Naltrexone Comparison – How It Stacks Up Against Other Medications

If you’re looking at naltrexone, you probably want to know how it measures up against other options. Below we break down the basics, the key differences, and when you might choose something else.

What Is Naltrexone?

Naltrexone is an oral or injectable drug that blocks the brain’s response to opioids and alcohol. By blocking the receptors, it reduces cravings and helps prevent relapse. The pill is taken once a day, while the injection (Vivitrol) is given once a month. It works best when combined with counseling or a support program.

Key Differences With Other Drugs

Effectiveness: Studies show naltrexone cuts heavy drinking days by about 30% and lowers opioid use when patients stay on the medication. Compared to disulfiram, which makes drinking uncomfortable, naltrexone lets you drink without the “hangover” feeling but still curbs the urge.

Side Effects: Common side effects are nausea, headache, and fatigue. They are generally milder than those of methadone, which can cause constipation and sedation. The monthly injection can cause injection‑site pain, but it avoids daily pill fatigue.

Dosing Convenience: A daily pill fits into a routine, but missing doses reduces its effect. The monthly shot removes the need to remember a daily pill, but you need a clinic visit.

Cost: Generic naltrexone pills are cheap, often under $20 a month. The injection is more expensive, typically $800‑$900 for a three‑month supply. Compare that to buprenorphine, which can cost a similar amount for daily tablets but may be covered by insurance.

Interaction With Other Medications: Naltrexone does not depress breathing like opioids, so it’s safer for people with lung issues. However, it can interfere with pain relief if you need an opioid after surgery. Always tell your doctor if you might need strong pain meds.

When you weigh these points, the right choice depends on your lifestyle, health, and support system. If you can handle a daily pill and want a low‑cost option, generic naltrexone is a solid pick. If you struggle with daily adherence, the monthly injection might be worth the higher price.

Other alternatives to consider include buprenorphine, methadone, and acamprosate. Buprenorphine works as a partial opioid agonist, easing withdrawal while still providing some effect. Methadone is a full agonist and requires daily clinic visits, but it’s very effective for heavy opioid users. Acamprosate helps maintain abstinence from alcohol by stabilizing brain chemistry, but it doesn’t block cravings like naltrexone.

In practice, many doctors combine naltrexone with behavioral therapy for the best results. The medication handles the chemical side of dependence, while counseling tackles habits and triggers. If you’re unsure which route fits you, ask your provider for a comparison chart based on your health history.

Bottom line: naltrexone offers a good balance of effectiveness, low side effects, and affordability, especially as a generic pill. The monthly injection adds convenience at a higher cost. Compare it side‑by‑side with buprenorphine, methadone, and acamprosate to find the match that works for your life.