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Naltrexone, an opioid antagonist, is an FDA-approved first-line medication for alcohol use disorder. It is available as a daily oral formulation or a monthly extended-release intramuscular injection. Naltrexone does not treat acute alcohol withdrawal; instead, it is used to reduce cravings, heavy drinking, and support abstinence. Patients can continue to drink while taking it without a disulfiram-like reaction. Common adverse effects include self-limited nausea, headache, and insomnia. It is contraindicated in patients with current opioid use, acute hepatitis, or liver failure.
References
Krist AH, Bradley KA. Addressing Alcohol Use. N Engl J Med. 2025;392(17):1721-1731. doi:10.1056/NEJMcp2402121.
Naltrexone hydrochloride tablet, film-coated [prescribing information]. Chartwell RX, LLC; updated June 19, 2026. DailyMed.