Reference: Naltrexone (for Alcohol) from A to Z

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Thanks max! Great information. http://ncadi.samhsa.gov/govpubs/BKD268/

from chapter 2: http://ncadi.samhsa.gov/govpubs/BKD268/28e.aspx

Naltrexone and the liver

Although naltrexone has few absolute contraindications, high doses of naltrexone (300 mg/day) may lead to elevations in serum bilirubin and liver enzymes (e.g., and Brogden, 1988; Sax et al., 1994) . For this reason, the medication is contraindicated for patients with acute infectious hepatitis or patients with liver failure. (For a review of clinical studies on naltrexone and liver damage, see Chapter 5.)

The Consensus Panel recommends caution in using naltrexone in patients whose serum aminotransferases results are over three times normal. In these patients, more frequent monitoring of LFTs should be considered. In general, improvements in liver function are expected if the patient responds to therapy and maintains abstinence. Physicians experienced in the use of naltrexone have given it safely to patients with significantly elevated serum aminotransferases. Because total bilirubin reflects more severe and potentially chronic liver dysfunction, the Consensus Panel recommends using total bilirubin to both evaluate and monitor the development of liver problems. A hepatologist may be consulted prior to beginning naltrexone therapy in patients with elevated total bilirubin.

Another issue clinicians should consider before determining a patient's eligibility for naltrexone therapy is that alcohol alone may be responsible for pretreatment elevated LFT results. In some cases, simply stopping the consumption of alcohol will immediately lower LFT values appreciably. When there is a question, the Consensus Panel recommends repeating LFTs after 5 to 7 days of abstinence. If the levels dramatically improve, then the patient may prove to be a suitable candidate for naltrexone. Research supports this observation: In a number of the treatment studies, LFTs in the group receiving naltrexone improved over those not receiving naltrexone, presumably because of the reduction in their drinking (O'Malley et al., 1992; Volpicelli et al., 1992, 1995a, 1997).

As with many disorders, the final decision to use naltrexone should be based on a risk-benefit analysis. Clinician and patient may choose to start naltrexone treatment in spite of the presence of medical problems because the potential benefits of reducing or eliminating alcohol consumption may outweigh the potential risk of naltrexone.

Well, that answers that!

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low dose naltrexone

Sent: Thursday, December 11, 2003 09:57

Subject: [low dose naltrexone] Reference: Naltrexone (for Alcohol) from A to Z

Encyclopedia of Naltrexone:Link to all you might want to know about Naltrexone at high dosages!Very interesting is Chapter 5http://ncadi.samhsa.gov/govpubs/BKD268/