Comprehensive medication guide to Naltrexone including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic naltrexone tablets on most commercial insurance plans (Tier 1–2); typically $0–$5 for Medicaid patients. Vivitrol requires prior authorization but the manufacturer's Vivitrol2gether copay program reduces cost to $0–$5 for 91% of eligible commercially insured patients.
Estimated Cash Pricing
$88–$168 retail for generic naltrexone 50 mg tablets (30-day supply); as low as $32.40 with GoodRx or $36.99 with SingleCare at participating pharmacies. Vivitrol (monthly injection) costs $1,200–$2,127 without insurance.
Medfinder Findability Score
45/100
Summarize with AI
On this page
Naltrexone is an FDA-approved prescription medication used to treat alcohol use disorder (AUD) and opioid use disorder (OUD). It belongs to a class of drugs called opioid antagonists — medications that block the effects of opioids and reduce the rewarding effects of alcohol.
Naltrexone is available as a 50 mg oral tablet taken once daily (generic only; brand-name ReVia and Depade have been discontinued) and as Vivitrol, a 380 mg extended-release injectable administered once monthly by a healthcare provider. It is also available as a combination medication with bupropion (Contrave) for weight management.
Naltrexone is not a controlled substance and has no abuse potential. Any licensed healthcare provider can prescribe it without special DEA licensing or training, and it can be dispensed at any regular pharmacy. It is on the WHO Model List of Essential Medicines and was first approved by the FDA in 1984.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Naltrexone is a competitive antagonist at opioid receptors in the brain — primarily the mu-opioid receptor, with weaker activity at kappa and delta receptors. As an antagonist, it binds to these receptors without activating them, blocking other substances from binding.
For opioid use disorder: When naltrexone occupies the mu-opioid receptors, opioid drugs (heroin, oxycodone, morphine) cannot bind or activate them. The result is that opioids produce no euphoria, no sedation, and no high. This removes the reinforcing reward that drives continued opioid use.
For alcohol use disorder: Alcohol stimulates the release of endorphins (the body's natural opioid-like chemicals), which bind to mu-opioid receptors and trigger dopamine release — creating the pleasurable buzz of drinking. Naltrexone blocks this pathway, blunting the reward of alcohol. Over weeks and months, this reduces cravings and decreases the motivation to drink. The active metabolite 6-beta-naltrexol also contributes to receptor blockade.
50 mg — oral tablet
Standard dose taken once daily. Generic only (ReVia and Depade brands discontinued). Currently subject to active shortage.
380 mg — intramuscular injection (Vivitrol)
Extended-release injectable administered once monthly by a healthcare provider. Brand name only — no generic available. Not affected by the current shortage.
Naltrexone oral tablets are subject to an active drug shortage that began in February 2024 and continues into 2026. The shortage is caused by a shortage of thebaine (the DEA-regulated active pharmaceutical ingredient), surging demand for addiction treatment medications, low manufacturer profit margins, and multiple manufacturers discontinuing their products.
Some manufacturers — including Accord Healthcare, Major Pharmaceuticals, and Sun Pharma — still have product available, which means naltrexone tablets can be found, but availability is highly variable across pharmacies. Independent pharmacies, grocery chain pharmacies, and warehouse club pharmacies may have stock when major chain pharmacies do not. Vivitrol (the injectable form) is not affected by the shortage.
If you're having difficulty finding naltrexone at your usual pharmacy, medfinder can call pharmacies near you to check which ones have it in stock and text you the results — saving you hours of phone calls.
Because naltrexone is not a controlled substance, any licensed healthcare provider in the United States can prescribe it without special DEA scheduling authority, training, or certification. There is no X-waiver, no special license, and no patient limit — making naltrexone one of the most accessible addiction treatment medications available.
Primary care physicians (family medicine, internal medicine, general practice)
Psychiatrists and addiction psychiatrists
Addiction medicine specialists
Nurse practitioners (NPs) and physician assistants (PAs)
Internal medicine physicians
OB-GYNs and other specialists when managing AUD or OUD in their patient population
Naltrexone can also be prescribed via telehealth in all 50 states. Platforms specializing in naltrexone prescribing include OAR Health, Monument, Ophelia, Confidant Health, and Bicycle Health. Telehealth access is particularly valuable for patients in rural areas or those with transportation barriers.
No. Naltrexone is not classified as a controlled substance by the DEA and is not scheduled under the Controlled Substances Act. It has no abuse potential, cannot produce a high or euphoria, and does not cause physical dependence. This distinguishes it significantly from other addiction treatment medications such as methadone (Schedule II) and buprenorphine (Schedule III).
Because naltrexone is not a controlled substance, any licensed healthcare provider can prescribe it — primary care physicians, nurse practitioners, physician assistants — without special DEA certification or training. It can also be prescribed via telehealth in all states without restriction. This makes naltrexone one of the most accessible and least regulated addiction treatment medications available.
Despite not being a controlled substance, naltrexone is still a prescription-only medication. You must have a valid prescription from a licensed provider to obtain it.
Naltrexone is generally well-tolerated at recommended doses. The most common side effects include:
Nausea (most common — takes with food to reduce)
Headache
Abdominal pain or cramping
Loss of appetite
Dizziness and drowsiness
Insomnia
Joint and muscle pain
Anxiety or nervousness
Serious side effects requiring immediate medical attention:
Signs of liver damage: jaundice, dark urine, severe abdominal pain, unusual fatigue (boxed FDA warning)
Precipitated opioid withdrawal (if opioids still in system when starting naltrexone)
Depression or suicidal ideation (contact provider immediately)
Severe injection site reactions (with Vivitrol): cellulitis, necrosis
Allergic reaction: hives, difficulty breathing, facial swelling — seek emergency care immediately
Know what you need? Skip the search.
Acamprosate (Campral)
FDA-approved for alcohol use disorder. Works by stabilizing glutamate/GABA systems. Safe for patients with liver disease. Taken 3 times daily. Best for maintaining abstinence rather than reducing active drinking.
Buprenorphine / Naloxone (Suboxone)
FDA-approved for opioid use disorder. Partial opioid agonist; can be started earlier in withdrawal than naltrexone. Controlled substance (Schedule III). Strong evidence for reducing OUD mortality.
Methadone
FDA-approved for opioid use disorder. Full opioid agonist dispensed through licensed OTP clinics only. Schedule II controlled substance. Highly effective for severe OUD.
Disulfiram (Antabuse)
FDA-approved for alcohol use disorder. Causes aversive reaction when alcohol is consumed. Best for highly motivated patients committed to complete abstinence. Older medication with some safety concerns.
Prefer Naltrexone? We can find it.
All opioids (oxycodone, hydrocodone, morphine, codeine, tramadol, methadone, buprenorphine, fentanyl)
majorContraindicated with naltrexone. Starting naltrexone while opioids are present causes precipitated withdrawal. Taking opioids during naltrexone treatment blocks their effect; attempting to override the blockade with high opioid doses can cause fatal overdose.
Thioridazine
majorCases of excessive lethargy and somnolence reported. Avoid combination.
Disulfiram (Antabuse)
moderateBoth naltrexone and disulfiram are potentially hepatotoxic. Combining them increases risk of liver damage. Use only if benefits outweigh risks, with close liver function monitoring.
Bremelanotide (Vyleesi)
majorSlows gastric emptying, reducing naltrexone absorption. Avoid combination when naltrexone is used for AUD or OUD due to risk of treatment failure.
Acamprosate (Campral)
minorNaltrexone increases acamprosate blood levels. Monitor; no dose adjustment typically required. Combination is sometimes intentional.
Lofexidine (Lucemyra)
moderateTaking lofexidine within 2 hours of oral naltrexone reduces naltrexone levels. Space doses appropriately.
Naltrexone is a proven, safe, and highly accessible treatment for both alcohol use disorder and opioid use disorder. As a non-controlled substance with no abuse potential, it can be prescribed by any licensed provider, filled at any pharmacy, and prescribed via telehealth — making it one of the most patient-friendly addiction treatment options available.
The main challenges patients face with naltrexone in 2026 are supply-related: the ongoing shortage of oral tablets means pharmacies across the country are inconsistently stocked. Patients should refill early, maintain a list of backup pharmacies, consider switching to Vivitrol (not in shortage), and ask their provider about 90-day supplies.
If you're struggling to locate naltrexone at a pharmacy near you, medfinder calls pharmacies in your area on your behalf and texts you which ones have your medication in stock — so you can stop searching and start your treatment.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini