Medications For Alcohol Use Disorder © Yale University

Oral Injectable
Naltrexone Naltrexone Acamprosate Disulfiram Topiramate Gabapentin
Mechanism Antagonist at Antagonist at Unknown; Inhibits breakdown of Unknown, Unknown,
of Action opiate opiate receptors modulates glutamate acetaldehyde by exerts action at action at calcium
receptors inhibiting the enzyme, GABAA and channels indirect
aldehyde glutamate receptors effects on GABA
dehydrogenase concentration

Doses 50mg, scored 380mg IM 333mg 250mg 200mg 300-600 mg

(i.e. cut in half) (125mg-500mg) (up to 300mg)
Take in divided
Take daily Every 4 weeks Take two tablets 3 Take daily doses 2-3 times a
times a day day

Side • Nausea • Nausea • Diarrhea • Disulfiram-ethanol • Sedation • Fatigue

effects • Headache • Headache reaction • Cognitive • Insomnia
• Dizziness • Dizziness • Rash dysfunction • Headache
• Fatigue • Fatigue • Drowsiness • Dizziness
• Nervousness • Nervousness • Metallic taste • Paresthesia
• Anxiety • Anxiety • Liver toxicity
• Pain at injection
site

Relative • Current • Current opioid use • Severe kidney • Psychosis or • History of kidney • Potential for
contra- opioid use • Acute hepatitis disease impaired cognition stones misuse and
indications • Acute or liver failure (CrCl < 30mL/min) • Severe coronary • Risk of metabolic diversion
hepatitis or artery disease acidosis • Dose adjusted in
liver failure Acute angle kidney disease
glaucoma

Duration: Medications for addiction treatment should be extended as long as is necessary and in partnership with the patient.
Note: This chart is just for reference. Consult the prescriber medication guide for complete details before prescribing these medications.