Nalmefene - Selincro

Cutting down for adults who regularly drink more than about 7.5 units a day (men) or 5 units a day (women).

Designed for people who want to drink less rather than stop completely. Not suitable if you get shakes, sweats or feel unwell when you go without a drink; that needs a different kind of medical care first.

NICE Technology Appraisal TA325 recommends nalmefene for cutting down drinking, alongside ongoing support.

Nalmefene is an opioid system modulator acting as an antagonist at mu- and delta-opioid receptors and a partial agonist at kappa-opioid receptors. This triple action modulates the brain’s reward system, reducing the reinforcing effects of drinking.

Take one tablet 1-2 hours before you expect to drink. If you’ve already started drinking, take it as soon as possible. On days you don’t drink, you don’t take it. Maximum one tablet (18mg) per day. Swallow whole with water.

Adults who regularly drink at a high level and do not get shakes or sweats when they go without. People who want to drink less without necessarily stopping. Those who prefer flexible, as-needed medication.

Not suitable for: People taking any opioid medicine, including methadone or buprenorphine. People with severe hepatic or renal impairment. Anyone who has taken opioids in the last 7 to 10 days.

These medicines are prescription-only and are not dispensed on a form alone. A doctor reviews your assessment and a recent liver result before prescribing.

First prescription: complete the online assessment (£120). A doctor checks your drinking history, your medical history and your liver result, and contacts you if anything else is needed. Once approved, your medication is dispensed and delivered.

Repeat prescription: a shorter doctor-reviewed check, at no charge, confirms it is still working for you and that nothing has changed.

You choose which one applies when you start. If you have had this medication from us before, choose the repeat review. If not, start with the full assessment.

Why the assessment? This medicine interacts dangerously with opioid painkillers and needs liver monitoring, so a doctor reviews every request. That is what the assessment covers, and why a form alone is never enough.

Tracked: Tracked delivery, arrives tomorrow - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer the branded version, let us know in your order form and we will confirm any price difference.

Online assessment by a doctor: £120. After that you order here and a doctor reviews every order at no charge. This is separate from the medication price shown in the order panel, so you only pay for what you need.

Naltrexone: nausea, headache, dizziness, anxiety, insomnia, joint/muscle pain. Acamprosate: diarrhoea, nausea, abdominal pain. Nalmefene: nausea, dizziness, insomnia, headache.

Naltrexone/nalmefene: do not use if you are taking opioids, or have taken them in the last 7 to 10 days. Severe hepatic or renal impairment.

Naltrexone/nalmefene: blocks opioid analgesics - inform all healthcare providers. Alternative pain relief needed.

Limited data in pregnancy. Use only if benefit outweighs risk. Discuss with specialist. Buprenorphine may be continued in pregnancy under specialist supervision to prevent relapse.

Do not take if using opioid-based medications - it will completely block any effect of opioids. Caution with any history of seizures. Caution in mild-to-moderate hepatic or renal impairment. Common side effects: nausea, dizziness, insomnia, headache - usually mild and short-lived. Drug interactions: diclofenac and fluconazole may increase nalmefene levels; rifampicin and omeprazole may reduce effectiveness. Clinical data support use for 6-12 months.