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Naltima (naltrexone) is primarily used to help patients quit alcohol; less frequently it is used to help reduce dependency on opioids, though it is not as effective in the latter. Still less commonly it is used in a variety of off-label uses which may or may not be related to addiction.

This medication is an opioid antagonist, meaning it eliminates the effects of opioids. This is true regardless of the opioid type or its intended use; patients taking Naltima will not respond to opioids given to treat pain. This is a concern in the event of an accident or prior to some medical procedures.

Naltima comes in tablets of 50 mg. Tablets may be split to make a smaller 25 mg dose, if needed. Food is optional but may help ease gastrointestinal side effects.

Quitting Alcohol with Naltima

It is with treating alcohol addiction that Naltima truly shines. The medication curbs both cravings and the pleasurable experience of drinking, and it does so even if drinking continues. In fact, there's some evidence that it works better if drinking continues; as there's no reward from drinking, cravings naturally diminish.

Naltima can be used on its own at home or, for more serious cases, may be administered with other medications in an inpatient setting. In both cases patients are most likely to succeed if there is a genuine desire to quit and a support network available.

At home, treatment is typically:

  • Take 50 mg once per day.
  • Treatment typically lasts 12 weeks, but may be extended if needed.

In inpatient settings dosage varies a lot more; daily dosage may be higher, or a significantly larger dose may be administered every other day or every few days. The medication may also be given intravenously or via injection. These methods should not be attempted outside of a supervised setting without explicit doctor approval.

Quitting Opioids with Naltima

Naltima is used to help patients quit opioids such as heroin, opium, methadone, codeine, and so forth; it eliminates pleasurable effects. An important distinction, however, is that Naltima does not diminish cravings for opioids; for this reason the medication is not as successful as when it is used for overcoming alcohol addiction.

Naltima therapy should ideally be started after the patient has been opioid-free for at least 7 to 10 days; otherwise the medication could trigger severe physical withdrawal symptoms, including:

  • Severe stomach or muscle cramps
  • Vomiting
  • Mental/mood changes
  • Hallucinations
  • Anxiety
  • Rapid or erratic heartbeat
  • Insomnia

The medication is so effective at blocking opioid effects that it's often used in overdose cases. As mentioned above, legitimate opioid use will not be an option while Naltima is being taken.

To help with opioid addiction:

  • Start with 25 mg on the first day.
  • Assuming no withdrawal effects occur, take 50 mg once per day after the first day.
  • Treatment typically lasts for 3 to 6 months, but may be extended if needed, sometimes for years.

As with alcohol, treatment may deviate to some extent in hospital or inpatient settings.

Off-Label Conditions

Off-label use---which is legal provided a doctor prescribed Naltima---is rare but does happen. Success is variable and sometimes controversial. Off-label uses include:

  • Fibromyalgia
  • Multiple sclerosis
  • Certain Cancers
  • Certain autistic behaviors
  • Depersonalization disorder
  • Impulse control disorders
  • Smoking cessation

There is relatively little documentation regarding the effectiveness of the treatment in off-label uses, so there are no widely-accepted dosage & administration guidelines. Patients are advised to find a doctor or organization familiar with using Naltima for a given condition.

Off-label uses usually involve lower daily doses than alcohol or opioid addiction, typically less than 50 mg per day. There may be exceptions, however. Doctor instructions should be followed.

Adverse Effects

If used as directed, Naltima is unlikely to produce any serious side effects. Most commonly reported are:

  • Indigestion
  • Nausea
  • Diarrhea
  • Mild headache
  • Dizziness
  • Difficulty sleeping

Liver function may be tested prior to treatment, particularly if alcohol is regularly consumed. Moderate to severe liver damage may require a lower dosage.


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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.

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