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ABSTRACT
Background: Pharmacotherapy, such as oral naltrexone, has proven effective in treating alcohol use disorder, although medication adherence has presented challenges. Although a formulation of extended-release naltrexone for intramuscular injection has been developed to counter daily adherence issues, injection-site reactions can occur within days of depot injection. Case: The authors report a case of an individual with alcohol use disorder who had a previously undescribed delayed injection-site reaction that occurred 11 days after injection. Subsequent challenge with the medication resulted in recurrence of the reaction. Discussion: Although extended-release naltrexone is generally well tolerated, injection-site reactions can complicate treatment and can appear more than 10 days after medication administration.
Funding
The study was supported by the US National Institutes of Health (UG1 DA015815 and R25 DA037756) and the Canadian Institutes of Health Research through the Canadian Research Initiative on Substance Misuse (SMN-139148). This research was undertaken, in part, thanks to funding for a Tier 1 Canada Research Chair in Inner City Medicine, which supports Dr. Evan Wood. The authors declare that they have no competing interests. Dr. Korthuis serves as principal investigator of 2 studies funded by the National Institute on Drug Abuse that receive XR-NTX study medication donated by Alkermes.
Author contributions
Keith Ahamad and Evan Wood prepared the first draft of the manuscript. All coauthors contributed to the drafting of the final manuscript.