nalmefene for reducing alcohol consumption in people with alcohol dependence

Last reviewed 10/2020

  • Nalmefene is an opioid system modulator with antagonist activity at the mu and delta receptors and partial agonist activity at the kappa receptor
    • Nalmefene as-needed has been shown to reduce the total amount of alcohol consumption and number of heavy drinking days and to improve liver function and clinical status in two published 6-month studies in patients with alcohol dependence (1,2)

    • Nalmefene has a marketing authorisation in the UK for 'the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking risk level without physical withdrawal symptoms and who do not require immediate detoxification'
      • the summary of product characteristics states that a high drinking risk level is defined as alcohol consumption of more than 60 g (7.5 units) per day for men and more than 40 g (5 units) per day for women

NICE state (3):

  • Nalmefene is recommended within its marketing authorisation, as an option for reducing alcohol consumption, for people with alcohol dependence:
    • who have a high drinking risk level (defined as alcohol consumption of more than 60 g per day for men and more than 40 g per day for women, according to the World Health Organization's drinking risk levels) without physical withdrawal symptoms and
    • who do not require immediate detoxification
  • the marketing authorisation states that nalmefene should:
    • only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption and
    • be initiated only in patients who continue to have a high drinking risk level 2 weeks after initial assessment

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