Case reports demonstrate extended-release naltrexone effectively blocks fentanyl's lethal respiratory effects, suggesting potential treatment benefits.
Despite the contribution of the μ-agonist fentanyl to the United States’s opiate overdose epidemic, no human studies specifically address the ability of extended-release preparations of the opiate antagonist naltrexone (NTX) to block fentanyl’s life-threatening μ-agonist-mediated respiratory depression. This paper presents three case histories of clinically necessary opiate challenges in opiate-abusing patients implanted with extended-release NTX (ER-NTX). It also reviews the sparse literature and is the first evidence that antagonist blood levels from ER-NTX preparations can completely block the lethal μ-agonist effects of at least 1,000 mcg of intravenous fentanyl.
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Colin Brewer (2025) studied this question.
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