Naltrexone is a generic tablet that costs a pharmacy about a dollar a pill, and depending on where you fill it, you will pay anywhere from about 76 cents to $1.84 for that same pill. The spread is not explained by anything about the medicine. It is explained by the counter.
That makes the useful question not “how much does naltrexone cost” in the abstract, but what this particular pharmacy charges to hand it to you, and what the visit that produces the prescription costs on top. This guide covers the standard-dose oral tablet, the 50 mg strength used for alcohol use disorder and opioid use disorder. If you are pricing the compounded 1.5 mg to 4.5 mg strengths used off-label for fibromyalgia and chronic pain, that is a completely different product with a completely different price, and it is covered in our low dose naltrexone cost guide. If you are pricing the monthly injection of the same molecule, see Vivitrol. All figures below were researched on September 3, 2026.
What Does Naltrexone Cost Without Insurance?
Prices below are cash prices, not insurance copays. Drugs.com figures come from its naltrexone, acamprosate and disulfiram price guides read September 3, 2026. The Cost Plus Drugs figure is the price its product page publishes for the 30-count fill, read the same day, with a flat $5 standard shipping charge listed separately in its own offer data. HealthWarehouse figures are its published quantity tiers. Acquisition costs are CMS National Average Drug Acquisition Cost rows effective August 19, 2026.
| Medication and fill | Low | Average | High |
|---|---|---|---|
| Naltrexone 50 mg, 30 tablets | $22.94 (Cost Plus Drugs) | $32.24 (Drugs.com) | $55.20 (HealthWarehouse) |
| Naltrexone 50 mg, 90 tablets | $88.22 (Drugs.com) | $116.11 (midpoint) | $144.00 (HealthWarehouse) |
| Naltrexone 50 mg, what the pharmacy pays for 30 | $34.18 (NADAC) | $34.18 (NADAC) | $34.18 (NADAC) |
| Acamprosate 333 mg delayed-release, 30 tablets | $20.17 (Drugs.com) | $20.17 (Drugs.com) | $20.17 (Drugs.com) |
| Acamprosate 333 mg delayed-release, 180 tablets | $99.76 (Drugs.com) | $99.76 (Drugs.com) | $99.76 (Drugs.com) |
| Disulfiram 250 mg, 30 tablets | $44.54 (Drugs.com) | $44.54 (Drugs.com) | $44.54 (Drugs.com) |
| Disulfiram 500 mg, 30 tablets | $109.23 (Drugs.com) | $109.23 (Drugs.com) | $109.23 (Drugs.com) |
| Prescribing office visit, average charge billed | $189.25 (CMS, 99213) | $233.00 (midpoint) | $276.45 (CMS, 99214) |
| Telehealth plan bundling visit and medication | $99/month (Oar Health) | $99/month | $99/month |
Several rows carry one published figure in all three columns because only one source lists that exact fill. Where a row does show a spread, the spread is the finding: the same 30 tablets of naltrexone 50 mg range from $22.94 to $55.20 depending on where you fill them.
NIAAA lists three medications approved in the United States for alcohol use disorder, naltrexone, acamprosate and disulfiram, and notes that all of them are nonaddictive. They are priced very differently, and the difference has nothing to do with how they work. Acamprosate looks cheapest at the 30-count but is taken several times a day, so the 180-count at $99.76 is the fill that matters for a month. Disulfiram at the 500 mg strength is the most expensive oral option on the list at $109.23 for 30.
One number in this cluster contradicts itself. NADAC prices the disulfiram 250 mg tablet at $1.81851 effective August 19, 2026, which is $54.56 for 30, while Drugs.com publishes a cash price of $44.54 for the same 30 tablets. The retail price is below the surveyed acquisition cost. The disulfiram 500 mg NADAC row is stranger still, sitting at $13.31433 per tablet and barely moving since December 2025, which would be $399.43 for 30 against a published retail price of $109.23. Treat the 500 mg acquisition row as unreliable and use the retail figure.
What Drives the Price
The dispensing margin, not the drug
At $1.13919 a tablet, the drug in a 30-tablet fill costs a pharmacy $34.18. Cost Plus Drugs sells that same fill for $22.94, below the national average acquisition cost, because it buys directly and publishes a fixed formula rather than a negotiated cash price. HealthWarehouse charges $55.20 for the same 30 tablets. Neither pharmacy is doing anything unusual. Cash prices on generics are set pharmacy by pharmacy, and the uninsured patient who does not compare funds the difference.
Quantity
Per-tablet cost falls with volume, because most of what you are paying is a fixed dispensing charge spread across the bottle. Drugs.com prices 20 tablets at $22.91 ($1.15 each), 30 at $32.24 ($1.07), 90 at $88.22 (98 cents) and 100 at $97.55 (98 cents). HealthWarehouse shows the same curve, from $3.06 for a single tablet down to $1.60 each at the 90-count. Whether you can use the larger quantity depends on how the prescription is written, so it is a question for the prescriber rather than something to fix at the counter.
The visit, which usually costs more than the pills
Naltrexone requires a prescription, and for most cash payers the appointment is the expensive half. In CMS data covering 2024 claims and released May 21, 2026, the average submitted charge nationally for an established-patient office visit at the 99213 level was $189.25, against a Medicare allowed amount of $85.37. At the 99214 level the average submitted charge was $276.45 against $119.71 allowed. That gap between what gets billed and what actually gets accepted is the space a cash payer negotiates in.
Where you get the prescription
There is no waiver, registration or special certification required to prescribe the oral tablet, which means the prescription can come from any licensed prescriber. That widens your options considerably compared with medications that can only be dispensed through federally regulated programs, and it is why telehealth pricing for this drug is competitive. Oar Health publishes a three-month membership at $297, which works out to $99 a month and includes the virtual consultation with a clinician plus the medication if it is prescribed.
Brand versus generic
There is effectively no brand market left. Every naltrexone 50 mg tablet on the US market is a generic, and Drugs.com shows no manufacturer coupons and no patient assistance programs for it, which is what you would expect for a drug this cheap. That is good news for price but it also means there is no manufacturer savings card to fall back on.
Cash Price vs. Insurance
Naltrexone is a textbook case where paying cash can beat running the prescription through a plan. A generic tier copay of $10 to $15 will beat the $22.94 Cost Plus price on the drug alone, but if you have a deductible you have not met, the plan will make you pay the full negotiated price, which can easily exceed every cash figure in the table above.
The tradeoff is real but small here. Money you pay in cash outside your insurance usually does not count toward your deductible or out-of-pocket maximum. On a $30 medication over a few months, that is not a decision worth agonizing over. Ask the pharmacist for both numbers and take the lower one.
The calculus changes on the visit side. A cash-pay appointment does not go toward your deductible either, and an office visit is a much larger number than the drug. If you are close to meeting a deductible for other reasons, running the visit through the plan may be worth more than the discount you would get paying cash.
Coverage for the medication itself is generally good. Unlike the compounded low-dose version, the 50 mg tablet is an FDA-approved generic that sits on standard formularies, so if you do have a plan, this is not usually the fight.
How to Pay Less
Price at least three pharmacies before you fill. The spread on this drug is 2.4x between the cheapest and most expensive published cash price we found for 30 tablets. That is real money on a medication people take for months. Compare a discount card against the plain cash price too, since cards routinely beat sticker prices on generics; our GoodRx vs. SingleCare comparison explains how the two work and when each one wins.
Ask whether a 90-day fill is an option. At Drugs.com prices, 90 tablets cost $88.22 versus $96.72 for three separate 30-tablet fills, and the per-tablet price drops from $1.07 to 98 cents. At HealthWarehouse the gap is wider, $144.00 for 90 against $165.60 for three months bought a month at a time. This only helps if the prescription is written that way.
Compare mail order against your corner pharmacy, but check the shipping. Cost Plus Drugs is the cheapest published price in our table at $22.94, and its own offer data lists a flat $5 standard shipping charge, which brings the delivered cost to $27.94. Because that fee is per order rather than per drug, mail order gets more attractive the more prescriptions you are filling at once.
Attack the visit, not the pills. Since the appointment usually costs several times the medication, that is where the savings are. Federally qualified health centers and sliding-scale clinics charge based on income, and NIAAA specifically advises asking programs whether they offer sliding-scale fees. Our guide to free clinics and sliding-scale care covers how to find one, and our fair price checker shows typical cash visit prices so you know when a quote is out of line.
Price the bundled telehealth option against doing it separately. At $99 a month, Oar Health’s plan is more than the drug costs on its own, but it includes the clinician visit. If you would otherwise pay $189 for an office visit plus $32 for the tablets, the bundle is cheaper in month one. If you already have a prescriber, it is not. Do the arithmetic for your own situation rather than assuming either way.
If a bill already arrived and looks wrong, push back on it. The pharmacy charge is rarely the problem, but the associated visit or facility charge can be, especially if the appointment happened in a hospital-owned clinic. Our guide to negotiating medical bills walks through requesting the self-pay rate and getting the adjustment in writing, and our negotiation script gives you the language.
The Bottom Line
A 30-day supply of naltrexone 50 mg costs $22.94 to $55.20 as a cash payer in September 2026, against an acquisition cost of $34.18 for the same 30 tablets. Nothing about that math rewards shopping hard on the medicine. It rewards not paying $55 when the same bottle is $23 down the road, and it rewards controlling the cost of the appointment that produces the prescription.
If you are pricing the whole treatment picture rather than one prescription, the other pages in this cluster cover the alternatives: the monthly Vivitrol injection, Suboxone and generic buprenorphine-naloxone, methadone through an opioid treatment program, and what a course of rehab actually costs when you pay for it yourself.