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Wedgewood compounds 1.4gm Naltrexone pellets
Naltrexone
is an opiate antagonist that reduces the euphoric effect of opiates and
alcohol. It was approved by the FDA in 1984 for the treatment of opiate
addiction, in 1994 for the treatment of alcoholism and in 2006 as a depot
injectable. Naltrexone and its active metabolite, 6-β-naltrexol,
are inverse agonists of µ-and κ-opiod receptors, and to a
lesser extent at δ-opioid receptors.[1] They
serve to block the effects of endorphins, endogenous opioid peptides in
the brain, thus indirectly attenuating the dopaminergic reinforcement/reward
system activity following alcohol intake.[2]
The endogenous opioid system is involved in the reinforcement of alcohol
use and naltrexone, by blocking the pleasurable effects or 'high' of alcohol,
presumably helps in the treatment of alcoholism.[3,
4] As a consequence, naltrexone reduces the quantity and frequency
of drinking among alcoholics who relapse.[5-7]
A systematic meta-analysis of 24 placebo-controlled trials presented in
32 papers with a total of 2861 patients treated concluded that naltrexone
produced a consistent decrease in relapse rate to heavy drinking and in
drinking frequency, although it did not appear to enhance absolute abstinence.[8]
Naltrexone is rapidly absorbed, with peak blood levels achieved approximately
one hour following oral administration.[9] It is primarily
metabolized by the liver, and converted to 6-β-naltrexol, which has
a plasma half life of 10 hours. Approximately 20 percent of the active
metabolite is bound to plasma protein and distributed widely, with relatively
high amounts found in the brain, fat, spleen, heart, testes, kidney and
urine.[9] Naltrexone and its metabolite 6-β-naltrexol,
with less than 1 percent of naltrexone, are excreted unchanged. Despite
the relatively short half lives of both compounds, the duration of naltrexone
blockade is much longer. Typically, an oral dose of 50mg naltrexone as
been shown to produce 80 percent inhibition of radiolabeled carfentanyl
binding for 72 hours.[10]
In alcohol dependence, naltrexone is considered a safe medication. Control
of liver values prior to initiation of treatment is recommended. There
has been some controversy regarding the use of opioid-receptor antagonists,
such as naltrexone, in the long-term management of opioid dependence due
to the effect of these agents in sensitizing opioid receptors. Following
therapy, the opioid receptors continue to have increased sensitivity for
a period during which the patient is at increased risk of opioid overdose.
This effect reinforces the necessity of monitoring of therapy and provision
of patient support measures by medical practitioners.
References
- Shader, R.I., Antagonists, inverse agonists, and
protagonists. J Clin Psychopharmacol, 2003. 23(4): p. 321-2.
- Benjamin, D., E.R. Grant, and L.A. Pohorecky, Naltrexone
reverses ethanol-induced dopamine release in the nucleus accumbens in
awake, freely moving rats. Brain Res, 1993. 621(1): p. 137-40.
- Volpicelli, J.R., et al., Effect of naltrexone
on alcohol "high" in alcoholics. Am J Psychiatry, 1995.
152(4): p. 613-5.
- O'Malley, S.S., et al., Experience of a "slip"
among alcoholics treated with naltrexone or placebo. Am J Psychiatry,
1996. 153(2): p. 281-3.
- O'Malley, S.S., et al., Naltrexone and coping
skills therapy for alcohol dependence. A controlled study. Arch
Gen Psychiatry, 1992. 49(11): p. 881-7.
- Volpicelli, J.R., M.A. Davis, and J.E. Olgin, Naltrexone
blocks the post-shock increase of ethanol consumption. Life Sci,
1986. 38(9): p. 841-7.
- Anton, R.F., et al., Naltrexone and cognitive
behavioral therapy for the treatment of outpatient alcoholics: results
of a placebo-controlled trial. Am J Psychiatry, 1999. 156(11):
p. 1758-64.
- Srisurapanont, M. and N. Jarusuraisin, Naltrexone
for the treatment of alcoholism: a meta-analysis of randomized controlled
trials. Int J Neuropsychopharmacol, 2005. 8(2): p. 267-80.
- Gonzalez, J.P. and R.N. Brogden, Naltrexone. A
review of its pharmacodynamic and pharmacokinetic properties and therapeutic
efficacy in the management of opioid dependence. Drugs, 1988. 35(3):
p. 192-213.
- Lee, M.C., et al., Duration of occupancy of opiate
receptors by naltrexone. J Nucl Med, 1988. 29(7): p. 1207-11.
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for use as an informational aid. It does not cover all possible uses,
actions, precautions, side effects, or interactions of the products shown,
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of using a particular product. You should consult your doctor about diagnosis
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not been evaluated by the Food and Drug Administration ("FDA"),
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