The standard naltrexone dose for alcohol use disorder is 50 mg once a day by mouth. If you would rather not take a daily pill, a 380 mg injection called Vivitrol is given once a month. Your provider picks the dose and form that fit your goals and health.
Daily dosing
One 50 mg pill every day, or a 380 mg shot once a month. The steady, everyday way to take it.
Every dayThe Sinclair Method
The same 50 mg pill, taken about an hour before you drink, on drinking days only.
Before drinkingWhat is the standard naltrexone dose for alcohol?
For alcohol use disorder, the usual dose is 50 mg once a day, taken as a single tablet. This is the dose used in the research that shows naltrexone reduces heavy drinking, and it fully blocks the alcohol reward for about a day, which is why it is taken once daily. You can take it in the morning or evening, with or without food, though taking it with food can help if you feel queasy at first. Taking it at the same time each day helps you remember and keeps the level steady.
Should you start at a lower dose?
Many providers start naltrexone at 25 mg, which is half a tablet, for the first three to four days. This lower starting dose helps your body adjust and can reduce early nausea, the most common side effect. After those first few days, you move up to the full 50 mg. Not everyone needs this step, but it is a common and gentle way to begin. In some cases, a provider may raise the dose to 100 mg a day, though 50 mg is standard for most people.
Naltrexone injection dose (Vivitrol)
If a daily pill is not for you, naltrexone also comes as a long-acting injection called Vivitrol. The dose is 380 mg given as a shot into a muscle, once every four weeks by a healthcare provider. One injection lasts the whole month, so there is no daily pill to remember. It is a good option for people who want steady coverage without thinking about it each day. The trade-off is that you need to visit a provider monthly for the shot.
The Sinclair Method dose
The Sinclair Method uses naltrexone in a targeted way to reduce drinking over time. Instead of a daily pill, you take one 50 mg tablet about one hour before you plan to drink, and only on days you drink. Taken this way, naltrexone blocks the reward of each drink, and the urge to drink slowly fades. The dose is the same 50 mg, just timed to your drinking rather than taken every day. Read more in our Sinclair Method guide.
What if you miss a dose?
If you take naltrexone daily and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and continue as usual. Missing a single day is not dangerous, but staying consistent gives you the best results. For the monthly injection, your provider will help you reschedule if you miss an appointment.
Naltrexone dosage at a glance
| Form | Dose | How often |
|---|---|---|
| Tablet (standard) | 50 mg | Once a day |
| Tablet (starting) | 25 mg | Once a day for the first few days |
| Tablet (higher) | Up to 100 mg | Once a day, in some cases |
| Tablet (Sinclair Method) | 50 mg | 1 hour before drinking, on drinking days |
| Injection (Vivitrol) | 380 mg | Once every 4 weeks |
A note on low-dose naltrexone: you may see doses of 1.5 mg to 4.5 mg called low-dose naltrexone, or LDN. That is a different, off-label use for conditions like chronic pain, not the dose for alcohol. For alcohol use disorder, 50 mg is the standard.
See also our naltrexone for alcohol guide, the naltrexone 50 mg tablet page, and naltrexone side effects.
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No spam. We will only email you about naltrexone for alcohol at Recovery Delivered.Frequently asked questions
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How long do you take naltrexone for alcohol?
Daniel R. Karlin, MD, MA
Board-certified psychiatrist and addiction medicine specialist. Author of 21+ peer-reviewed publications (1,355 citations) including recent work in JAMA (2025) and the British Journal of Psychiatry (2023).
- Sources.
- American Academy of Family Physicians. Alcohol Use Disorder: Medication Options. American Family Physician, 2024 (naltrexone 50 mg orally per day, may start at 25 mg or increase to 100 mg; 380 mg intramuscularly per month).
- U.S. Food and Drug Administration. Prescribing information for naltrexone (ReVia) and naltrexone extended-release injectable (Vivitrol).
- Singh D, Saadabadi A. Naltrexone. StatPearls. National Library of Medicine.
This page is for education only and is not medical advice. Never start, stop, or change your dose without talking to a licensed provider.
