In the mid-1980s, the food and drug administration (FDA) cleared the use of naltrexone chiefly to treat substance abuse. Its main use focused on treating people addicted to intoxicants such as opioids. It works as a barricade between receptor-cells and intoxicants. But, at a very lose dosage level; this drug is known for its pain management capabilities as well as anti-inflammatory properties. The drug is known to block pains and can give needful relief from a likely onset of chronic inflammation and internal swelling. You need to know more about the side effects and risks associated with micro-doses of naltrexone before starting your medication plan.

The commonly administered dosage level of naltrexone is in the range of 60 to 90 milligrams (mg). At nearly 1/11th of this standard dose – i.e., less than 5 mg, the drug is found to offer a wide range of benefits. The most important line-of-action is its ability to cause a feel-good or euphoric state of mind. It is believed to boost the making of euphoria-causing chemicals, also called as endorphins. Another school of thought believes that low dosages of naltrexone can suppress the actions of white cells-based receptors. This numbing action is assumed as the reason behind turning insensitive to pain.

A caveat: More scientific evidences are needed to fully substantiate the use of low dosages of naltrexone for conditions such as muscular pains (fibromyalgia), Crohn’s disease, autoimmune conditions like multiple sclerosis, etc. Fibromyalgia is a chronic condition wherein you feel pains, tiredness and related discomforts. You may witness symptoms such as painful periods, stiffening of muscles, sleeping problems, etc. Crohn’s disease is a chronic condition which can impair the linings of your intestinal walls. But, most of these claims remain largely unproven and are hence poorly evidenced. The low-dose form awaits more trials on a broader scale to fully validate its therapeutic properties.

Side effects of low-dose naltrexone

The extent to which dosage strengths are lowered depends largely on how well your body responds to the medication plan. Your current medical condition also plays a key role in determining the low dosage levels. When it is used as a therapy to treat substance abuse, the starting dosage is fixed at a bare minimum level. It is highly recommended to follow all the directions of your treating physician to avoid any major, adverse side effects.

Common side effects

The common side effects of using low dose naltrexone include feeling dizzy, weariness, sleep-related disorders, headaches, abdominal problems such as nausea. In some instances, people have also experienced high levels of anxiety, pains in joints or their bones, cramping of abdominal muscles, runny nose or being in a restless state of mind. These adverse reactions and side effects are known to disappear on their own; especially, when your body gets used to this drug. However, if you see these adverse side effects to persist for a longer span of time, you need to quickly reach out and seek medical attention.

Liver related conditions

Lower dosage strength of naltrexone is unlikely to cause any major hepatic disorders. But, if you already have a liver condition – say, inflammation of the liver (hepatitis) or cirrhosis – you need to tell your medical team about such conditions beforehand. At very low dosage levels of naltrexone, people living with liver conditions may develop a few signs of hepatic damage. The common signs include darkened discharge of urine, discoloration of skin or eyes, persistent pain in your upper or mid abdomen, vomiting or nausea.

Hypersensitivity and allergic reactions

Low dosages levels of naltrexone are unlikely to cause any major allergies or hypersensitivity. In very remote instances, some people have however turned allergic to low dose equivalents of this drug. Typical allergies may show up as drowsiness, respiratory problems – like wheezing, gasping or shortness of breath, rashes on skin or hives, persistent spells of itchiness or inflammation. A small percentage of people have reported swelling of facial parts such as lips and oral organs like throat, tongue, etc. In all such circumstances, you are advised to seek medical help as soon as possible.

Prior clinical conditions and use of low doses of naltrexone

Drugs such as naltrexone may have a few passive or not-so-active ingredients. These items may silently trigger a few adverse side effects or allergies. It is a good practice to tell your physician if you are allergic to passive ingredients present in drugs such as this. Also, it is important to tell your doctor about prior ailments as well as present medical conditions, if any. People who have recently had episodes of substance abuse or addiction to intoxicants such as marijuana, alcohol or cannabis need to exercise an added level of caution. People living with renal conditions like inflammation of kidneys, drop in absorption efficiency of kidneys, imbalance of electrolytes and other related renal conditions need to stay away from taking low doses of naltrexone.

Dizziness caused by naltrexone

Intake of naltrexone is likely to lead to a severe spell of drowsiness as well as dizziness. If your current lifestyle includes consumption of alcohol, you need to tell about your lifestyle habits to your physician. Your doctor will advise you to reduce the consumption of alcohol. In a few acute instances, you may be advised to completely stop taking alcohol or other intoxicants. As an added precaution, it is strongly recommended not to engage in activities which may need a higher level of mental agility or focus. This only means, you must not operate heavy machines or engage in activities such as driving, etc.

As mentioned, dizziness is one of the most common side effects of this drug. Hence, it may interfere with anesthetic drugs and can make your feel drowsy. It is hence a good practice to inform your medical team about the intake of naltrexone prior to a surgical intervention. In fact, your surgeon will advise you to stop taking this drug for at least two or three weeks prior to the date of your surgical procedure. The same precaution needs to be observed prior to a dental procedure.

Interactions between naltrexone and other drugs

Drugs like naltrexone are more likely to interact with other meds. It is strongly recommended to make a list of all the drugs you are currently consuming. As you make this list, take care to include prescription drugs, over the counter (OTC) meds, herbal supplements, dietary aids, etc. Once you have given this list of drugs to your physician, never add more medicines to this list or change the strength of medications consumed presently. Naltrexone may interact with cough and cold meds which are based on opioids; these include drugs like hydrocodone, codeine, etc. You also need to be more careful with the intake of drugs like disulfiram, dextromethorphan, a few types of anti-diarrheal meds, etc. Naltrexone may also work adversely with lab reagents and may distort the results of some lab tests. The odds are more when reagents are used. It is hence important to tell your medical team at the lab about intake of naltrexone, its dosage strength as well as how long you have been taking it.

Overdose of naltrexone

People who have forgotten to take a dose of naltrexone are advised not to take a double dose of the drug. Instead, you are advised to wait for the next dose, and take a regular dose i.e., as prescribed by your treating doctor. People who take double doses may trigger risks of an overdose. An excessive dose of naltrexone can lead to adverse side effects such as respiratory problems (shortness of breath, wheezing or gasping), inflammation of tongue or lips, itchiness, headaches, passing out, etc. Some of these symptoms may lead to near-fatal or fatal outcomes. If you notice any of these signs, call 911 as soon as possible or contact the poison control center closer to you.

Other precautions

Women who are pregnant must not take this drug. The effects of this drug on fetus largely remain unknown. In some rare instances, this drug is administered onto pregnant women only if it is essential. Never take this drug without consulting your physician. Also, this drug may get into mother’s milk and can reach the feeding infant. Owing to this reason, women who are breastfeeding or nursing a baby must not use this drug. Infants who are fed with breastmilk that has with traces of this drug are likely to experience feeding problems, sleeping disorders, persistent crying, etc.

Periodic monitoring of liver condition

As a safety measure, you are advised to monitor your liver health on a periodic basis. Upon noticing any changes in color of your eye or skin, pains in abdomen or changes in texture of urine, you need to keep your medical team informed about these adverse signs. Your treating physician may change the strength of this drug or may make needful changes in its dosage frequency in accordance with your medical condition.

You need to remember that the abovementioned allergic reactions, adverse side effects or discomforts do not constitute a complete list of all likely adverse effects. Hence, it is possible to witness new discomforts or unknown side effects. If you notice such unlisted side effects, you are advised to call 911 immediately and seek needful medical help without delay. You can also call a local poison control center or the emergency helpline contact points of the food and drug administration (FDA). Those living in any of the provinces in Canada need to contact a poison control unit located in the province you are currently living, or reach out to an emergency helpline of Health Canada. Last but not least, take needful care to store this drug away from direct exposure to excessive humidity or light.

In sum, the most commonly experienced side effects of low dose naltrexone are dizziness, headaches, tiredness, insomnia as well as abdominal discomforts such as vomiting or nausea. In a few instances, people who took low doses of naltrexone reported painful bones or joints, cramps, heightened levels of anxiety or may remain in a restless frame of mind. Most of these adverse side effects are known to go away on their own after a few days – i.e., after your body gets used to low doses of this drug. But, if you see these side effects persist for a longer time, you are advised to take medical help on an emergency basis. You need to call 911 immediately or contact the poison control center located near your home.

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