Introduction

Nalmefene (trade name: Selincro) has been approved in Germany since February 2013 for the treatment of alcohol dependency in people who show no physical withdrawal symptoms and do not require immediate detoxification. This drug is an option for people who want to lower their alcohol intake but have not been successful on their own within two weeks. Daily alcohol intake must be more than 60 g for men or 40 g for women, which is the equivalent of about three bottles of beer for men and two bottles for women.

Nalmefene is particularly suitable for men and women who want to stop drinking alcohol completely but are on a waiting list to start therapy.

Nalmefene influences the production of neurotransmitters in the brain, lowering the craving for alcohol.

Application

Patients take one tablet of nalmefene on days when they feel the urge to drink alcohol. The daily dosage is 18 milligrams. People with an alcohol dependency are often aware of what time of day their urge for alcohol will start. The drug should be taken one or two hours beforehand.

The treatment is combined with psychosocial support such as counseling, behavioral therapy or psychotherapy.

Other treatments

If using medication to reduce alcohol intake is an option, the drug naltrexone has been standard therapy. Use of naltrexone should also be complemented by counseling, behavioral therapy or psychotherapy.

Assessment

In late 2014 the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) assessed the advantages and disadvantages of nalmefene and psychosocial support compared with previous standard therapies for people with alcohol dependency.

However, the manufacturer did not provide any data suitable for answering this question,  so it is not possible to judge whether nalmefene has any advantages or disadvantages.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the "early benefit assessment of medications." On the basis of this review and the hearings received, G-BA passed a resolution on the added benefit of nalmefene (Selincro).