How do you counsel patients on the risks vs benefits of naltrexone for alcohol use disorder with persistently elevated liver enzymes?
Is there an absolute cutoff for AST/ALT that you use where the risks outweigh the potential harm reduction benefits of using the medication?
2 Answers
Mednet MemberInvited Expert
Primary Care · Boston University School of Medicine
Answered on
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 underly...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Primary Care · Oregon Health & Science University
Answered on · Updated on
I agree with Dr. @Dr. First Last'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 ...
Join for free or sign in to see the full answer