Naltrexone XR: When & How to Initiate?

Naltrexone XR is an opioid antagonist, which is FDA approved for opioid use disorder. The main benefits of naltrexone-XR are:

extended duration of its action protecting individuals from relapse for a month
avoiding non-adherence risk of daily medication compliance.
improved treatment retention.
effectiveness of XR-naltrexone is comparable to buprenorphine.

Let’s begin by answering this question first:

Welcome to your Naltrexone XR

Naltrexone XR

(Q): 32-year-old male with a history of opioid use disorder is interested in naltrexone XR once a month injection. Which of the following is the correct indication of initiating Naltrexone XR now for him?

Last use of opioids 15 days ago + no opioid withdrawal symptoms + urine drug screen negative for opioids

Last use of opioids 15 days ago + opioid withdrawal symptoms + urine drug screen negative for opioids

Last use of opioids 8 days ago + opioid withdrawal symptoms + urine drug screen negative for opioids

Last use of opioids 5 days ago + opioid withdrawal symptoms + urine drug screen positive for opioids

WATCH THE FOLLOWING 5 MIN VIDEO DISCUSSION TO FIND YOUR ANSWER:

INTERESTED IN LEARNING MORE?

Watch the following academy chapter summarizing this clinically relevant topic in the following five sections:

WATCH ACADEMY CHAPTER:

This chapter will be discussed in the following sections:

Assessment: before initiation of Naltrexone XR
Clinical Opiate Withdrawal Scale (COWS)
Naltrexone (oral) challenge test
Naloxone (i.m) challenge test
When NOT to prescribe Naltrexone XR: Contraindications.

References:

Am J Drug Alcohol Abuse. 2020 May 3; 46(3): 289–296.
Lancet. 2011 Apr 30; 377(9776):1506-13.
JAMA Psychiatry. 2017 Dec 1; 74(12):1197-1205.

INTERESTED IN LEARNING MORE?

JOIN PSYCHIATRY EDUCATION FORUM ACADEMY MEMBERSHIP

This is a closed membership for medical professionals only.

30+ Courses/Sections: Each chapter within these sections is of direct clinical relevance for your daily practice.
Journal Club: we will post the most recently published psychiatry articles relevant to your daily clinical practice.
Coffee Club: contain short discussions with clinical experts in the field of psychiatry.
Essentials of Inpatient Psychiatry Book: All chapters from this book are included in the academy sections.
Discussion Forum & Community: Connect with other medical professionals and discuss your difficult-to-treat clinical cases.
Conference Discounts: Academy members get discounted access at our conferences.
Goal: is to have all important clinically relevant topics in one place for ease of access.

SUBSCRIBE TO OUR EMAIL NEWSLETTER: