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Opoid and naltrexone taken together and patient has reaction what to do

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naltrexone opioid precipitated withdrawal emergency symptoms official prescribing information

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naltrexone AND opioid withdrawal

Call emergency services now if the patient has trouble breathing, is very sleepy or unconscious, has blue/gray lips, chest pain, fainting, severe confusion/hallucinations, uncontrolled vomiting/diarrhea, or severe agitation.
Taking naltrexone while opioids are in the body can trigger sudden, severe precipitated opioid withdrawal. It can begin quickly and may require hospital treatment, including IV fluids and monitoring. Do not give additional opioids to “overcome” naltrexone. That can be dangerous and may cause a fatal overdose as naltrexone wears off.
Until help arrives:
  • Do not take any more naltrexone or opioids unless a clinician directing emergency care says otherwise.
  • Keep the person with someone. If drowsy or vomiting, place them on their side and watch their breathing.
  • If unresponsive and not breathing normally, start CPR if trained and follow emergency-dispatch instructions.
  • Tell emergency staff exactly: opioid name, amount, route, and time used; naltrexone form and time taken, including whether it was an injection.
  • If this might be an allergic reaction with facial/tongue swelling, hives, wheeze, or breathing difficulty, treat it as an emergency immediately.
Common withdrawal symptoms include severe anxiety/restlessness, sweating, chills, muscle aches, dilated pupils, nausea/vomiting, diarrhea, abdominal cramps, runny eyes/nose, and shaking. SAMHSA’s naltrexone guidance and the FDA naltrexone label warn that abrupt antagonist-triggered withdrawal can be severe enough for hospitalization or intensive care.

Any treawnt for it

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naltrexone precipitated opioid withdrawal treatment emergency management official

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naltrexone AND precipitated withdrawal treatment

Yes, but treatment should be supervised urgently by a clinician or emergency department if symptoms are moderate to severe. Naltrexone can cause abrupt opioid withdrawal that may last up to about 48 hours.
What clinicians generally do
  • Stop further naltrexone doses.
  • Check breathing, blood pressure, heart rate, temperature, hydration, and mental status.
  • Give fluids, often IV fluids if vomiting or diarrhea is significant.
  • Use medications for symptoms, such as anti-nausea medicine, antidiarrheal or antispasmodic treatment, and medications for pain or anxiety when medically appropriate.
  • An alpha-2 agonist such as clonidine may reduce sweating, agitation, fast pulse, and other withdrawal symptoms, but it can lower blood pressure, so it needs medical monitoring.
  • Severe cases may require hospital or ICU monitoring, especially with confusion, hallucinations, uncontrolled vomiting/diarrhea, dehydration, very high blood pressure, or heart problems.
Do not try to treat it by taking more opioid. Naltrexone blocks opioid effects, and taking higher amounts can lead to overdose later as the blockade decreases.
For mild symptoms only: stop further naltrexone, drink small frequent amounts of oral rehydration fluid if able, stay with a responsible adult, and contact the prescribing clinician or poison center today. But seek emergency care now if there is persistent vomiting, inability to keep fluids down, severe pain/agitation, fainting, confusion, hallucinations, chest pain, or any breathing problem.
A SAMHSA clinical reference advises stopping naltrexone and supportive care, with hydration and symptom-directed medicines; clonidine may be used under supervision. The FDA prescribing information notes some cases require hospitalization or intensive care.
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