ReVia - Naltrexone

Naltrexone (ReVia). Naltrexone is another medication that has specific FDA approval for the treatment of alcohol use disorders. It is used as an interference therapy. Naltrexone blocks opioid receptors in the brain and is believed to reduce alcohol-induced euphoria. The absence of pleasurable effects associated with alcohol consumption should plausibly lead to a decrease in the behavior of drinking alcohol. Evidence to date has demonstrated that recovering alcoholics treated with naltrexone have fewer days of drinking and longer periods of sobriety between relapses. 

Naltrexone (ReVia). Naltrexone is a very potent antagonist of the actions of opiates. It has been used to reduce the rewarding effects of not only opiates but alcohol as well. Like buprenorphine, naltrexone appears to reduce craving for opiates by blocking their pleasurable effects. Naltrexone is not useful for detoxification and in fact worsens withdrawal. Naltrexone can be useful for maintenance treatment in those patients motivated to achieve total abstinence. It is taken at a constant dose of 50mg/day. A sustained-release depot formulation currently under development will likely help to overcome adherence issues that often undermine treatment for substance use disorders. 

The physician prescribes naltrexone (ReVia) 25 mg PO initially. The nurse is to observe the patient carefully and if no withdrawal signs appear, 100 mg PO of the drug is prescribed every other day. On hand is naltrexone 50-mg tablets. The nurse administers as the initial dose. 

TO MEDICAL PERSONNEL TREATING ME IN AN EMERGENCY This patient is taking the oral opioid antagonist reVia , formerly known as Trexan (naltrexone hydrochloride). 

Naltrexone (Depade, ReVia, Vivitrol) Nicotine Gum (Nicorette, others) Nicotine Nasal Spray (Nicotrol NS) Nicotine Transdermal (Habitrol, NicoDerm, CQ, Nicotrol, others) Orlistat (Xenical, Alii [OTC])... 

Finally, as noted earlier, comorbid substance abuse, particularly with bipolar male patients, is a strong predictor of suicide-related lethality. It is critically important to recognize these complicating disorders and aggressively intervene with appropriate clinical strategies. Referral to Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other related counseling support programs, as well as prescription of naltrexone (Revia) in the appropriate patients, may also help to diminish the risk of serious morbidity (see also the section The Alcoholic Patient in Chapter 14). 

Naltrexone (Depade, ReVia, Vivitrol) [Opioid Antagonist]... 

EFFECTS IN THE ABSENCE OF OPIOID DRUGS Subcutaneous doses of naloxone (narcan) up to 12 mg produce no discernible subjective effects, and 24 mg causes only slight drowsiness. Naltrexone (revia) also appears to be a relatively pure antagonist but with higher oral efficacy and a longer duration of action. At doses in excess of 0.3 mg/kg naloxone, normal subjects show increased systolic blood pressure and decreased performance on tests of memory. High doses of naltrexone appeared to cause mild dysphoria in one study but almost no subjective effect in several others. 

Currently, three drugs are approved in the U.S. for treatment of alcoholism disulfiram (antabuse), naltrexone (revia), and acamprosate. Disulfiram has a long history of use but has fallen into disfavor because of its side effects and problems with patient adherence to therapy. Naltrexone and acamprosate were introduced more recently. The goal of these medications is to assist the patient in maintaining abstinence. 

Naltrexone (revia see Chapter 22) has been shown to block some of the reinforcing properties of alcohol and has resulted in a decreased rate of relapse in the majority of published double-blind clinical trials. It works best in combination with behavioral treatment programs that encourage adherence to medication and to remaining abstinent from alcohol. A depot preparation with a duration of 30 days (vivitrol) recently received FDA approval and may improve medication adherence, the major problem with the use of medications in alcoholism. 

Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol and/or opioid dependence. It is marketed in generic form as its hydrochloride salt, naltrexone hydrochloride, and sold under the trade names Revia and Depade. Naltrexone and its active metabolite 6-p-naltrexol are competitive antagonists at p- and K-opioid receptors, and to a lesser extent at 8-opioid receptors [5]. Naloxone is a drug used to counter the effects of opioid... 

Naltrexone (trade names Revia , Vivitrof , Nemexin is a pure opioid antagonist like naloxone, however with a more pronounced and longer-lasting effect. It has sufficient oral bioavailability to be used for the treatment of drug addicts. Its synthesis proceeds in an analogous manner to that of naloxone. 

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