How much naltrexone for alcohol?
Alcohol Use Disorder
The standard dose is 50 mg once a day by mouth. Some people start at 25 mg for a few days to ease nausea, then move up to 50 mg.
Naltrexone doses at a glance
Doses for alcohol use disorder
Standard dose
50 mg once a day
Starting dose
25 mg for a few days
Higher dose
Up to 100 mg a day
Monthly shot
380 mg every 4 weeks
Sinclair Method
50 mg before drinking
When to take
Any time of day
Take with food?
Optional
Missed a dose?
Take when you remember
Controlled substance?
No
50 mg is the standard. Your provider sets the dose that fits you.
50 mg
the standard dose, taken once a day by mouth
380 mg
one Vivitrol shot, given once every 4 weeks
25 mg
an optional starting dose for the first few days to ease nausea
The standard naltrexone dose for alcohol use disorder is 50 mg once a day by mouth. If you would rather not take a daily pill, a 380 mg injection called Vivitrol is given once a month. Your provider picks the dose and form that fit your goals and health.
Daily dosing
One 50 mg pill every day, or a 380 mg shot once a month. The steady, everyday way to take it.
Every day
The Sinclair Method
The same 50 mg pill, taken about an hour before you drink, on drinking days only.
Before drinking
What is the standard naltrexone dose for alcohol?
For alcohol use disorder, the usual dose is 50 mg once a day, taken as a single tablet. This is the dose used in the research that shows naltrexone reduces heavy drinking, and it fully blocks the alcohol reward for about a day, which is why it is taken once daily. You can take it in the morning or evening, with or without food, though taking it with food can help if you feel queasy at first. Taking it at the same time each day helps you remember and keeps the level steady.
50 mg once a day is the standard dose. It is the dose proven to reduce heavy drinking, and it blocks alcohol’s reward for about a full day.
Should you start at a lower dose?
Many providers start naltrexone at 25 mg, which is half a tablet, for the first three to four days. This lower starting dose helps your body adjust and can reduce early nausea, the most common side effect. After those first few days, you move up to the full 50 mg. Not everyone needs this step, but it is a common and gentle way to begin. In some cases, a provider may raise the dose to 100 mg a day, though 50 mg is standard for most people.
Naltrexone injection dose (Vivitrol)
If a daily pill is not for you, naltrexone also comes as a long-acting injection called Vivitrol. The dose is 380 mg given as a shot into a muscle, once every four weeks by a healthcare provider. One injection lasts the whole month, so there is no daily pill to remember. It is a good option for people who want steady coverage without thinking about it each day. The trade-off is that you need to visit a provider monthly for the shot.
The Sinclair Method dose
The Sinclair Method uses naltrexone in a targeted way to reduce drinking over time. Instead of a daily pill, you take one 50 mg tablet about one hour before you plan to drink, and only on days you drink. Taken this way, naltrexone blocks the reward of each drink, and the urge to drink slowly fades. The dose is the same 50 mg, just timed to your drinking rather than taken every day. Read more in our Sinclair Method guide.
What if you miss a dose?
If you take naltrexone daily and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue as usual. Missing a single day is not dangerous, but staying consistent gives you the best results. For the monthly injection, your provider will help you reschedule if you miss an appointment.
Do not double up. Never take two doses at once to make up for a missed one. Take the missed dose when you remember, or skip it if your next dose is close.
Naltrexone dosage at a glance
| Form | Dose | How often |
|---|---|---|
| Tablet (standard) | 50 mg | Once a day |
| Tablet (starting) | 25 mg | Once a day for the first few days |
| Tablet (higher) | Up to 100 mg | Once a day, in some cases |
| Tablet (Sinclair Method) | 50 mg | 1 hour before drinking, on drinking days |
| Injection (Vivitrol) | 380 mg | Once every 4 weeks |
A note on low-dose naltrexone: you may see doses of 1.5 mg to 4.5 mg called low-dose naltrexone, or LDN. That is a different, off-label use for conditions like chronic pain, not the dose for alcohol. For alcohol use disorder, 50 mg is the standard.
See also our naltrexone for alcohol guide, the naltrexone 50 mg tablet page, and naltrexone side effects.
Looking for naltrexone by telehealth? See our naltrexone online service page.
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Frequently asked questions
What is the usual dose of naltrexone for alcohol?
What is the usual dose of naltrexone for alcohol?
The usual dose is 50 mg once a day by mouth. Some people start at 25 mg for a few days to reduce nausea, then move up to 50 mg. A 380 mg monthly injection (Vivitrol) is an option if you prefer not to take a daily pill.
Can you take 100 mg of naltrexone?
Can you take 100 mg of naltrexone?
Yes, in some cases. While 50 mg a day is standard, a provider may raise the dose to 100 mg for certain patients. Do not increase your own dose without talking to your provider first.
When should you take naltrexone, morning or night?
When should you take naltrexone, morning or night?
You can take naltrexone at any time of day, with or without food. Pick a time you can keep consistent. If it makes you drowsy or keeps you awake, ask your provider whether morning or night works better for you.
How long do you take naltrexone for alcohol?
How long do you take naltrexone for alcohol?
There is no fixed length. Many people take naltrexone for several months to a year or more, based on their progress and goals. Your provider will review how it is working and help you decide how long to continue.
- Sources.
- American Academy of Family Physicians. Alcohol Use Disorder: Medication Options. American Family Physician, 2024 (naltrexone 50 mg orally per day, may start at 25 mg or increase to 100 mg; 380 mg intramuscularly per month).
- U.S. Food and Drug Administration. Prescribing information for naltrexone (ReVia) and naltrexone extended-release injectable (Vivitrol).
- Singh D, Saadabadi A. Naltrexone. StatPearls. National Library of Medicine.
This page is for education only and is not medical advice. Never start, stop, or change your dose without talking to a licensed provider.