Articles
Naltrexone, explained
36 guides on how naltrexone works for alcohol, what it's like to take, what it costs and how it compares. Every claim links to its source.
Naltrexone for alcoholDoes Naltrexone Work?Yes, modestly, for alcohol. In pooled trials, for every 11 people on daily naltrexone, 1 more avoided a return to heavy drinking. What changes the odds.Read it · 8 min 
Side effects and safetyNaltrexone Side Effects: How Common Each One Is and When to Call a Doctor13 min read
The Sinclair MethodThe Sinclair Method: What It Is and What the Evidence Shows10 min read
Cost and getting a prescriptionHow Much Does Naltrexone Cost?9 min read
Low-dose naltrexone (off-label)Low-Dose Naltrexone (LDN): Off-Label Doses, Evidence by Condition and Side Effects13 min read
Naltrexone basics
Dosage, how long it lasts, legal status, and how it differs from naloxone.
Naltrexone: What It Is Used For and How It WorksNaltrexone is a prescription opioid blocker for alcohol and opioid use disorder: a daily 50 mg tablet or the monthly Vivitrol shot. Not a controlled substance.12 min · Updated October 17, 2026
How Long Does Naltrexone Stay in Your System?Naltrexone tablets: half-life about 4 hours (13 for its metabolite); Vivitrol: 5-10 days. What drug tests look for, and when to stop before surgery.10 min · Updated October 17, 2026
Is Naltrexone a Controlled Substance?No. Federal law excludes naltrexone (and Vivitrol) from controlled-substance schedules, but it still needs a prescription. See the CFR text and DEA list.4 min · Updated October 17, 2026
NalmefeneNalmefene is an opioid blocker. In the US, Opvee spray and Zurnai auto-injector reverse overdoses; in Europe, Selincro tablets help cut drinking.7 min · Updated October 17, 2026
Naltrexone and Bupropion (Contrave)Naltrexone plus bupropion is sold as Contrave, a weight-management tablet. Separate tablets are off-label and barely studied. Safety rules if you drink.8 min · Updated October 17, 2026
Naltrexone Brand NamesVivitrol, the monthly shot, is the only naltrexone brand still sold for addiction. ReVia and Depade tablets are gone; generics remain. Checked October 2026.6 min · Updated October 17, 2026
Naltrexone Dosage: Label Doses for Alcohol, Opioids and Vivitrol, and What's Off-LabelNaltrexone tablets: 50 mg a day for alcohol or opioid use disorder, after an opioid-free gap. Vivitrol: 380 mg every 4 weeks. Missed doses, liver, stopping.12 min · Updated October 17, 2026
Naltrexone vs Naloxone: What's the Difference?Naloxone (Narcan) reverses an opioid overdose in minutes. Naltrexone is a daily pill or monthly shot for alcohol or opioid use disorder. Compare them.8 min · Updated October 17, 2026
Naltrexone vs SuboxoneSuboxone is easier to start; in insurance records, buprenorphine had the clearer link to fewer overdoses. Once started, Vivitrol did as well in two trials.9 min · Updated October 17, 2026
What to Avoid When Taking NaltrexoneOn 50 mg naltrexone or Vivitrol, avoid opioids, including some cough and diarrhea medicines and kratom. A sourced interaction table, from ibuprofen to Xanax.10 min · Updated October 17, 2026
Naltrexone for alcohol
How well it works for drinking, how soon, drinking on it, and how it compares with acamprosate.
Naltrexone for Alcohol Use DisorderNaltrexone is one of three FDA-approved drugs for alcohol use disorder. In trials, treating 11 people kept 1 more from returning to heavy drinking vs placebo.12 min · Updated October 17, 2026- Does Naltrexone Work?Yes, modestly, for alcohol. In pooled trials, for every 11 people on daily naltrexone, 1 more avoided a return to heavy drinking. What changes the odds.8 min · Updated October 17, 2026
How Long Does Naltrexone Take to Work?Naltrexone has no build-up phase: tablets peak within an hour. What the trials show about drinking in the first days and weeks, and when to judge it.7 min · Updated October 17, 2026
Medication to Stop DrinkingNaltrexone, acamprosate and disulfiram are FDA-approved for alcohol use disorder; topiramate and gabapentin are used off-label. Effect sizes, guideline grades and risks.10 min · Updated October 17, 2026
Naltrexone and Alcohol: What Happens If You Drink on ItNaltrexone causes no Antabuse-style reaction with alcohol, but you still get drunk. What drinking on it feels like, timing, hangovers and the limits.8 min · Updated October 17, 2026
Naltrexone vs Acamprosate: Which Works Better?Head to head, neither drug has clearly won. Naltrexone is one pill a day and tilts toward less heavy drinking; acamprosate is six and tilts toward abstinence.11 min · Updated October 17, 2026
Naltrexone vs Disulfiram (Antabuse)Naltrexone dulls the reward from drinking; disulfiram makes you sick if you drink. In blinded trials disulfiram did no better than placebo; open-label, it did.12 min · Updated October 17, 2026
The Sinclair Method
Taking naltrexone only before drinking: what the trials show and where the 78% figure comes from.
Cost and getting a prescription
Prices, insurance, online programs, and our reviews of four of them.
Where to Get Naltrexone Online: Prescribers, Programs and Prices13 online naltrexone programs compared on price, insurance and states. Posted monthly fees ran from $89 to $249 when we checked on Oct 17, 2026.13 min · Updated October 17, 2026- How Much Does Naltrexone Cost?What online naltrexone programs and the Vivitrol shot cost, checked Oct 17, 2026, and how Medicare, Medicaid and private insurance change what you pay.9 min · Updated October 17, 2026
Oar Health Reviews: A Prescription by Message, Paid Three Months at a TimeOar Health charges $50 to start, then $297 every 3 months if prescribed. We checked its terms, its compounded Clutch mint, and its Trustpilot and BBB records.10 min · Updated October 17, 2026
Reframe App Reviews: A Well-Rated App Whose Own Documents DisagreeReframe rates 4.7 on Apple but 3.6 on Trustpilot. We checked its real prices, its four different cancellation rules, and Reframe Med+'s compounded naltrexone.11 min · Updated October 17, 2026
Ria Health Reviews: Insurance-Billed Alcohol Treatment With No Posted PriceRia Health bills insurers like Anthem and UnitedHealthcare but posts no price. We checked its terms, medications, breathalyzer program, evidence and ratings.11 min · Updated October 17, 2026
Sunnyside Reviews: A Drink-Less App Not Meant for Alcohol Use DisorderSunnyside Med lists $99/month; its co-founder says a $50 intake fee makes the first charge $347. We checked the app, the B6 claim, the study and ratings.11 min · Updated October 17, 2026
Side effects and safety
How common each side effect is, the label warnings, and when to call a doctor.
- Naltrexone Side Effects: How Common Each One Is and When to Call a DoctorNausea (10%) and headache (7%) lead the list in a 570-person study. Most tend to show up early and pass. What is rare, and the signs that need a doctor now.13 min · Updated October 17, 2026
Can You Take Naltrexone While Pregnant?No randomized trial has tested naltrexone in pregnancy. What small studies found, why guidelines treat starting and continuing differently, and breastfeeding.9 min · Updated October 17, 2026
Does Naltrexone Make You Sleepy or Tired?Sometimes. In pooled alcohol trials, about 9 more people per 100 had daytime sleepiness on naltrexone than on placebo. Insomnia was more common too.5 min · Updated October 17, 2026
Naltrexone and Your Liver: What Liver Tests Show at the Usual DoseNaltrexone's liver warning came from 300 mg/day studies. What the label says now, when liver tests are done, what ALT/AST results mean, and cirrhosis data.9 min · Updated October 17, 2026
Precipitated WithdrawalPrecipitated withdrawal is sudden opioid withdrawal set off by buprenorphine, naltrexone, Vivitrol, naloxone or nalmefene. Symptoms, timing by drug, and risk.8 min · Updated October 17, 2026
Vivitrol, the monthly shot
The extended-release injection: how it is given, its side effects, and pill vs shot.
Vivitrol: The Monthly Naltrexone Shot for Alcohol and Opioid Use DisorderVivitrol is a 380 mg naltrexone shot given monthly for alcohol or opioid use disorder. You must be opioid-free first. Cash from $1,758 a shot (Oct 2026).13 min · Updated October 17, 2026
Naltrexone ImplantNo naltrexone implant is FDA-approved. What trials abroad found, why one is listed on DailyMed, the risks, and the approved monthly shot. Checked Oct 2026.9 min · Updated October 17, 2026
Naltrexone vs Vivitrol: Pill or Monthly Shot?Same drug, two forms. The shot hasn't been shown to cut drinking more, but people stay on it longer. Pills $23-$32/month; shot from $1,758 (Oct 2026).13 min · Updated October 17, 2026
Vivitrol Side Effects: Trial Rates, Injection-Site Reactions and When to Get HelpVivitrol side effects from the label: injection-site reactions in 69% and nausea in 33% vs 50% and 11% on placebo, plus the serious risks and when to call.15 min · Updated October 17, 2026
Low-dose naltrexone (off-label)
Off-label low doses: what studies tested, what they found, and the cautions.
- Low-Dose Naltrexone (LDN): Off-Label Doses, Evidence by Condition and Side EffectsLow-dose naltrexone (LDN) is compounded and off-label; no LDN product is FDA-approved. Study doses, trial results, side effects and October 2026 prices.13 min · Updated October 17, 2026
LDN Side Effects: What Low-Dose Naltrexone Trials Found Compared With PlaceboOff-label low-dose naltrexone (LDN) side effects, trial by trial vs placebo: vivid dreams and nausea stood out. How long they last, 12-month data, stopping.8 min · Updated October 17, 2026
What to Avoid When Taking Low-Dose Naltrexone (LDN)On low-dose naltrexone (off-label), opioids are the warning with clear support. Kratom, Imodium, surgery, alcohol, benzos, thyroid pills and supplements, graded by evidence.9 min · Updated October 17, 2026