Opioid receptor modulator
Nalmefene
Brand names: Selincro
Adult dose
Dose: 18mg PO 1–2h before anticipated drinking, on as-needed basis
Route: PO
Frequency: PRN
Clinical pearls
- Reduction of alcohol consumption in adults with high drinking-risk level (NICE TA325)
- Not a treatment for abstinence — used to reduce drinking on as-needed basis
Contraindications
- Concurrent opioid use (any)
- Acute opioid withdrawal
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Nausea
- Dizziness
- Insomnia
- Headache
Interactions
- Opioids (precipitates withdrawal — STOP nalmefene before opioid use)
Reference: BNF; NICE TA325; https://bnf.nice.org.uk/drugs/nalmefene/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Morphine Milligram Equivalents (MME) Calculator · Pain / Opioids
- Opioid Conversion / Equianalgesic Guide · Pain Management
- Numeric Rating Scale (NRS) Pain Assessment and Management · Pain Management
- Finnegan Neonatal Abstinence Scoring Tool (FNAST) · Neonatal Abstinence Syndrome
- Myasthenia Gravis Activities of Daily Living (MG-ADL) Scale · Neuromuscular
- Modified Finnegan Neonatal Abstinence Score (NAS) · Neonatal
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF