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The following information outlines important safety considerations and warnings associated with the use of naltrexone (ReVia). Please read carefully and consult with your healthcare provider if you have any questions or concerns.

• Increased Sensitivity to Opioids: After completing treatment with naltrexone for opioid use disorder, your sensitivity to opioids increases. If opioids are taken again, it could result in life-threatening side effects, even at previously tolerable doses. This risk is particularly significant upon resuming opioid use after naltrexone therapy.

• Opioid Withdrawal Symptoms: Initiating naltrexone while having recently used opioid medications can lead to severe withdrawal symptoms. These may include nausea, vomiting, sweating, and agitation, starting as soon as five minutes after taking naltrexone and potentially lasting for two days or more, depending on the opioid previously used.

• Liver Health Concerns: Although rare, naltrexone may cause liver injury. It is crucial to discuss your complete medical history with your healthcare provider before beginning this medication. Those with a history of liver issues may require closer monitoring of liver enzymes. Contact a healthcare professional immediately if you experience symptoms such as fatigue, dark urine, nausea, stomach pain, or yellowing of the skin or eyes.

• Mental Health Risks: There have been reports of depression and suicidal thoughts among individuals taking naltrexone. While it's uncertain if naltrexone is the cause, any changes in mood should be reported to your healthcare provider promptly. Seek medical attention immediately if you experience severe depression or thoughts of self-harm.

Contraindications:

• Do not use naltrexone if you are currently taking opioids for pain, dependent on opioids, or undergoing maintenance therapy with opioids such as methadone or buprenorphine.
• Avoid starting naltrexone if you are actively experiencing opioid withdrawal or have not passed a naloxone challenge test.

Always consult with your healthcare provider for guidance tailored to your specific health situation.

Common side effects:

• Nausea or vomiting
• Headaches
• Dizziness
• Nervousness or anxiety
• Tiredness
• Trouble sleeping

Less common but important to monitor:

• Stomach pain or cramps
• Low energy
• Joint and muscle pain

Serious side effects:

• Dry mouth
• Reduced appetite
• Increased thirst
• Skin rash
• Depression
• Irritability
• Diarrhea
• Constipation
• Sexual problems

Naltrexone is a medication used to manage alcohol and opioid dependence by blocking opioid receptors in the brain. While effective, it's important to be aware of potential interactions with other substances and medications.

Opioid Medications: Naltrexone blocks the effects of opioids, including prescription pain relievers like Oxycodone, hydrocodone, and morphine, as well as illicit drugs such as heroin. Taking naltrexone while opioids are still in your system can lead to sudden and severe withdrawal symptoms. Therefore, it's recommended to be opioid-free for at least 7 to 10 days before starting naltrexone treatment.

Cough and Cold Medications: Some over-the-counter and prescription cough syrups contain opioids like codeine or hydrocodone. Using these while on naltrexone can trigger withdrawal symptoms. It's advisable to check the ingredients of any cough or cold medications and consult your healthcare provider for alternatives.

Antidiarrheal Medications: Certain antidiarrheal drugs, such as diphenoxylate/atropine (Lomotil), contain opioids. Combining these with naltrexone can cause withdrawal symptoms. Non-opioid antidiarrheal options should be considered instead.

Alcohol: While naltrexone is used to reduce alcohol cravings, consuming alcohol during treatment can still impair coordination and judgment. Both alcohol and naltrexone can affect liver function, so it's best to avoid alcohol to reduce the risk of liver damage.

Central Nervous System (CNS) Depressants: Combining naltrexone with medications that depress the CNS, such as benzodiazepines (e.g., Diazepam, Alprazolam) or certain antipsychotics (e.g., Thioridazine), can increase sedation and drowsiness. If these medications are necessary, they should be used under close medical supervision.

Liver Function: Naltrexone is processed by the liver, so combining it with other substances that affect liver function, like Disulfiram (used for alcohol dependence), can increase the risk of liver damage. Regular liver function tests may be necessary when using these medications together.

Herbal Supplements: Some herbal products, such as St. John's Wort, may interact with naltrexone by affecting liver enzymes, potentially altering the medication's effectiveness. It's important to inform your healthcare provider about any supplements you're taking.

Cannabis and CBD Products: Using cannabis or cannabidiol (CBD) while on naltrexone may enhance the effects of cannabis. Discuss any use of these products with your healthcare provider to ensure safe and effective treatment.

Always inform your healthcare provider about all medications, supplements, and substances you are using to avoid potential interactions and ensure the safe use of naltrexone.