Tuesday October 23rd 2018

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Is Depade Safe?


ARTICLE OVERVIEW: Yes, Depade is relatively a safe medication. In fact, Depade (naltrexone) is a medication used to help people stay sober and continue to avoid drinking or using drugs. Here, we will review some basic safety information about Depade and its side effects. Plus, we’ll look at the use of Depade for long-term treatment and how it should be taken. 


ESTIMATED READING TIME: 10-15 minutes.


TABLE OF CONTENTS


How It Works

Depade is a brand name for a drug containing naltrexone, an opioid antagonist, which is commonly used to treat the withdrawal symptoms from alcohol or drug addiction. Antagonists are types of medications that block certain nerve receptors in the brain. They work by interfering with the rewarding effects of opiates or opioids.

In other words, naltrexone blocks the euphoric and sedative effects of drugs or alcohol so that you won’t be tempted to use these harder drugs.

Depade works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Instead, naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings. When used as a treatment for alcohol dependency, naltrexone blocks the euphoric effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment and avoid relapses.


If a person relapses and uses a narcotic drug or drinks alcohol, the naltrexone found in Depade prevents the feeling of getting high or intoxicated.


Psychoactive Effects

You cannot get high on Depade. Naltrexone is not addictive. Therefore, there is little to no abuse or diversion potential. Furthermore, discontinuation of naltrexone is not associated with a withdrawal syndrome, and it is not necessary to taper the dose.

Still, people using naltrexone should not use any other opioids or illicit drugs; drink alcohol; or take sedatives, tranquilizers, or other drugs.

Why not?

People on naltrexone may have reduced tolerance to opioids and may be unaware of their potential sensitivity to the same, or lower, doses of opioids than they used to take. If you use naltrexone and relapse after a period of abstinence, it is possible that previous dosage can now trigger life-threatening consequences, including respiratory arrest and circulatory collapse.

Uses

This medication is used to prevent people who have been addicted to certain hard drugs from taking them again. Types of drugs that cause addiction and that Depade is prescribed to help treat include:

  • Codeine
  • Heroin
  • Hydrocodone
  • Fentanyl
  • Morphine
  • Oxycodone

This medication is also used to treat alcohol abuse. It can help people drink less alcohol or stop drinking altogether. It also decreases the desire to drink alcohol when used with a treatment program that includes counseling, support, and lifestyle changes. In fact, most medications used to treat addiction are best used as part of a complete treatment program that includes compliance monitoring, counseling, behavioral contracts, and lifestyle changes. So, experts agree that prescription naltrexone should be part of a comprehensive management program that includes psychosocial support.

NOTE HERE: It is important that medical managed withdrawal (detoxification) from opiates or opioids be completed at least 7 to 10 days before extended-release injectable naltrexone is initiated or resumed. Research has shown that naltrexone decreases reactivity to drug-conditioned cues and decreases craving. Persons who have been treated with extended-release injectable naltrexone may have reduced tolerance to opioids and may be unaware of their potential sensitivity to the same, or lower, doses of opioids that they used to take.

Who Needs Depade

Addiction is very common health problem today. Some experts even think it’s America’s #1 social and health issue. Thankfully, Depade is once medications that can be used to prevent relapse. But how many people might consider this preventative drug?

According to the World Health Organization, 5.4 % of our world’s population could be diagnosed with a substance use disorder. In fact, it is estimated that 8-13% of people who live in developed countries experience some sort of addiction. This can be food, video gaming, alcoholism, or drugs.

The 2016 National Survey on Drug Abuse and Health found that about 22.5 million Americans aged 12+ deal with substance use disorder. The survey classifies addiction into two main categories: alcohol and drug abuse.

  • 15.1 million people aged 12+ had drinking problems in 2016.
  • 7.4 million people aged 12+ had illicit drug use problems in 2016.

Moreover, this SAMHSA report shows that 21 million people aged 12 or older needed substance use treatment. And the consequences of not getting treatment are deadly. In 2016, the National Institute on Drug Abuse reported that 64,000 drug overdose deaths occurred in one single year.

When combined with talk therapy, medications can help alot! The 2015 Center for Behavioral Health Statistics and Quality report found that about 3.4 million visits to physician offices in 2010 involved medication prescriptions (including Depade) to treat substance use disorders. About 44.3 % of the prescriptions for substance use disorders were made by general and family practice physicians, while 20.1% were made by psychiatrists.

So, why do we need Depade?

Because it can address addiction… and help people find a way forward.

Where to Find It

Depade can be prescribed by any healthcare provider who is licensed to prescribe medications; special training is not required.

You must be opioid-free for a minimum of 7 to 10 days before Depade treatment is initiated, to reduce the risk of precipitated withdrawal. If switching from methadone to naltrexone, you have to be completely withdrawn from the opioid first.

Risks

The drug, while fairly safe, does have certain risks. If you relapse while on Depade, you are likely to experience sudden withdrawal effects, as the medication breaks the connection between a substance of abuse and the opioid receptors in the brain. This is one reason why it is very important to avoid relapse while on this particular medication and why one who is taking Depade must no longer be dependent on alcohol or opioids.

Side Effects

Depade, like most drugs, can causes a number of side effects. These can range from uncomfortable to dangerous. And while naltrexone has a low incidence of common adverse events, the drug can have some serious side effects of its own, and therefore, must be taken exactly as prescribed.

Common side effects include:

  • Chronic trouble sleeping
  • Feel like throwing up
  • Feeling anxious
  • Giant hives
  • Head pain
  • Inflammation of skin caused by an allergy
  • Joint pain
  • Low energy
  • Muscle pain
  • Rash
  • Stomach cramps
  • Throwing up

Infrequent side effects:

  • Change in pulse
  • Chills
  • Constipation
  • Cough
  • Diarrhea
  • Dizzy
  • Easily angered or annoyed
  • Excessive thirst
  • Fast heartbeat
  • Hoarseness
  • Loss of appetite
  • Nervous
  • Runny nose
  • Sinus irritation and congestion
  • Sneezing
  • Stuffy nose
  • Throat pain

Rare side effects:

  • Abnormal liver function tests
  • Altered mental status
  • Blurred vision
  • Confused
  • Depression
  • Difficult or painful urination
  • Drowsiness
  • Earache
  • Eye irritation
  • Fever
  • Frequent urination
  • Hallucination
  • Having thoughts of suicide
  • Hepatitis caused by drugs
  • High blood pressure
  • Inability to have an erection
  • Inflammation of a vein
  • Inflammation of the eye
  • Involuntary quivering
  • Itching
  • Low platelet count and bleeding from immune response
  • Mood changes
  • Nosebleed
  • Pain in the eye
  • Ringing in the ears
  • Stomach or intestinal ulcer
  • Swollen lymph nodes
  • Trouble breathing
  • Twitching

Normally, these side effects are not very problematic. However, a person can experience more severe effects if they begin drinking or taking drugs while on the medication. It is very important that the individual is no longer dependent on any of these substances when they begin taking Depade.

Serious Side Effects

Naltrexone’s FDA-approved label includes a black-box warning regarding hepatotoxicity, although these reversible effects tend to be associated with much higher doses than those used in routine clinical practice (e.g., 300 mg/day or more) and tend to occur only after a person is on these high doses for extended periods.

Seek help if the following side effects appear, because they may indicate serious liver problems:

  • Bad stomach ache
  • Dark or tea-colored urine
  • Light-colored bowel movements
  • Yellowing in the whites of the eyes
  • Yellow skin

Also, go to a health care provider right away for:

Difficulty breathing. It may be caused by a case of allergic pneumonia. Seek evaluation for signs and symptoms of pneumonia.
Injection site reactions. This may occur from the injectable naltrexone. Seek evaluation for worsening skin reactions.

Its important to know that if side effects occur, you should not discontinue the medication. Instead, report the unwanted effects to your doctor or substance abuse treatment provider. An adjustment in dosage or a change in medication might help.

Treating Side Effects

Common side effects that may occur when taking Depade can include gastro-intestinal issues and general discomfort. For your convenience, we have listed them below and recommend known ways to reduce them. If you experience any of these symptoms, or other unusual effects that are uncomfortable or last a long time, report them your prescribing doctor as soon as possible.

For diarrhea, drink plenty of water or juice. Also, ask your doctor to recommend an over-the-counter medicine.
For fatigue, take the pill in the morning. Avoid naps. Go to bed at the same time every night. Exercise. Do not drink caffeine after lunchtime.
For headache use over-the-counter headache medicines according to package instructions.
For joint or muscle pain use over-the-counter pain medicines according to package instructions.
For nervousness, take a walk, take a hot bath, or take deep breaths.
For vomiting or upset stomach, take the pill with food or after a meal. Take an antacid product as directed by your doctor.

Long-Term Use

Q: Is Depade safe for long-term use?
A: Yes, Depade is generally safe for long-term use.

In fact, you will not become physically dependent on it at all. You can stop taking Depade at any time without experiencing any withdrawal or craving.

Furthermore, Depade has no addictive potential, so you can keep taking it for as long as you need it or benefit from it. However, you should never stop regular use on your own. If you feel you no longer need this prescription medicine and want to discontinue treatment, consult your doctor to prevent any setbacks to the other aspects of your addiction recovery process.

Safe Dosing

The usual adult oral dosage of Depade is one 50-mg tablet daily. However, your doctor may instruct you to go for a visit every 2-3 days and take a higher dose of 100-150mg to keep you stable until the next scheduled dosing. The injectable extended-release form of the drug is administered at 380 mg intramuscular once a month.

The FDA label states that naltrexone should be taken for up to 3 months to treat drinking problems. Healthcare providers should tailor the length of treatment to individual persons. Naltrexone has been administered to persons who are alcohol dependent for 6 months to 1 year with no additional safety concerns.

Contraindications

Always seek medical advice before using a prescription drug like Depade. In fact, Depade can be dangerous in some situations. Below we present a list of situations where the use of Depade should not be considered. If you experience any of these circumstances, seek advice from your prescribing doctor for better management and treatment alternatives.

Additionally, here is a list situations in which use of naltrexone may require careful consideration or medical monitoring:

 

Depade and Pregnancy

Naltrexone is considered FDA pregnancy category C, meaning its effects on the fetus are unknown. Women of childbearing age should be informed of this and counseled to use effective birth control when sexually active. Some clinicians may choose to obtain a pregnancy test before starting naltrexone and whenever pregnancy is suspected. If a woman becomes pregnant while using naltrexone, the clinician and patient should decide together whether to continue the medication, given the potential risks and benefits.

Tell Your Doctor If…

  • You have an allergy to naltrexone or any other ingredient found in Depade.
  • You are allergic to any substance. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough;
  • swelling of face, lips, tongue, or throat; or any other signs.
  • You are taking an opioid drug like morphine or oxycodone, are addicted to an opioid drug, or are having withdrawal signs.
  • You have taken a pain drug within the past 7 to 10 days.
  • You are pregnant.
  • You are breast-feeding or plan to breast-feed.

Tell your doctor and pharmacist about all drugs or supplements that you are taking. This include:

  • prescription drugs
  • over-the-counter drugs
  • natural products
  • vitamins and minerals
  • supplements

Also, share current and past health problems with your prescribing doctor. You must check to make sure that it is safe for you to take Depade (naltrexone tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

Safety Recommendations

1. Do a urine test for opiates and a naloxone challenge test before starting Depade treatment. You should be opiate-free for at least 7-10 days.
2. Inform your doctor about any allergies. Depade contains some inactive compounds that may cause allergic reactions.
3. Do not take opiate drugs when using Depade. It will block their effects and can lead to sudden withdrawal symptoms, overdose or death.
4. Go to your doctor for regular tests on your liver if you have a pre-existing liver condition.
5. Do not take any opiate medications such as some pain killers, cough syrups, and diarrhea medicines. Depade will block the effects of these meds.
6. If you are pregnant or thinking about conceiving, discuss the possible risks with your doctor. Depade should be used by pregnant women only when the benefits outweigh the risks, otherwise methadone is a safer option.
7. Consult your doctor before breastfeeding your baby while on Depade. Medicine still has not concluded whether Depade is excreted via breast milk.
8. Before undergoing any medical treatment, tell your doctor or dentist that you are taking Depade. Also, for medical emergency situations carry a medical identification stating that you are taking this medication.

Your Questions

Still have questions?

We love to hear from our readers. So, if you, or someone you love, are taking naltroxone and want more information about it, or have additional questions, feel free to post them in the comments section below. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular enquiry, we will refer you to someone who does.

We are here to help you.

Reference Sources: DRUGABUSE: Pharmacological treatment (Medications)
NCBI: Naltrexone extended-release injection: an option for the management of opioid abuse
NCBI: Oral naltrexone
NIH: Prescribing medications
SAMHSA: The facts about naltrexone for treatment of opioid addiction
SAMHSA: Naltrexone
SAMHSA: Substance abuse treatment advisory

Photo credit: Aban Nesta

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