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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

  1. Shader, R.I., Antagonists, inverse agonists, and protagonists. J Clin Psychopharmacol, 2003. 23(4): p. 321-2.

  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.

  3. Volpicelli, J.R., et al., Effect of naltrexone on alcohol "high" in alcoholics. Am J Psychiatry, 1995. 152(4): p. 613-5.

  4. 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.

  5. 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.

  6. 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.

  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.

  8. 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.

  9. 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.

  10. 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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405 Heron Drive Suite 200 • Swedesboro, NJ 08085-1749 • 888-678-1967
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