Naltrexone Interactions: What to Avoid When Taking Naltrexone

Many people looking to change their relationship with alcohol are initially unaware that there’s medication that can help. Naltrexone is an FDA-approved medication that’s proven to help people cut back or stop drinking by reducing a person’s desire for alcohol. It does this by blocking the pleasurable effects of alcohol in the brain, which can decrease alcohol cravings over time. Naltrexone can support goals for sobriety and moderation, is non-addictive, and is generally well-tolerated. 

Like with any prescription, it’s important to be careful about any potential interactions between naltrexone and other medications. This article will provide a general overview of the most common interactions, but it’s important you disclose all your medications with your prescribing physician for the most personalized guidance.


How Does Naltrexone Interact With Opioids?

It’s not recommended to take opioids and naltrexone at the same time or within ten days of each other. The greatest risk with mixing naltrexone and opioids is an increased risk of opioid overdose. Naltrexone can block the “high” feeling that people get from opioids, and can also make them more sensitive to low doses. This can lead to overdose, even if opioids are taken at low doses. 

These risks apply to both illegal opioids such as heroin and legal prescription medications such as oxycodone, hydrocodone, codeine, and morphine. It’s also worth noting that naltrexone use can affect opioid tolerance. For example, if a person returned to opioid use while taking naltrexone, there is the potential that the same dosage of opioid that was used in the past could now bring life-threatening complications such as respiratory arrest or circulatory collapse. 

Naltrexone Interactions with Other Common Medications

Naltrexone may interact with a variety of different drugs and change how those medications work. To make sure you can take naltrexone safely, it’s best to keep a comprehensive list of all prescription and nonprescription drugs that you are taking, as well as herbal supplements or synthetic vitamins, and share that list with your doctor and pharmacist. 

Below is a non-exhaustive list of products that may interact with naltrexone: 

  • Dextromethorphan: common in over-the-counter cough, cold, or flu medicine. 
  • Diphenoxylate: an active ingredient in diarrhea medication
  • Disulfiram: another drug that is used to treat alcohol use disorder, though unlike naltrexone, disulfiram works by blocking the processing of alcohol in the body. Disulfiram is only suitable for individuals practicing complete abstinence
  • Thioridazine: a drug used to treat schizophrenia 

It’s also worth noting that naltrexone can interfere with certain laboratory tests, especially drug tests, and cause false test results. If you are taking naltrexone and are scheduled for a lab test, be sure to inform your medical team.

"Alcohol will become less important to you" Diagram of a brain, with a portion labeled "thoughts about alcohol" getting smaller over time

Can You Take Naltrexone With Antidepressants?

Most people who are prescribed naltrexone and an antidepressant are able to take both without issue. Naltrexone doesn’t have many known interactions with antidepressants, and some studies have even shown that taking naltrexone concurrently may increase the effectiveness of antidepressants. Another study found that naltrexone treatment may even reduce depressive symptoms. That said, the best approach is to speak with your doctor about the specific medications you are taking so that any interactions or co-occurring side effects can be assessed and handled appropriately. 

Naltrexone Disease Interactions

Naltrexone can be taxing on the liver, especially at high doses. Therefore, if a person is suffering from liver conditions such as hepatitis, fatty liver, or cirrhosis, naltrexone may not be the right medication for them. The same goes for someone who suffers from kidney disease, hemophilia, or other bleeding disorders. As always, your doctor will be able to provide the best guidance. At Monument, you can virtually meet with a specialized physician who will review your health history and help you determine which medication to stop drinking, if any, is safe and appropriate for you. 

What Food and Drugs to Avoid When Using Naltrexone

There are no specific foods or drinks that need to be avoided while taking the medication. While many people take naltrexone with the goal of limiting or eliminating alcohol use, naltrexone and alcohol don’t have any dangerous interactions. You can read more about what drinking on naltrexone is like. However, naltrexone can interact with hundreds of other drugs, so it is vital to be fully transparent with your doctor about your health history before starting medication-assisted treatment. 

Naltrexone is not a magic sobriety pill, but it can be an incredibly helpful tool for decreasing cravings and building healthier habits. Medication-assisted treatment is most effective when combined with other treatment modalities such as alcohol therapy and support groups. At Monument, you can engage in treatment entirely from the comfort of your own home.


  1. WebMD. “Disulfiram Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing,” Accessed Nov, 5. 2022.
  2. Mayo Foundation for Medical Education and Research. “Naltrexone (Oral Route) Description and Brand Names,” Accessed Nov, 5. 2022.
  3. EverydayHealth. “Naltrexone (Vivitrol) – Side Effects, Interactions, Uses, Dosage, Warnings,” Accessed Nov, 5. 2022
  4. Psychiatric Research Institute. What Is Naltrexone?,” Accessed Nov, 5. 2022

Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use in patients with active liver disease must be carefully considered in light of its hepatotoxic effects. In the treatment of alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list.

Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.

About the Author

Rob ManciniRob Mancini is a freelance content writer and copywriter. His passions include health and wellness, personal development, nature, meditation, sustainability, food, travel, and sleeping in his Birkenstocks. Connect with him on Linkedin at: