selincro/nalmefene and alcohol

I am wondering why your husband knows nothing about this. It is always helpful if the person closest to you is aware of what you are doing and has a full understanding of the treatment so that they can support you.

It sounds like you haven't been well advised as to how it should be taken. It should ONLY be taken before drinking (we advise two hours before) and not taken if you are not going to be drinking in the next few hours. The only reaction it has with alcohol is a decrease in your desire to drink large amounts, it doesn't make you feel sick if taken with alcohol, it is designed to be used that way.

It is also important that, once you have started the treatment, you do not drink without taking a pill.

It's up to you, but it really is worth persisting, maybe start again when you have a few days when it doesn't matter if you just go to bed if you are feeling rough.

Hi Tina,

I would like to second what Paul has said.  These tablets DO work and it is definitely worth persisting.  The first and second tablet is always the worst, but from then on you will notice the side effects reducing each day.

The only other thing to check is that you are not taking any other medication that is reacting badly with the Selincro.  If you are taking anything already that contains opiates, then those opiates are already occupying the receptors in your brain.  You would think your doctor will have checked this for you, but sadly a lot of doctors are not really aware of the ins and outs of this medication.

As an opioid-blocking medication, taking Selincro will push these opiates away, basically creating an opiate-withdrawal which could be making you feel so horrendous too.

If you are not taking any other medication at the moment, then please reconsider throwing the tablets away.  You are through the worst of it now and it will only get better.

Eat a good meal about 30 minutes before the tablet, drink plenty or water both with the tablet and during the 2 hour wait, and then drink.

I've been taking nalmefene for more than three months and it does now seem to be reducing the craving, slowly but surely. The first week taking it was the worst and the side-effects disappeared after that. They seem to vary in intensity with different people, but the effects from each pill become less and less as you go through that first week, or thereabouts..

I recently got the Roy Eskapa book 'the cure for alc...' and was glad that i did since it's very interesting as to how the use of this drug came about and subjects such as alcohol deprivation effect, pharmacological extinction (the Sinclair method), learning and un-learning alcoholism, a chapter to show ones GP which I will be copying to give mine, since he has been asking me is it working and seems to think that in time I should no longer need the prescription. In the book it mentions that it can often take 3 to 4 months for a noticable reduction in tendency to drink excessively, but it can take up to 9 or ten months for some people, to get a noticable reduction in craving. I'm probably one of those people but have noticed a bit less of an urgency so far, as to my compulsion to drink heavily and it appears to be diminishing more and more as time goes on. Considering that i started drinking at 16, almost 40 years ago, it is understandable that it could take a number of months to return the brain to the way it was before the first drink was taken. Also, in my case, due to a major road accident in my mid-twenties (motorcycle, of course!) I became addicted to morphine while being on it for a few weeks in hospital and in the book he describes how morphine and alcohol use the same opioid receptors in the brain. That, to read, was an eye-opener, since my addiction to drink seems to have started then, when i got out of hospital.

Anyway, i would strongly recommend that you recover those pills from the bin and weather the slight storm of those first few pills. Each pill will likely give less side-effect than the previous one and then you're most likely laughing, and over a bit of time you should notice a progressive difference and begin to get your lifeback again to where it was before the 'problem' of drinking excessively began..

It definitely is better than continuing drinking without first taking the pill and also, for most people, better than trying to abstain completely which only increases the craving via the deprivation effect.

Best of luck with it,

Flat9

Awesome reply, Flat9. I hope many people read your post.

Although reading the book isn't essential to this working, I do feel everyone should read it.  Knowledge is power and when you truly understand what is happening in your brain and what the medication is doing, everything seems to fall into place much better.

Tina, if you wish to read this book, please PM me your email address and I will send you a PDF copy of it by return.  (Dr Eskapa is always happy for as many people to have access to the book as possible, especially those in need of help, so he has given me permission to do this).

Joanna

C3 Europe.

yes, the more insight and encouragement the better. It appears to help to understand something of what happens in the brain's wiring even though the drug obviously works whether you read it or not!

It also does seems to help convince that it's worth sticking with the medication, since a person may otherwise have doubts and possibly pack it in as a result. Encouraging to see how many thousands of people (and AA rats!) it has helped in various countries and hopefully as word spreads, countless more others will benefit and the GP's become better informed of it's use. One pill (day) at a time! 😃

It is also important to note that a pill will remain active for 8-11 hours (it varies between these times for different people) Drinking after the pill becomes inactive is the same as drinking too early, drinks will slip through while you are unprotected.

It may well be that you ARE one of those whose body takes longer to get the message, but I thought I would post this information as some adjustments may help it happen faster for you.

Good luck!

But, since you mention it as being important, i'll try make sure it's at least 90 minutes before imbibing, if at all possible! Maybe i'd be better off with the naltrexone, or naloxone (also mentioned in the book)? Although, with the naltrexone, it seems that you have to take it three times a day and larger quantities/grams? Presumably the naloxone is similar to it or a slight variation?

Also, at the other end of using it, if one takes a selincro/nalmefene at 2pm (like i did today, it's Friday!), if my last drink tonight is at 1am, should i take another pill a couple of hours before that or would there be enough of it left in my system to reasonably protect the receptors?

It's a pity there isn't some kind of nalmefene-alyser to help guage how much of it is active in your system so as to be fully sure that no reinforcement is taking place!

I'm also conscious of the fact that my doctor seems to be just giving me a 28 pill prescription rather than the repeat (3 month) that he gives me for antihystamine, so i'm at times reluctant to take a second one, so as to make them last. I know you can't advise against more than the one per day manufacturers advise, but we know that extra amounts appear to have been safetly taken in trials, so will use own judgement on that score!

Thanks again for your much appreciated help Paul,

Best regards,

Flat9

The recommended daily dose for Nalmefene is one 18mg tablet per day. As you say, I cannot advise you to take a second if you drink again the same day after that first pill has worn off. However, it IS true, as you also say, that, during clinical trials, many times the daily dose was given to people with no ill-effects You DO need to ensure that you don't drink after the drug has reduced to below the therapeutic level in your body.

GPs will not prescribe more than 28 days, particularly when you first start on Nalmefene as 28 pills is over £100 so, if he gave you, say, 3 months, and you used only a week's worth, hundreds of pounds of NHS money would be sitting in your cupboard unused. Also, the GP (like us) needs to ensure that the medication is having a positive effect in order to justify ongoing treatment for clinical reasons as well as financial ones.

One of the main benefits of Nalmefene over Naltrexone is that it is more gentle on the liver. With Nalmefene, you do not have to have repeated Liver Function Tests (LFT - Blood test), you do with Naltrexone. WE arrange one LFT before treatment with Nalmefene starts because we can't justify telling a person to carry on drinking at all without knowing the condition of their liver.

Naloxone has a much shorter period of action as its half life is only between 60 and 90 minutes. Naltrexone's is 4 hours and Nalmefene's is almost 11 hours.

The gauge you are suggesting would be useful can be your own body and how quickly your drinking is reducing / how high your desire to drink is. The thing we have noticed is that people rarely need to worry about drinking again much later in the day if they ensure that they only drink when protected, because the desire reduces to a level where people simply don't bother to have more than a small amount of alcohol.

             I have battled alcohol addiction for over 30 years to the point it got me in so much trouble that i went to AA. I have not had a drink for over a year now but still crave it everyday. I am so over AA in every aspect but it did serve a purpose. I know if i pick up a drink that i will be off and running again so the fear stops me but i know its only a matter of time. I did try naltrexone before AA and it didn,t work but i'm not sure if i gave it a chance.

I desperately want to try Selincro and TSM. I have managed to get a hold of 28 Selincro tablets with access to more. My question to you is what would you suggest how and what to start the dosage and process of re-introducing alcohol and Selincro into my system again. As i said before its only a matter of time before i pick up a drink so i would like to be pre-armed. Cheers

The dosage is 18mg (1 tablet) per day on days that you drink. You need to take the pill two hours before you drink to allow it to be fully absorbed by the body and have its best effect.

I would recommend that you take it for the first time when you are staying at home as you may suffer side effects (nausea, sleeplessness and some people report some strange 'detachment' effects). These side effects will get less each time you take the pill and be gone after a few times of taking it so it is worth persisting.

Good luck

I took my 1st Selincro a week ago and OMG i got one with the lot in the way of side effects, I can't remember ever feeling that sick and wierd. I havn't been game to take another. My doctor is away at the moment and i have lots of questions.

You sound very knowledgable with this product so here goes. I have a enlarged prostate and take one Tamsulosin per day at night. When i took the Selincro at 10am i waited until 12.30 to drink. I was only a bit light headed then and had 3 glasses of wine over the next hour then stopped drinking which was good. After that i felt very wierd and restless and not well, That night when i took the Tamsulosin it felt like it got 10 times worse. Do you know if Tamsulosin reacts with Selincro. I know you can't give medical advise but you might have heard something before.

What i will say is that i definately didn't want to keep drinkng and because i felt sick for 3 days i still have not had a drink. I feel scared to try this medication again. Any advise, cheers Chris

People appear to be finding Naltrexone a lot easier to take than Nalmefene because the side effects are less potent for many. It may be worth having a chat to your GP about trying to change to Naltrexone.

If you did persist with Nalmefene, the side effects do get less and stop after a few days.

I took Selincro last night and hardly slept, and had heart rates that were slightly higher than usual. Blood pressure soared to 135/100 when. I normally 120/79. Is this normal? I only had a few beers and 2 glasses of wine but I ended up pulling to one side and vomiting too. Any ideas?

Side effects are very common in the beginning, as with beginning any new medication, and can take a little while to subside - the first time is usually the worst though.

In the meantime, have a good meal about an hour prior to taking the tablet as this helps reduce nausea, and drink lots of water throughout the 2 hours you need to wait before drinking, with the table and then during the rest of the time you are awake.  These two things will really help make any side effects much more manageable.

The short term discomfort is usually well worth the long term benefits that this medication gives.