This article describes possible interactions with naltrexone oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Naltrexone comes as tablets that you swallow. It’s also available as a solution that’s injected into your muscle. Interactions of naltrexone may vary depending on the form of naltrexone you’re prescribed.
Other drugs and naltrexone
The drugs in the list below may interact with naltrexone oral tablet. This article doesn’t include all drugs that may interact with naltrexone.
Drug classes or drugs that may interact with naltrexone oral tablet include:
- opioid drugs*
- drug examples: morphine (MS Contin), oxycodone (Roxicodone, OxyContin, others)
- what might happen: increases the risk of serious side effects of naltrexone; naltrexone blocks the effects of opioid drugs, including certain drugs for diarrhea and cough
- other opioid antagonists:
- drug examples: naldemedine (Symproic), naloxegol (Movantik)
- what might happen: can increase the effect of both naltrexone and the other opioid antagonist (naltrexone is an opioid antagonist); can increase the risk of side effects of both naltrexone and the other opioid antagonist
- certain antipsychotic drugs:
- drug examples: thioridazine, chlorpromazine
- what might happen: can increase the risk of side effects of naltrexone and the antipsychotic drug
- the synthetic cannabinoids dronabinol (Marinol) and nabilone (Cesamet):
- what might happen: can increase the effect of the synthetic cannabinoid and its risk of side effects
- bremelanotide (Vyleesi):
- what might happen: can significantly increase the effect of naltrexone and its risk of side effects
- disulfiram:
- what might happen: can increase the risk of side effects of naltrexone and disulfiram
- lofexidine (Lucemyra):
- what might happen: can make naltrexone less effective
* You should not take naltrexone if you’re currently taking an opioid. To learn more, see the “When to avoid naltrexone” section below.
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When to avoid naltrexone
Certain health conditions or other factors could increase some risks with naltrexone oral tablet. Because of this, doctors may not prescribe naltrexone in these cases. These health conditions or other factors are called contraindications.
Here’s a list of naltrexone contraindications for the oral tablet:
- Dependence on opioids. If you’re currently dependent* on opioids, taking naltrexone oral tablet may cause sudden opioid withdrawal.† This could require treatment in a hospital. Doctors may prescribe naltrexone oral tablet to treat opioid use disorder. In this case, they’ll tell you when it’s safe to begin taking it.
- Experiencing opioid withdrawal. If you’re actively experiencing opioid withdrawal, taking naltrexone oral tablet may cause your withdrawal symptoms to worsen. Doctors may prescribe naltrexone oral tablet to treat opioid use disorder. In this case, they’ll tell you when it’s safe to begin taking naltrexone.
- Failure of the naloxone challenge test or having a positive result for a urine drug screen for opioids. Before you begin taking naltrexone oral tablet, your doctor may administer tests. These include a naloxone challenge test and a urine drug screen. Both tests check whether you’re actively taking an opioid. If the tests determine that you are, taking naltrexone oral tablet may cause sudden opioid withdrawal. This can require treatment in a hospital.
- Taking an opioid. If you’re taking an opioid, taking naltrexone oral tablet may cause sudden opioid withdrawal. This can require treatment in a hospital.
- Past allergic reaction to naltrexone. If you’ve ever had an allergic reaction to naltrexone oral tablet, taking it again may cause another allergic reaction.
* With dependence, your body needs the drug to function as usual.
† Withdrawal is a side effect that can occur when you stop taking a drug on which your body has become dependent.
Before you start taking naltrexone, tell your doctor if anything listed above relates to you. They can recommend whether you should take naltrexone.
Questions about naltrexone and interactions
Here you’ll find answers to some common questions about naltrexone and possible interactions.
Do low-dose naltrexone interactions differ from those with higher doses?
They might. Low-dose naltrexone may be used off-label for certain uses. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved to treat or help prevent.
Because low-dose naltrexone is for off-label use (not an approved use), large studies haven’t been conducted on its use. This means there isn’t much information about drug interactions for it.
Due to the risk of serious side effects, you should not take an opioid drug if you’re taking low-dose naltrexone. To learn more, see the “When to avoid naltrexone” section above.
Is it safe to take ibuprofen or acetaminophen while I’m taking naltrexone? Do these drugs interact?
Ibuprofen (Advil, Motrin) is typically safe to take with naltrexone, as these drugs do not interact. But ibuprofen does have other interactions. Before taking ibuprofen, check with your doctor or pharmacist. They can check for interactions with your medications or health conditions.
Both acetaminophen (Tylenol) and naltrexone can cause side effects related to the liver, including liver damage. While taking naltrexone, check with your doctor or pharmacist before taking acetaminophen. They can review whether another pain reliever would be a better option for you.
Alcohol and naltrexone
If you’re taking naltrexone oral tablet to treat alcohol use disorder, you should not consume alcohol.
If you’re taking naltrexone oral tablet to treat opioid use disorder, the effects from drinking alcohol may be lessened. (Some people refer to these effects as a “buzz.”) But some people may still experience decreased reflexes, coordination, or judgment from drinking alcohol and taking naltrexone oral tablet.
Talk with your doctor if you have questions about consuming alcohol while taking naltrexone oral tablet.
Other interactions and naltrexone
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether naltrexone oral tablet has these interactions.
The information below doesn’t include all other interactions possible with naltrexone.
Naltrexone and supplements
Before taking naltrexone oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Naltrexone interactions with herbs
Naltrexone oral tablet isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking naltrexone oral tablet.
Naltrexone interactions with vitamins
Naltrexone oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking naltrexone oral tablet.
Naltrexone and food
Naltrexone oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking naltrexone oral tablet.
Naltrexone and vaccines
Naltrexone oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking naltrexone oral tablet.
Naltrexone and lab tests
Certain tests may be used to check whether opioids are in your system. Naltrexone oral tablet may interfere with the accuracy of those tests.
Because of this, talk with your doctor or pharmacist before having any tests while taking naltrexone oral tablet. They can check to see whether a specific test can provide accurate results while you’re taking naltrexone.
Naltrexone and cannabis or CBD
Reports have shown that cannabis (commonly called marijuana) and cannabis products may interact with naltrexone. Cannabidiol (CBD) is an example of a cannabis product.
Taking naltrexone and cannabis may enhance the effect of cannabis. Taking the two together also can increase the risk of side effects of cannabis.
Before you take naltrexone, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and naltrexone
Certain medical conditions or other health factors may increase the risk of interactions with naltrexone oral tablet. Before taking naltrexone, tell your doctor about your health history. They’ll determine whether naltrexone is right for you.
These health conditions or other factors might interact with naltrexone oral tablet:
* To learn more, see the “When to avoid naltrexone” section above.
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Textline at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Preventing naltrexone interactions
You may be able to help avoid certain interactions with naltrexone oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking naltrexone oral tablet.
Taking naltrexone exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about naltrexone and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- If I have a liver condition, how will you determine whether naltrexone oral tablet is safe for me to take?
- What treatments for diarrhea are safe to use while I’m taking naltrexone oral tablet?
- What treatments for cough are safe to use while I’m taking naltrexone oral tablet?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
