Last Updated on August 30, 2021
If you’ve been prescribed naltrexone, or you’re considering taking it to help you cut back on alcohol, you may be wondering if it’s safe to mix it with other medications. Many Americans take one or more prescription drugs, and it can be confusing—but also important—to understand which combinations are safe.
Fortunately, naltrexone (and its injectable version, Vivitrol) is a relatively safe medication, with few interactions. But there are some drugs, specifically opioids, that you cannot take at the same time.
We recommend consulting with a medical professional before taking any prescription medication, including naltrexone. This is because each person’s body and medical history is different, and there may be combinations that aren’t good for you, personally.
With that said, below we’ll discuss the most common naltrexone drug interactions, and the drug’s compatibility with some of the most widely prescribed medications in the United States.
Does Naltrexone Interact With Other Medications?
As a general rule, naltrexone blocks the effectiveness of any opioid-based medication, but otherwise has few interactions with other drugs.
Naltrexone is often prescribed to treat opioid addiction, precisely because it prevents these drugs from having their usual effect. This can be a major plus if you are trying to stop taking these drugs. But if you are taking any opioid-based medication for pain management, naltrexone can cause it to stop working. This can cause potentially serious consequences—including acute withdrawal.
If you are prescribed medications containing hydrocodone, codeine, oxycodone, tramadol, or any other opioid drug, do not begin taking naltrexone until you have stopped taking these drugs, and consult with your doctor before beginning treatment. Most medical professionals recommend waiting at least 7-14 days from stopping these medications before starting naltrexone or Vivitrol.
Other common opioid-based medications incompatible with naltrexone include diarrhea medications like diphenoxylate1, and cough medicines containing dextromethorphan2. People taking naltrexone will not experience the benefits of these drugs, and the combination is best avoided.
In summary, as Ria Health CMO Dr. John Mendelson puts it, “Any medication that acts through the opioid receptor will be blocked by naltrexone.” If you are uncertain whether a medication you are taking is opioid-based, consult your doctor.
Can You Take Naltrexone and Antidepressants?
Naltrexone is generally safe to take with antidepressants, and may even have some benefits for depression. In fact, some research suggests that naltrexone actually boosts the effectiveness of antidepressant medications such as sertraline (Zoloft)3. Studies on Celexa and naltrexone showed more neutral results, but the mixture still appeared to be safe4.
The combination of naltrexone and bupropion, another antidepressant, is sometimes prescribed to aid in weight management5. This mixture can be risky if you have high blood pressure or a history of seizures, but these medications generally interact safely.
However, as Dr. Mendelson notes, naltrexone can cause mood disturbances in some people. This is generally a side effect of naltrexone itself, and not a medication interaction. But if you are being treated for anxiety or depression, it’s important to consult with your doctor before taking naltrexone. Continue to discuss any negative impacts on your mood as time goes on.
Naltrexone and Other Common Prescriptions
As discussed above, naltrexone is not known to interact negatively with non-opioid medications. Therefore, many of the most common medications prescribed in the US are safe to combine with naltrexone. These include:
- Levothyroxine and naltrexone: This common thyroid medication has no known interactions with naltrexone or Vivitrol.
- Atorvastatin and naltrexone: Also known by the brand name Lipitor, this cholesterol medication is among the most common prescriptions in the United States, and is also safe to combine with naltrexone6. However, as both are processed through the liver, it may be best to avoid alcohol while taking this combination, especially if you have any liver damage7.
- Lisinopril and naltrexone: Another common prescription in the US, this high blood pressure medication is also safe to take alongside naltrexone, with the same note of caution around one’s liver health and continued alcohol use8.
Pain medicines that do not contain opioids, such as Tylenol and Motrin, are also generally safe to combine with naltrexone. The same is true of benzodiazepines such as Xanax, Klonopin, and Ativan, and antihistamines like Benadryl and Zyrtec. So long as the medication does not interact with opioid receptors, it should be safe to take alongside naltrexone.
However, once again, you should always discuss any medicines you are taking with your doctor to ensure there are no risks specific to your body and medical history. Never take prescription medications without a prescription!
Naltrexone Side Effects
Despite having few interactions with other drugs, naltrexone can still cause negative side effects. While many people tolerate naltrexone well, some experience a type of intoxication, dizziness, or dysphoria from the medication. Others experience headaches, nausea, or diarrhea. If you’re taking naltrexone with another medication and you experience any of these symptoms, it may not be a medication interaction, but rather a side effect of naltrexone on its own.
Negative side effects from naltrexone often go away within 30 days. But if they persist beyond this, or are severe enough to interfere with your life, consult with your doctor. There are several effective alternatives to naltrexone. One of them may be a better fit for your personal body chemistry.
Support For Taking Naltrexone To Cut Back or Quit Drinking
If you’re interested in taking naltrexone to help you drink less alcohol, professional medical support can make a big difference. Consulting with a doctor can help you avoid negative medication interactions, manage any side effects, and help you find alternatives if you don’t react well to naltrexone.
Ria Health is one online program that gives you access to expert medical support, prescription medication, weekly coaching meetings, and digital tools to track your progress—all from a smartphone app. Find out how our approach is revolutionizing care for alcohol use disorder.