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This medication must not be used in people currently taking opiates, including methadone. Doing so can cause sudden withdrawal symptoms. Concerns for liver toxicity initially arose from a study of nonaddicted obese patients receiving 300 mg of naltrexone. Naltrexone has been reported to cause liver damage (when given at doses higher than recommended). Naltrexone is only part of a complete treatment program that may also include additional forms of counseling and/or monitoring. This is due to the risk of acute opioid withdrawal if naltrexone is taken, as naltrexone will displace most opioids from their receptors. It is important that you attend all counseling sessions, support group meetings, education programs, or other treatments recommended by your doctor. Use naltrexone regularly to get the most benefit. Some physicians use a naloxone challenge to determine whether an individual has any opioids remaining. Naltrexone may be taken with food if it upsets your stomach. The most common side effects reported with naltrexone are gastrointestinal complaints such as diarrhea and abdominal cramping. Your doctor may recommend that naltrexone be given to you by a family member or other caregiver. A decreased desire for opioids, though, may take a few weeks. After stopping naltrexone treatment, you may be more sensitive to lower doses of opioids, increasing your risk of possibly life-threatening side effects from the narcotic (e.g., decreased breathing, loss of consciousness). Follow all directions on your prescription label. Before using this medication, tell your doctor or pharmacist your medical history, especially of: current or recent use (in the last 7 to 14 days) of any type of opioid drug (such as morphine, methadone, buprenorphine), kidney disease, liver disease. Talk to your doctor if you are using marijuana. It is not likely that naltrexone will cause liver damage when taken in recommended doses.

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