Naltrexone drug interactions

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

Mason BJ, Goodman AM, Dixon RM, Hameed MHA, Hulot T, Wesnes K, Hunter JA, Boye-son MG. A pharmacokinetic and pharmacodynamic drug interaction study of acamprosate and naltrexone. Neuropsychopharmacology. (2002) 27, 596-606. 

Less interaction with other euphoriant drugs Sooner transfer to naltrexone after detoxification... 

Release of naltrexone. The release of naltrexone using poly (ortho ester) II has already been discussed in Sect. 4.2.5. Since it was not possible to form highly loaded devices that had useful mechanical properties due to an interaction between naltrexone and the polymer at the device fabrication temperatures, it was decided to use the ductile polymer since naltrexone could be mixed into the polymer at room temperature and with appropriate mechanical mixing, high drug loadings could be achieved. 

---