can lead to dehydration. Signs of severe dehydration, such as decreased urination, unusual tiredness, or dizziness when standing, necessitate medical attention.
Additionally, if individuals experience severe abdominal pain, yellowing of the skin or eyes, dark urine, or pale stools, these could indicate a more serious liver problem and require immediate medical evaluation. It is important to communicate any bothersome or persistent side effects to a healthcare provider. Discontinuing naltrexone without medical consultation is not recommended, as a doctor can assess the situation and suggest appropriate adjustments or alternative strategies.