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After opioid detoxificationpatients are likely to have reduced tolerance to opioidsAs the blockade of exogenous opioids provided by REVIA wanes and eventually dissipates completelypatients who have been treated with REVIA may respond to lower doses of opioids than previously usedjust as they would shortly after completing detoxification.
There was limited evidence of a weak genotoxic effect of naltrexone in one gene mutation assay in a mammalian cell linein the Drosophila recessive lethal assayand in non-specific DNA repair tests with EcoliHoweverno evidence of genotoxic potential was observed in a range of other in vitro testsincluding assays for gene mutation in bacteriayeastor in a second mammalian cell linea chromosomal aberration assayand an assay for DNA damage in human cellsNaltrexone did not exhibit clastogenicity in an in vivo mouse micronucleus assay.
A rapidly acting opioid analgesic which minimizes the duration of respiratory depression is preferredThe amount of analgesic administered should be titrated to the needs of the patientNon-receptor mediated actions may occur and should be expectede.gfacial swellingitchinggeneralized erythemaor bronchoconstrictionpresumably due to histamine release.
The drug is reported to be of greatest use in good prognosis opioid addicts who take the drug as part of a comprehensive occupational rehabilitative programbehavioral contractor other compliance-enhancing protocolREVIAunlike methadone or LAAMlevoalpha-acetyl-methadoldoes not reinforce medication compliance and is expected to have a therapeutic effect only when given under external conditions that support continued use of the medication.
In view of the lack of actual experience in the treatment of REVIA overdosepatients should be treated symptomatically in a closely supervised environmentPhysicians should contact a poison control center for the most up-to-date information.
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