Nalmefene treatment for alcohol and drug dependence
Nalmefene is an opioid receptor modulator used in the treatment of alcohol dependence and has also been investigated for its potential use in the treatment of drug dependence. As an opioid receptor antagonist, nalmefene blocks the effects of opioid drugs and may reduce the euphoric or “high” feeling associated with opioid use, potentially helping to reduce the drive to use opioids again. It has also been investigated in relation to cocaine and other stimulant dependence. The European Medicines Agency (EMA) has approved nalmefene tablets for the treatment of alcohol dependence.
How nalmefene works
Nalmefene acts on specific opioid receptors involved in the brain’s reward and motivation pathways. By modifying opioid signalling, it helps reduce the reinforcing effects associated with alcohol and support a reduction in alcohol consumption.
Rather than requiring immediate abstinence, the aim of treatment is to help suitable patients reduce their alcohol intake and regain greater control over their drinking. For the best outcome, treatment should be provided alongside ongoing medical advice and, where appropriate, psychological support.
Nalmefene vs. naltrexone
Nalmefene is very similar to naltrexone, as it is also an antagonist at the mu ($\mu$) and delta ($\delta$) opioid receptors. However, nalmefene is considered to have a longer duration of action and a stronger binding affinity than naltrexone.
Like naltrexone, nalmefene blocks the effects of opioids and can reduce the euphoric effects associated with opioid use. Its potential applications in opioid and cocaine dependence have been investigated, although these are not established licensed indications for nalmefene.
Nalmefene also has partial agonist activity at the kappa (κ) opioid receptor. This property has been investigated for its potential role in reducing dysphoria, low mood, loss of motivation, and depressive symptoms during recovery, although these potential benefits remain an area of ongoing research.
Another important characteristic of nalmefene is its pharmacokinetic profile. Although nalmefene is extensively metabolised by the liver, its hepatic safety profile may be more favourable than that of some other opioid antagonists, including naltrexone, in certain clinical circumstances. However, nalmefene clearance is reduced in patients with hepatic impairment, resulting in increased exposure to the drug. Appropriate medical assessment is therefore required before treatment is considered, particularly in patients with liver conditions. In patients with mild or moderate hepatic impairment, treatment should be prescribed with appropriate caution and monitoring.
Nalmefene injections: Off-label treatment
In the UK, the licensed form of nalmefene for the treatment of alcohol dependence is an oral tablet. Nalmefene injection is not a licensed formulation for the treatment of alcohol dependence in the UK. Where clinically appropriate, it may be prescribed by a doctor as an off-label treatment option.
Our doctors can discuss this option following a comprehensive medical assessment. Any decision to use an off-label treatment is made by the treating clinician after carefully considering your individual circumstances, the potential benefits and risks, and available treatment alternatives.
We ensure that all patients receive clear and transparent information about the treatment, including its off-label status, so that they can make a fully informed decision before proceeding.
Who may be suitable for nalmefene treatment?
Nalmefene treatment is not suitable for everyone. Before recommending a tailored treatment plan, our doctors will review your alcohol consumption, medical history, current medication, general health, and personal goals.
A consultation provides a supportive, confidential space to discuss your drinking patterns, previous attempts to reduce your alcohol intake, and the treatment options best suited to your needs.
Nalmefene treatment at our clinic
Our clinic provides confidential, medically supervised care for patients seeking help with alcohol dependence.
Where clinically appropriate, our doctors can discuss injectable nalmefene as an off-label treatment option, explaining the proposed treatment protocol, potential benefits and risks, suitable alternatives, and ongoing follow-up care.
Nalmefene treatment pricing
The cost of nalmefene treatment depends on the specific treatment plan recommended following your medical assessment. Our 3-month injectable nalmefene treatment is priced at £800.
Please contact our clinic team for further information about what is included in the treatment and any follow-up care.
How to book an appointment
Our addiction treatment clinic provides medically supervised nalmefene treatment following a thorough clinical assessment. For suitable patients, we offer nalmefene injections for a 3-month treatment period as an off-label treatment option.
If you would like to discuss medical treatment for alcohol dependence, you can book a confidential appointment with our specialist addiction treatment clinic.
During your appointment, our doctor will evaluate your individual circumstances, discuss suitable treatment options, and determine whether a nalmefene injection is appropriate for you.
You can also explore our Naltrexone Implant Treatment page to learn about another medically supervised treatment option for alcohol dependence.
For current pricing across our treatment options, please see our full treatment pricelist.
