Efficacy
- Naltrexone has been shown to reduce heavy drinking days and improve abstinence in patients with AUD
- It has also been found to attenuate brain responses to alcohol cues, which may help maintain abstinence
Safety
- Oral naltrexone (50 mg) and intramuscular naltrexone (380 mg) appear to be safe in patients with liver disease, including compensated cirrhosis, and may improve and prevent alcoholic liver disease
In conclusion, naltrexone is a recommended first-line treatment for alcohol use disorder, with demonstrated efficacy in reducing heavy drinking and improving abstinence. It is generally safe, including in patients with compensated liver disease, but should not be used in patients with acute hepatitis, liver failure, or those using opioids.