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Nalmefene and other drug interactions

Posted , 3 users are following.

odishon
odishon

Hi,

I am continuing my research into Nalmefene and have read the patient leaflet and am reading Roy Eskapa's book. My main concern is that I am already on around seven other medications and from all accounts not a lot of research has yet been done on interactions with Nalmefene.

Some medications I am on are mentioned. I take Co-codamol pretty much daily for lower back pain - although I have to confess some days I take it without the back pain because guess what? yep it makes me feel good. I do realise I would have to be free of Co-codamol for around two weeks before taking Nalmefene and don't think I would have too much of a problem weening myself of it.

The second medication mentioned which I also take is Omeprazole or the version I take Esomeprazole. This is for stomach acid and I've taken it for years. There is an interaction listed on the Nalmefene patient leaflet but I don't understand it.

The third one which concerns me is Venlafaxine which is an antidepressant. This drug managed to get me out of a major depression when I could just tell my brain was 'broken' despite a counsellor telling me my thought patterns were making me depressed. Everything was great in my life and yet I felt dreadful until around six weeks after beginning Venlafaxine. One problem though, it practically doubled my craving for alcohol and made me 'give in' much more than normal. I Googled this side affect and I'm not alone. I am slightly concerned what mixing Nalmefene with this antidepressant would do.

So, I am just wondering if anyone has any experience of being on any of these medications or similar ones, when beginning Nalmefene.

I have a feeling that when I do see my doctor he won't know any more than I do about this.

0 likes, 22 replies

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  • PaulJTurner1964
    PaulJTurner1964 odishon

    Posted

    Omeprazole can affect the absorption of Nalmefene meaning you get lower the dose. I would guess that the reason you need Omeprazole is that your alcohol consumption causes the excessive stomach acid. You may find that you don't need it if you are drinking less.

    It will lower the effect of co-codamol as that contains codeine which is an opiate and Nalmefene blocks the opioid receptors. You need to get that changed for a non-opiate pain killer. The biggest danger is that you would take more co-codamol than you should and risk overdose. You would NOT get the good feeling from co-codamol if taking Nalmefene.

    Regarding antidepressants. They are largely ineffective if you drink a lot as alcohol is a depressant. It is possible that your depression is alcohol-related and that drinking less will result in your depression lifting without the need for anti-depressants. However, taking antidepressants with Nalmefene is not contraindicated. Drinking with antidepressants IS.

    I hope you have a doctor who is willing to look at reviewing all of your medication if you are started on Nalmefene.

    I am going to send you a link which may interest you, in a private message.

    • odishon
      odishon PaulJTurner1964

      Posted

      Thanks Paul.

      I had investigations into the stomach acid and they said I just produce too much. My Mum has the same problem. I guess the fact I've been a binge drinker then a heavy drinker since the age of 16 doesn't help it though. I'll make sure my GP changes the medication.

      Re Co- codamol, completely understand it won't work as a pain reliever or to give that 'warm' feeling once I'm taking Nalmefene so the plan is to stop it a couple of weeks before starting Nalmefene. I'm hoping if I cut down the drinking I'll have more energy to get fitter and do my back exercises which will reduce the back pain. I have two slipped discs.

      Depression again is in the family but as alcohol is a depressant I know it can't help. Part of the problem with Venlafaxine is that it works so well I don't get that 'booze doom' the day after drinking therefore I now drink more.

      This is why I have realised I can't go on using booze, antidepressants and Co-codamol to constantly affect my mood. I've tried so many times to stop or cut down the booze which is why reading about The Sinclair Method has been a revelation.

    • pete92573
      pete92573 PaulJTurner1964

      Posted

      I have been taking Nalmefene for 6 days and all is going well. I did not realise until i read the accompanying leaflet that taking Omeprazole was an issue. I cannot see my GP utill Friday, in the meantime i have halved my dose of Ome..  to 20mg. I have peptic polyps, hence acid. I will ask my GP if  Lansoprazole is ok to switch to. if you have any other advice it would be appreciated. Many thanks for all your postings
    • odishon
      odishon pete92573

      Posted

      I spoke to the manufacturer and it's apparently just a theory that it could affect the absorption so no rush to change, just when you see your doctor will do.

      I think my main conflicting drug was Venlafaxine which was counteracting the Nalmefene with huge alcohol cravings.

    • PaulJTurner1964
      PaulJTurner1964 pete92573

      Posted

      Hello Pete. Odishon is correct. The only issue with Omeprazole and Nalmefene is that it can slow down the absorption so you need to take that into account. If you find that your drinking is not reducing as much as you think it should and you are not making the progress you hope for, try extending the time between your pill and your first drink by about half an hour. We have found that many people need a minimum of 2 hours for Nalmefene to be fully effective, even when they are not taking anything that affects the absorption.

       

    • pete92573
      pete92573 PaulJTurner1964

      Posted

      Thanks Paul

      I currently take it 2hours before so will try 2h 30m before. I feel it is having an effect, just not as much as I hoped, but it is only 6 days!

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