Product description: Naltrexone 25mg Maintenance Dose — The Sinclair Method for Alcohol Use Disorder
The Naltrexone 25mg Maintenance Dose — The Sinclair Method for Alcohol Use Disorder is our ongoing supply option for established TSM patients. So this product provides 25mg maintenance capsules in three pack sizes to match your drinking frequency. Furthermore, choose from Small Repeat (30 capsules), Medium Repeat (60 capsules), or Large Repeat (100 capsules). In fact, all packs support both standard 25mg dosing and the 50mg step-up option (two capsules together). Vegetarian HPMC capsules suit vegetarian and vegan patients.
Who this product is for
This product is designed for established Sinclair Method patients. So it isn’t for new TSM patients starting treatment. Furthermore, it doesn’t include titration capsules. In fact, it assumes you’ve completed the initial 10-day build-up phase.
Additionally, three pack sizes match different drinking frequencies. So you choose the pack that matches your usage. Furthermore, this avoids paying for supply you don’t need.
Why three pack sizes
Established TSM patients have different drinking frequencies. So one pack size doesn’t fit everyone. Furthermore, matching pack size to usage patterns makes sense clinically and practically.
The frequency consideration
Some TSM patients drink several days per week. Others drink only occasionally. So supply duration varies enormously from patient to patient.
For example, a patient drinking 2 days per week uses 8 capsules per month. In contrast, a patient drinking 6 days per week uses 24 capsules per month. Furthermore, matching pack size to usage prevents both waste and frequent reordering.
The cost consideration
Larger packs offer better cost-per-capsule value. So frequent drinkers save money with larger packs. Furthermore, less frequent drinkers don’t overpay for supply they won’t use.
Additionally, three price points suit different budgets. In particular, patients can start small and step up if needed.
The convenience consideration
Reorder frequency matters for many patients. So larger packs mean fewer reorders. Furthermore, this reduces administrative burden for established patients.
However, some patients prefer smaller frequent orders. In fact, this suits changing usage patterns and lifestyle circumstances.
The three pack sizes
Small Repeat Pack — 30 x 25mg capsules
- 30 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Compounded to specialist quality standards
- Suits less frequent drinkers (4-6 days per month)
- Also suits 2 drinking days per week (approximately 15 weeks supply)
- Ideal for patients wanting smaller ongoing orders
- Lowest price point in the maintenance range
- Price: £119
Medium Repeat Pack — 60 x 25mg capsules
- 60 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Compounded to specialist quality standards
- Suits moderate drinkers (2-3 drinking days per week)
- Approximately 20 weeks supply at 3 drinking days per week
- Approximately 15 weeks supply at 4 drinking days per week
- Balanced pack size for many established patients
- Better cost-per-capsule than Small Repeat
- Price: £199
Large Repeat Pack — 100 x 25mg capsules
- 100 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Compounded to specialist quality standards
- Suits more frequent drinkers (4-7 drinking days per week)
- Approximately 25 weeks supply at 4 drinking days per week
- Approximately 14 weeks supply at 7 drinking days per week
- Best cost-per-capsule value in the range
- Reduces reorder frequency significantly
- Also supports 50mg dosing (approximately 7-12 weeks supply)
- Price: £319
The 50mg step-up option
All three packs support the 50mg step-up option. So this provides flexibility for dose adjustment if needed.
- Two 25mg capsules taken together equal 50mg dose
- Discuss with prescriber before stepping up
- Same one-hour-before-drinking timing applies
- Take both capsules together, not spread out
- Doubles capsule usage per drinking day
- Consider Medium or Large Repeat for 50mg dosing
Supply duration by pack size and drinking frequency
How long each pack lasts depends on your drinking pattern:
At 25mg dosing (one capsule per drinking day)
- Small Repeat (30 caps): 2 days/week = 15 weeks; 3 days/week = 10 weeks; 4 days/week = 7-8 weeks
- Medium Repeat (60 caps): 2 days/week = 30 weeks; 3 days/week = 20 weeks; 4 days/week = 15 weeks
- Large Repeat (100 caps): 3 days/week = 33 weeks; 5 days/week = 20 weeks; 7 days/week = 14 weeks
At 50mg dosing (two capsules per drinking day)
- Small Repeat (30 caps): 2 days/week = 7-8 weeks; 3 days/week = 5 weeks
- Medium Repeat (60 caps): 2 days/week = 15 weeks; 3 days/week = 10 weeks
- Large Repeat (100 caps): 3 days/week = 16 weeks; 5 days/week = 10 weeks; 7 days/week = 7 weeks
Which pack suits you best
Choose Small Repeat if
- You drink less frequently (4-6 days per month)
- You want the lowest price point
- You prefer smaller ongoing orders
- Your drinking pattern varies month to month
- You want to try our maintenance product initially
Choose Medium Repeat if
- You drink 2-3 days per week
- You want balanced pack size and pricing
- You prefer moderate reorder frequency
- You want better cost-per-capsule than Small Repeat
- You’re on stable 25mg maintenance
Choose Large Repeat if
- You drink 4-7 days per week
- You want the best cost-per-capsule value
- You prefer fewer reorders
- You’re on 50mg step-up dosing
- You have very stable long-term treatment
- You want maximum supply between reorders
What all packs include
Full instructions
- Clear maintenance dosing guidance
- Sinclair Method protocol reminders
- 50mg step-up instructions if needed
- Missed dose guidance
- When to contact us for support
- Red flag symptoms to watch for
No subscription commitment
- One-off purchase pattern
- No automatic re-orders
- You control when to reorder
- Reflects our belief that treatment should fit your circumstances
Free delivery
- Discreet plain packaging
- Suitable for home or workplace delivery
- No mention of contents on packaging
Vegetarian and vegan suitable
- Vegetarian HPMC capsule shells
- No animal-derived components
- Free from gelatin
- Free from common allergens
- Halal and kosher suitable
Who benefits most from this product
This product particularly suits established TSM patients:
- Patients who have completed initial titration phase
- Patients on stable 25mg maintenance dosing
- Patients wanting pack size matched to their usage
- Patients on long-term TSM maintenance
- Patients wanting simple reorder patterns
- Patients preferring value over convenience or vice versa
- Patients familiar with Sinclair Method protocol
Who this product isn’t for
Some patients need different products:
- New TSM patients (Starter Pack or Extended Starter Pack better)
- Patients still needing titration capsules
- Patients who haven’t completed 10-day build-up phase
- Patients wanting initial assessment period
- Patients unfamiliar with Sinclair Method protocol
Where this product fits in TSM management
A staged approach to Sinclair Method treatment:
- Stage 1: Initial assessment and consultation
- Stage 2: Starter Pack or Extended Starter Pack for new patients
- Stage 3: Titration phase completion (10 days at 4.5mg)
- Stage 4: Maintenance phase begins (25mg one hour before drinking)
- Stage 5: Response assessment at 8-12 weeks
- Stage 6: Naltrexone 25mg Maintenance Dose (this product) for ongoing supply
- Stage 7: Pack size choice based on drinking frequency
- Stage 8: Ongoing prescriber review and long-term treatment optimisation
So this product sits at Stage 6 for established maintenance patients. In short, it’s the ongoing supply option with pack size flexibility.
What this product is and isn’t
What it isn’t
First of all, it isn’t a starter product. So new TSM patients need packs with titration capsules.
Also, it isn’t right for anyone currently or recently using opioid medications. Furthermore, the interaction risks precipitated withdrawal which can be dangerous.
Additionally, it isn’t a quick fix for alcohol concerns. In fact, TSM works through gradual medication-based extinction over months.
What it doesn’t replace
It doesn’t replace proper prescriber engagement. So even established patients need ongoing clinical review.
Additionally, it doesn’t replace support where you need it. Furthermore, therapy, counselling, or specialist services often work alongside medication.
Why assessment still matters
Above all, even established patients need periodic assessment. So we review your progress, side effects, and treatment approach. Furthermore, this ensures ongoing supply remains clinically appropriate.
Courier Pharmacy supply pathway
Step 1: Online assessment
Complete the alcohol treatment consultation on courierpharmacy.co.uk. This covers:
- Confirmation you’ve completed titration
- Current response to TSM
- Any side effects experienced
- Any health changes since starting
- Current medications review
- Mental health status check
- Your drinking frequency (helps pack size selection)
- Whether 50mg step-up is being considered
Step 2: Prescriber review
Your consultation goes to our UK-qualified prescriber. They assess:
- Whether continued treatment is clinically appropriate
- Whether 25mg dosing remains suitable
- Whether 50mg step-up should be considered
- Which pack size matches your usage
- Whether any red flags need addressing
- Whether ongoing support is appropriate
Step 3: Discreet delivery
Your order arrives in plain packaging with clear supporting materials:
- Full written dosing instructions
- Sinclair Method protocol reminders
- Side effect monitoring guidance
- When to contact us for support
- Red flag symptoms to watch for
- Free prescriber support throughout treatment
Key features and specs
- Active ingredient: naltrexone hydrochloride 25mg per capsule
- Class: opioid receptor antagonist
- Form: oral capsules (compounded to specialist quality standards)
- Capsule composition: vegetarian HPMC capsules, suitable for vegetarian and vegan patients
- Route: oral, taken one hour before drinking (Sinclair Method)
- Pack sizes: Small Repeat (30 caps £119), Medium Repeat (60 caps £199), Large Repeat (100 caps £319)
- Maintenance dose: 25mg taken one hour before drinking
- Step-up option: two 25mg capsules = 50mg equivalent if needed
- Clinical use: ongoing alcohol use disorder treatment via The Sinclair Method
- Legal status: prescription-only medicine (POM)
- Assessment: full online consultation required before supply
- Storage: below 25°C in original packaging, protect from light and moisture
- Delivery: free discreet plain packaging
- Not for: new patients needing titration, severe physical alcohol dependence, opioid use, active or chronic liver disease, active mental health crisis, pregnancy, breastfeeding, under 18
Why choose Courier Pharmacy for TSM maintenance
At Courier Pharmacy, our approach starts with a simple idea. So treatment should fit the person, not force the person to fit the system.
Dr Ada Jex-Cori
Our service is shaped by the philosophy of Dr Ada Jex-Cori, our brand pharmacist.
Dr Ada represents the spirit of the pharmacy. So she is evidence-led, community-rooted, and willing to challenge one-size-fits-all medicine. Furthermore, she is named in honour of three pioneering women in science.
In our fictional world of Ethrewell, Dr Ada fights against standardised approaches. In the real world, she represents what we stand for. Above all, her view is straightforward. You are not broken. The system is.
Alcohol treatment deserves proper clinical framing
This is a sensitive clinical area. Courier Pharmacy is different. So we recognise that:
- Alcohol use disorder affects self-image and mental wellbeing
- Many patients delay seeking help due to stigma
- Traditional pathways don’t suit everyone
- Evidence-based treatment matters more than moralising
- Realistic expectations improve outcomes
- Different pack sizes suit different circumstances
- Ongoing patient relationships matter for TSM success
Honest framing about maintenance treatment
What long-term TSM realistically involves:
- Long-term commitment for lasting change
- Consistent pre-drinking dosing essential
- Response varies between individuals
- Some patients continue for years
- Others tapper off after extinction is complete
- Individual assessment guides duration
Honest framing about limits
What we don’t offer:
- We don’t offer this to new TSM patients (need Starter Pack first)
- We don’t offer this to opioid users
- We don’t offer this to patients with active liver disease
- We don’t offer without ongoing assessment
- We don’t offer detox for severe physical dependence
- We don’t replace comprehensive addiction services
Prescriber support throughout treatment
Our team is here to discuss:
- Whether continued maintenance is appropriate
- Whether pack size should change
- Whether 50mg step-up should be considered
- Managing any side effects
- Tracking progress meaningfully
- Long-term treatment planning
- When and how to consider tapering
Trust earned, not claimed
We are GPhC-regulated. So our content is grounded in evidence. In particular, TSM has strong research support for alcohol use disorder. Furthermore, we reference NICE guidance on alcohol dependence and the licensed naltrexone Summary of Product Characteristics.
If continued TSM maintenance isn’t right for your situation, we’ll tell you honestly.
More than a prescription: our community
Healthcare shouldn’t only happen when you’re paying for it.
Every fortnight we run free drop-in talks and clinics at Insomnia, Derby, from 10am to 12pm. So we show up, even when it’s free.
Bring a question, bring a friend, bring a stack of bewildering letters from another clinic. We’ll sit with you.
We cover weight management, GLP-1 therapy, MCAS, menopause, women’s health, men’s health, chronic pain, digestive health, allergies, asthma, sleep, migraine, skincare, acne, alcohol use disorder support, and whatever else people bring through the door. No appointment. No cost. No pressure. Just real support and treatment that fits.
How naltrexone works
Understanding the pharmacology helps explain both what to expect and why the timing matters.
Naltrexone as an opioid antagonist
The core mechanism:
- Naltrexone is an opioid receptor antagonist
- It blocks opioid receptors in the brain
- Alcohol triggers opioid release which normally causes pleasure
- With naltrexone present, alcohol's rewarding effect is blocked
- Over time, this weakens the brain's reward association with drinking
The extinction process
How TSM produces long-term change:
- Each drinking occasion with naltrexone weakens the reward pathway
- This process is called pharmacological extinction
- Similar to how phobias respond to gradual exposure therapy
- Works over weeks and months, not days
- Requires consistent pre-drinking dosing to succeed
- Missing doses undermines the extinction process
Why timing matters
The one-hour rule:
- Naltrexone reaches peak blood levels approximately one hour after dosing
- Peak concentration provides optimal opioid receptor blockade
- So dosing one hour before drinking gives best protection
- Drinking before the one-hour mark reduces effectiveness
- Coverage lasts several hours after peak
The three pack sizes
Small Repeat Pack — 30 x 25mg capsules
- 30 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Suits less frequent drinkers (4-6 days per month)
- Also suits 2 drinking days per week (approximately 15 weeks supply)
- Ideal for patients wanting smaller ongoing orders
- Lowest price point in the maintenance range
- Price: £119
Medium Repeat Pack — 60 x 25mg capsules
- 60 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Suits moderate drinkers (2-3 drinking days per week)
- Approximately 20 weeks supply at 3 drinking days per week
- Balanced pack size for many established patients
- Better cost-per-capsule than Small Repeat
- Price: £199
Large Repeat Pack — 100 x 25mg capsules
- 100 x 25mg naltrexone capsules
- Standard TSM maintenance dose
- Suits more frequent drinkers (4-7 drinking days per week)
- Approximately 25 weeks supply at 4 drinking days per week
- Best cost-per-capsule value in the range
- Reduces reorder frequency significantly
- Also supports 50mg dosing (approximately 7-12 weeks supply)
- Price: £319
Realistic treatment expectations
Timeline for effects
What to genuinely expect on established maintenance:
- You should already have seen initial response from titration and early maintenance
- Continued gradual reduction in drinking desire
- Ongoing pharmacological extinction with each dose
- Sustained response requires consistent pre-drinking dosing
- Long-term treatment supports lasting change
Response variability
Honest about what to expect:
- Not all patients respond identically
- Some see dramatic reductions in drinking
- Others see gradual moderate reductions
- A minority need to step up to 50mg for adequate response
- Response depends partly on consistent dosing
- Missing pre-drinking doses reduces efficacy
What this product may help with
- Ongoing reduction in alcohol consumption
- Reduced desire to drink over time
- Improved control over drinking occasions
- Sustainable long-term treatment approach
- Better outcomes than untreated harmful drinking
What this product doesn't claim to do
Honest framing matters:
- It doesn't cure alcohol use disorder overnight
- It doesn't work equally for all patients
- It doesn't work without consistent dosing
- It doesn't replace addressing underlying causes
- It doesn't address non-alcohol addictions
- It doesn't work for severe physical dependence
- It doesn't provide immediate results
Where this product fits in TSM management
A staged approach to Sinclair Method treatment:
- Stage 1: Initial assessment and consultation
- Stage 2: Starter Pack or Extended Starter Pack for new patients
- Stage 3: Titration phase completion (10 days at 4.5mg)
- Stage 4: Maintenance phase begins (25mg one hour before drinking)
- Stage 5: Response assessment at 8-12 weeks
- Stage 6: Naltrexone 25mg Maintenance Dose (this product) for ongoing supply
- Stage 7: Pack size choice based on drinking frequency
- Stage 8: Ongoing prescriber review and long-term optimisation
So this product sits at Stage 6 for established maintenance patients. In short, it's the ongoing supply option with pack size flexibility.
Which pack suits you best
Choose Small Repeat if
- You drink less frequently (4-6 days per month)
- You want the lowest price point
- You prefer smaller ongoing orders
- Your drinking pattern varies month to month
- You want to try our maintenance product initially
Choose Medium Repeat if
- You drink 2-3 days per week
- You want balanced pack size and pricing
- You prefer moderate reorder frequency
- You want better cost-per-capsule than Small Repeat
- You're on stable 25mg maintenance
Choose Large Repeat if
- You drink 4-7 days per week
- You want the best cost-per-capsule value
- You prefer fewer reorders
- You're on 50mg step-up dosing
- You have very stable long-term treatment
Supply duration by pack size
How long each pack lasts depends on your drinking pattern:
At 25mg dosing (one capsule per drinking day)
- Small Repeat (30 caps): 2 days/week = ~15 weeks; 3 days/week = ~10 weeks
- Medium Repeat (60 caps): 2 days/week = ~30 weeks; 3 days/week = ~20 weeks; 4 days/week = ~15 weeks
- Large Repeat (100 caps): 3 days/week = ~33 weeks; 5 days/week = ~20 weeks; 7 days/week = ~14 weeks
At 50mg dosing (two capsules per drinking day)
- Small Repeat (30 caps): 2 days/week = ~7-8 weeks; 3 days/week = ~5 weeks
- Medium Repeat (60 caps): 2 days/week = ~15 weeks; 3 days/week = ~10 weeks
- Large Repeat (100 caps): 3 days/week = ~16 weeks; 5 days/week = ~10 weeks; 7 days/week = ~7 weeks
Frequently asked questions
Can I use this pack if I'm a new TSM patient?
No — this product is for established patients only:
- New patients need our Starter Pack or Extended Starter Pack
- Those packs include the titration capsules
- You need to complete the 10-day build-up phase first
- Then move to maintenance dose products
Which pack size should I choose?
Based on your drinking frequency:
- Less frequent drinkers (4-6 days/month): Small Repeat
- Moderate drinkers (2-3 days/week): Medium Repeat
- Frequent drinkers (4-7 days/week): Large Repeat
- On 50mg dosing: Medium or Large Repeat
- Discuss with our prescriber if unsure
When should I consider stepping up to 50mg?
Discuss with your prescriber if:
- Response feels limited after 8-12 weeks at 25mg
- Drinking pattern hasn't shifted meaningfully
- You want to trial the standard TSM dose
- Two 25mg capsules together provide 50mg
How long should I continue treatment?
Depends on your response and goals:
- Some patients continue for months
- Others continue for years
- Some taper off after extinction is complete
- Individual response guides duration
- Discuss with prescriber regularly
Can I stop taking naltrexone?
Yes, but consider:
- Discuss stopping with prescriber first
- Sudden stopping is generally safe
- Without naltrexone, extinction stops progressing
- Some patients experience return of drinking urges
- Others maintain change without medication
What if I need emergency surgery or dental work?
Important safety planning:
- Naltrexone blocks opioid pain medications
- Standard pain management may not work
- Inform any healthcare provider you're taking naltrexone
- Alternative pain strategies needed
- Carry a medical card noting current use
Are these capsules suitable for vegans?
Yes:
- Vegetarian HPMC capsule shells
- No animal-derived components
- No gelatin
- Suitable for vegetarian and vegan patients
- Also suitable for halal and kosher observance
Do I need to take a capsule every day?
No — only on drinking days:
- Sinclair Method protocol: only take before drinking
- Do NOT take on non-drinking days
- This differs from the titration phase (daily dosing)
- Consistent pre-drinking dosing makes TSM work
How do I order this product?
Complete the alcohol treatment consultation on courierpharmacy.co.uk. Our prescriber reviews your progress and confirms which pack size suits you. Furthermore, if different treatment would suit better, we'll suggest that.
Disclaimer: This page is for information only and isn't a substitute for personal medical advice. Naltrexone is a prescription-only medicine (POM). It's used for alcohol use disorder via The Sinclair Method under prescriber supervision. ABSOLUTELY CONTRAINDICATED in patients currently or recently (within past 7-10 days) using opioid medications — combining risks precipitated withdrawal which can be dangerous. Also contraindicated in active or chronic liver disease, severe physical alcohol dependence needing medically-supported detox, acute alcohol withdrawal, active mental health crisis, pregnancy, breastfeeding, and under 18. Report any signs of liver problems immediately (jaundice, dark urine, abdominal pain). Report any mood changes promptly. Any suicidal thoughts should trigger immediate contact with GP, NHS 111, Samaritans (116 123), or emergency services (999). Signs of severe allergic reaction require immediate medical attention (999). Naltrexone blocks opioid pain relief — inform any healthcare provider of current use before any procedure or emergency care. Carry a medical card noting current naltrexone treatment. This is our maintenance product for established patients only — new patients need our Starter Pack or Extended Starter Pack first.
How this content was created
Written by the Courier Pharmacy editorial team and reviewed by a GPhC-registered prescribing pharmacist.
The content is grounded in the licensed naltrexone Summary of Product Characteristics, NICE guidance on alcohol dependence (CG115), NICE CKS on alcohol problem drinking, published research on The Sinclair Method, and the real experience of patients approaching alcohol reduction through medication-based pathways at Courier Pharmacy.
Author: The Courier Pharmacy Clinical Editorial Team
Reviewed by: GPhC-registered Independent Prescriber and Superintendent Pharmacist, Courier Pharmacy
Date of last review: 14 June 2026.
References
- National Health Service (2024) Alcohol misuse. Available at: https://www.nhs.uk/conditions/alcohol-misuse/ (Accessed: 27 July 2026).
- National Institute for Health and Care Excellence (2011, updated) Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115). Available at: https://www.nice.org.uk/guidance/cg115 (Accessed: 27 July 2026).
- World Health Organization (2001) AUDIT: The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care. Available at: https://www.who.int/publications/i/item/audit-the-alcohol-use-disorders-identification-test-guidelines-for-use-in-primary-care (Accessed: 27 July 2026).
- Bush, K. et al. (1998) ‘The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking’, Archives of Internal Medicine, 158(16), pp. 1789–1795. Available at: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/208954 (Accessed: 27 July 2026).
- Sinclair, J.D. (2001) ‘Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism’, Alcohol and Alcoholism, 36(1), pp. 2–10. Available at: https://pubmed.ncbi.nlm.nih.gov/11139409/ (Accessed: 27 July 2026).
- British National Formulary (no date) Naltrexone hydrochloride. Available at: https://bnf.nice.org.uk/ (Accessed: 27 July 2026).
- Courier Pharmacy (2026) The Sinclair Method: Blocking Endorphin-Driven Reward. Courier Pharmacy. Available at: https://courierpharmacy.co.uk/the-sinclair-method-blocking-endorphin-driven-reward/ (Accessed: 27 July 2026).
