Drug Interactions between naltrexone and tapentadol

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including tapentadol. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

GENERALLY AVOID: Consumption of alcohol while taking extended-release formulations of tapentadol may cause rapid release of the drug, resulting in high systemic levels of tapentadol that may be potentially lethal even in opioid-tolerant patients. Alcohol appears to disrupt the extended-release mechanism, causing 'dose-dumping' into the bloodstream. A clinical study evaluated healthy volunteers administered a single dose of extended-release tapentadol (100 mg or 250 mg) with 240 mL of 40% alcohol. The mean peak tapentadol concentration (Cmax) was 48% higher when alcohol was combined with the 100 mg dose and 28% higher when alcohol was combined with the 250 mg dose, as compared to control. Additionally, the systemic exposure (AUC) of tapentadol increased by 16-17% when combined with alcohol.

MANAGEMENT: Patients taking extended-release formulations of tapentadol should not consume alcohol or use medications that contain alcohol. In general, narcotics such as tapentadol should not be combined with alcohol. Modified and/or extended-release tapentadol formulations must also be swallowed whole and not crushed, chewed or divided.

Naltrexone may cause liver problems, and using it with other medications that can also affect the liver such as ethanol (alcohol) may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.