Reduction of alcohol consumption in patients with alcohol
dependence who have a high drinking risk level without
physical withdrawal symptoms, and who do not require
immediate detoxification
▶BY MOUTH
▶Adult: 18 mg daily if required, taken on each day there
is a risk of drinking alcohol, preferably taken 1–2 hours
before the anticipated time of drinking, if a dose has
not been taken before drinking alcohol, 1 dose should
be taken as soon as possible; maximum 18 mg per day
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Recent history of acute alcohol
withdrawal syndrome. recent or current opioid use
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Continued treatment for more than 1 year.
history of seizure disorders (including alcohol withdrawal
seizures). psychiatric illness
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Before initiating treatment,
prescribers should evaluate the patient’s clinical status,
alcohol dependence, and level of alcohol consumption.
Nalmefene should only be prescribed for patients who
continue to have a high drinking risk level two weeks after
the initial assessment.
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NICE decisions
▶Nalmefene for reducing alcohol consumption in people with
alcohol dependence (November 2014) NICE TA325
Nalmefene (Selincro ®) is recommended within its
marketing authorisation, as an option for reducing alcohol
consumption, for patients with alcohol dependence:
. who have a high drinking risk level (defined as alcohol
consumption of more than 60 g per day for men and
more than 40 g per day for women, according to the
World Health Organization’s drinking risk levels)
without physical withdrawal symptoms, and
. who do not require immediate detoxification.
The marketing authorisation states that nalmefene
should:
. only be prescribed in conjunction with continuous
psychosocial support focused on treatment adherence
and reducing alcohol consumption, and
. be initiated only in patients who continue to have a high
drinking risk level 2 weeks after initial assessment.
www.nice.org.uk/guiance/ta325
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