nalorex

Le NALOREX (Naltrexone) est utilisé pour combattre l'accoutumance aux opiacés (traitement de soutien dans le sevrage de la toxicomanie et dans la prévention des rechutes).Informations pratiques Délivré seulement sur ordonnance.Délivrance hospitalière. Mode d'action NALOREX est un antagoniste des opiacés: il empêche l'action des opiacés sur leurs récepteurs du système nerveux central. En cas d'oubli Suivre la prescription de votre médecin traitant.Effets secondaires Il est difficile de distinguer les effets indésirables des effets de la toxicomanie. On note parfois : anxiété, douleurs abdominales, nausées, douleurs articulaires et musculaires, maux de tête. Plus rarement : troubles digestifs, soif exagérée, perturbations de l'humeur, éruptions cutanées, troubles de la libido. Contre-indications /Précautions d'emploi NALOREX est contre-indiqué en cas d'allergie à la naltrexone, d'insuffisance hépatique grave, état de dépendance aux opiacés.Consultez votre médecin avant de prendre NALOREX en cas de troubles hépatiques ou rénaux.Consultez votre médecin avant de prendre NALOREX en cas de grossesse ou d'allaitement (contre-indiqué).L'utilisation de NALOREX est déconseillée chez les nourrissons et les enfants.Les sujets âgés ne doivent prendre NALOREX que sous contrôle médical (déconseillé).Les conducteurs de véhicules et les utilisateurs de machines doivent être avertis des risques inhérents à NALOREX.L'utilisation prolongée de NALOREX est déconseillée. Interactionsmédicamenteuses L'association à un opiacé peut avoir une issue fatale. Consultez votre médecin avant d'associer NALOREX à un autre traitement.La consommation d'alcool doit être proscrite avec NALOREX.NALOREX peut interagir avec d'autres. Si vous prenez un autre médicament, signalez-le toujours au médecin ou au pharmacien.Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. It is marketed in generic form as its hydrochloride salt, naltrexone hydrochloride, and marketed under the trade names Revia and Depade. In some countries, an extended-release formulation is marketed under the trade name Vivitrol. It should not be confused with naloxone, which is used in emergency cases of overdose rather than for longer term dependence control.Naltrexone can be described as a substituted oxymorphone – here the tertiary amine methyl-substituent is replaced with methylcyclopropane.Naltrexone, and its active metabolite 6-ß-naltrexol, are competitive antagonists at µ- and ?-opioid receptors, and to a lesser extent at ,,-opioid receptors. The plasma halflife of naltrexone is about 4 h, for 6-ß-naltrexol 13 h. The blockade of opioid receptors is the basis behind its action in the management of opioid dependence—it reversibly blocks or attenuates the effects of opioids.Its use in alcohol (ethanol) dependence has been studied and has been shown to be effective[1]. Its mechanism of action in this indication is not fully understood, but as an opioid-receptor antagonist it's likely to be due to the modulation of the dopaminergic mesolimbic pathway which ethanol is believed to activate.Naltrexone is metabolised mainly to 6ß-naltrexol by the liver enzyme dihydrodiol dehydrogenase. Other metabolites include 2-hydroxy-3-methoxy-6ß-naltrexol and 2-hydroxy-3-methoxy-naltrexone. These are then further metabolised by conjugation with glucuronide .Naltrexone is sometimes used for rapid detoxification ("rapid detox") regimens for opioid dependence. The principle of rapid detoxification is to induce opioid-receptor blockade while the patient is in a state of impaired consciousness so as to attenuate the withdrawal symptoms experienced by the patient. Rapid detoxification under general anaesthesia involves an unconscious patient and requires intubation and external ventilation. Rapid detoxification is also possible under sedation. The rapid detoxification procedure is followed by oral naltrexone daily for up to 12 months for opioid dependence management. There are a number of practitioners who will use a naltrexone implant placed in the lower abdomen, and more rarely, in the posterior to replace the oral naltrexone. This implant procedure has not been shown scientifically to be successful in "curing" the subject of their addiction, though it does provide a better solution than oral naltrexone for medication compliance reasons. Naltrexone implants are made by at least three companies, though none are FDA approved. There is currently scientific disagreement as to whether this procedure should be performed under local or general anesthesia, due to the rapid, and sometimes severe, withdrawal that occurs from the naltrexone displacing the opiates from the receptor sites.Rapid detoxification has been criticised by some for its questionable efficacy in long-term opioid dependence management. Rapid detoxification has often been misrepresented as a one-off "cure" for opioid dependence, when it is only intended as the initial step in an overall drug rehabilitation regimen. Rapid detoxification is effective for short-term opioid detoxification, but is approximately 10 times more expensive than conventional detoxification procedures. Aftercare can also be an issue, since at least one well-known center (check before you assume they will take you) in the United States reported that they will remove an implant from any patient arriving in their facility before admission.The usefulness of naltrexone in opioid dependence is very limited by the low retention in treatment. Like disulfiram in alcohol dependence, it temporarily blocks substance intake and does not affect craving. Though sustained-release preparations of naltrexone has shown rather promising results, it remains a treatment only for a small part of the opioid dependent population, usually the ones with an unusually stable social situation and motivation (e.g. dependent health care professionals).