I understand that Nalmefene effects our opiod receptors in the same way as Naltrexone, but is not processed through the liver. For those of us who have been heavy drinkers, it would seem wise not to add to the already overtaxed liver's workload. Where are we insofar as studying how effective Nalmefene is, when compared to Naltrexone? Can Nalmefene now be prescribed by general practitioners, or purchased offshore? Is it taken in the same manner as Naltrexone; ie: Nalmefene+Drinking=Cure?

If nalmefene is eventually approved for addictive drinking it will work exactly as naltrexone does. It is also a 'cheap' generic medication and is thought to be less stressful on the liver. Having said that, naltrexone is usually prescribed at 50 mg per 24 hour period for alcohol and is judged safe at up to 300 mg per 24 hour period. Nalmefene has a longer half-life and will stay in the system longer and it may even have a higher affinity for the opioid receptors than naltrexone - most studies have been done with naltrexone but nalmefene may eventually replace naltrexone as standard. From what I can see one is not more effective than the other. Newer opioid antagonists may be developed but essentially the ones we have have been shown to be effective. David Sinclair knows much more about this than I do but if anyone is interested I could dig out some research?

Dr. Eskapa, I cannot tell you how impressed I am by your dedication to this worthwhile cause - I know you haven't accomplished this much easily. Thank you.

I am definitely interested in more information. Anything that can do the job and bypass the liver would seem to be a better choice. I'm thinking of my adult daughter, who has been a very heavy drinker for nearly (gulp!) 20 years now. I saw her yesterday, and she is beginning to look jaundiced - I would hesitate to encourage her to try Naltrexone unless she went for a complete workup, which I know she would not consider. As you might imagine, I'm extremely concerned for her, and would do anything possible to help her get a handle on her drinking. She has a four year old son. . .

But do we yet have the choice between those drugs in the U.S.? Can/will physicians prescribe this newer drug for alcohol addiction? I see that River Pharmacy doesn't carry nalmefene.

G4M - no, nalmefene is not available anywhere yet. It is much closer to being approved in the E.U. than in the U.S. Dr. Sinclair said that one more large clinincal trial would need to be done before E.U. approval. Don't hold your breath on obtaining it from a U.S. source anytime soon.