How do you counsel patients on the risks vs benefits of naltrexone for alcohol use disorder with persistently elevated liver enzymes?   

Before answering this question, it is first important to point out that obtaining baseline liver function tests (LFTs) is not necessary before starting a patient on any formulation of naltrexone (oral or long-acting injectable XR). However, it is essential to consider if the patient has an under...

I agree with Dr. @Hurstak's answer. I usually recommend a trial of oral naltrexone for at least a couple of weeks to ensure patients do not develop DILI from naltrexone before giving naltrexone IM. The IM form can't really be removed once administered, so it's helpful to check that a patient wi...