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Side Effects of Naltrexone (Depade, Revia, Vivitrol)


Description: Naltrexone, sold under the names Depade, Revia and Vivitrol, is an “antidote” to opioid analgesics ingested in excess quantity. As such, the drug reverses the effects of opioid toxicity. Naltrexone is commonly used as a management drug in patients with opioid or alcohol dependency.


Common Side Effects of Naltrexone

Common side effects according to the REVIA® drug label as reported by the FDA include (these occurs in more than 1% of patients taking the drug):

  • Headache
  • Dizziness
  • Anxiety
  • Fatigue
  • Insomnia
  • Somnolence
  • Loss of appetite
  • Irritability
  • Disorientation
  • Confusion
  • Depression
  • Suicidal ideation
  • Paranoia
  • Hallucinations
  • Nightmares
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Joint pain
  • Muscle pain
  • Delayed ejaculation

Less Commmon Side Effects

Rare side effects of taking naltrexone according to the REVIA® drug label as reported by the FDA include:


  • Asthenia (a physical feeling of weakness)
  • Agitation
  • Hyperkinesia (increased movement)
  • Alcohol withdrawal syndrome (when taking naltrexone for alcohol dependence)
  • Euphoria
  • Delirium
  • Decreased libido
  • Hemorrhoids
  • Ulcers
  • Diarrhea
  • Excessive flatulence
  • Dry mouth
  • Tremors
  • Twitches
  • Shoulder pain
  • Leg and knee pain
  • Itching
  • Sneezing
  • Sore throat
  • Hoarseness
  • Shortness of breath
  • Dyspnea (cough)
  • Bronchitis
  • Pneumonia
  • Nosebleeds
  • Edema
  • Increased blood pressure
  • Palpitations
  • Tachycardia (fast heart rate)
  • Acne
  • Athlete’s foot
  • Alopecia (hair loss)
  • Rash
  • Blurred vision
  • Photophobia (sensitivity to light)

Understand Your Risks with the Rxight® Genetic Test


Adverse reactions can occur with this medication. Research suggests that polymorphisms (variations) in the genes that encode for the opioid receptor (OPRM1) can have a direct result of the therapeutic effect of the medication (Targeting treatments for alcohol dependence: the pharmacogenetics of naltrexone,” Addiction Biology, Sep 2006


The allele A118G, for instance, has been shown to predict clinical response to the medicine in individuals with alcohol dependence. There is some suggestion that these polymorphisms also governs the probability of developing adverse effects to the drug.


How Does Pharmacogenetic Testing Work?


Identifying such polymorphisms in patients before they take the medication can aid physicians and pharmacists in their clinical decision making. The doctors can identify which patients will respond well to the medicine and adjust the dosage accordingly.


Rxight® pharmacogenetic testing identifies polymorphisms on more than 18 genes, including OPRM1, to see how a patient is likely to respond to hundreds of clinically relevant medications, including naltrexone.


Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry


Read more about Rxight® genetic testing for medication