If I take 50 mg at lunch and have a glass of wine, will that same 50 mg pill last me through dinner if I have another glass of wine? I was taking half a pill and it worked at first but now I find I have to take the whole pill. Also when I first take the pill it makes me very drowsy. Is this normal? I normally can drink at least two bottles of wine a day. TSM is helping me stick to less than one. I have not been doing it very long but it seems like it will be a miracle for me!
Also if I take a second 50 mg pill before dinner will that be too much Naltrexone for one day?
Thank you

Hey CG, I'd say if you can tolerate the 50 mgs at lunch and then again before drinking at night then it should be ok, but then again I'm not sure if the book addresses this and I'm no expert. I think the 50 mgs is still working after a couple of hours, but I have seen posts that suggest the doubling up of Nal. I hope you find what works for you. Let us know how it goes. Keek

Naltrexone dose drops to half after 4 hours, so if you take a dose before lunch, then drink again outside that 4 hours window I'd top up with another 25 or 50mg. Yes drowsiness is a side effect, but also a side effect normal people experience after drinking alcohol.

Thank you so much- this is a big help!!!
CG

UK, I'm a bit confused about the dosing and topping off as well and curious what the source is for Nal dropping to half life after four hours?

I would have to go back and reread all the boring parts of the book about the studies, but I thought on 50mg once a day was good for the whole day/night, and that its half life was the following day. In fact when the book addresses adding back endorphin- producing activities, it recommends having a full AF/Nal free day before.

I've seen so many different recommendations on this - and we all depend so much on each other's experiences to shape our own treatment plan.

There have been days when I take my 50mg pill in the morning, and then drink from noon to 10pm, my usual 2 bottles...if it will help my progress, and seems to be the majority opinion that topping off is the way to go, perhaps I should give it a try.

This is from Chapter 17, "For Medical Professionals" - I'm just puting it here for reference. If those who have been successful with TSM feel that adding a dose later in the day is necessary, then I want to explore that. I do try to delay taking my pill in order to delay the start of my drinking...but there have been days in these first 3 weeks that the drinking started in the morning. Only one of those this week, thank goodness.

“Naltrexone should be taken only on days when alcohol drinking occurs or at least is expected to occur. The naltrexone pill should be taken approximately an hour before the first drink of the day. It can be taken in the morning (there still will be a blockade of opioid receptors that evening) but at that time patients may not have an accurate perception of whether they are likely to be drinking that day or not. It is, therefore, generally recommended to postpone taking naltrexone until an hour before the first expected drink.”

Excerpt From: Eskapa, Roy. “The Cure for Alcoholism.” BebBella. iBooks.
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Check out this book on the iBookstore: https://itunes.apple.com/us/book/the-cu ... 4585?mt=11

writer, thanks for looking that up. I've been on and off this board since October 2009. Too often dosage questions come up and answers are given that are incorrect. It's so important, I think, to stick to the original dosage recommendation of .50 per 24 hour period.

If a man, for example, were 6'5" and weighed 350 pounds and drank 2 bottles of scotch per 24 hour period there might be a need for another .50 but other than that I think Dr. Sinclair set his dosage for the "average" drinker.

I think most women would certainly be covered. Many of us have a hard time getting naltrexone and it's a shame to 'waste' a pill unnecessarily in my opinion.

I wonder if we feel the bodily effects of the alcohol after hours of drinking (but perhaps not the brain buzz) and so think we need another .50 dose later in the day? I don't know. I wish there was a downloadable copy of the book here!!
Babs

Thanks CG for asking the question and to all those who have answered. This is a question that I wanted answered for myself too.

I've been doing TSM for 4 weeks now and have made it up to the full dose of 50mg. I drink at lunchtime and in the evening and have been taking 50mgs twice a day 1 hour before each session.I had also read through previous posts but as there was some conflicting advice I decided to err on the side of caution. Whilst I don't think it's doing me any harm ( and my units are definitely coming down) I don't want to take more than I have to.

Babs makes such a good point about 'wasting' a pill unnecessarily. I've tried to reorder mine online this morning and Goldpharma are currently out of stock of Revia (the brand I've been using) and won't have more until 'sometime in August'. I don't want to switch brands or supplier but am now worried about running out and will have to be quite careful about making the ones I've got last. This may be part of the solution for me.

Thanks,

Ruth.

https://en.wikipedia.org/wiki/Naltrexone

and other sources all say half-life of naltrexone = 4 hours. This means if you start off with 50mg in your body, 4 hours later you'll have 25mg, 4 hours later(8h total) it's 12.5mg.

Well that's how I understand it and why it's recommended to top up.

I'm not a Dr, used to be a scientist and half-life I learned via radioactive decays, so could be completely off the ball here!

Sometimes I'd take half a pill, 25mg 4 hours into a drinking session. Don't know if it worked or not, TSM just worked for me full stop.