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Vivitrol

Generic name: naltrexone
Dosage form: extended-release intramuscular injection (powder for suspension)
Drug class: Drugs used in alcohol dependence

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 4, 2023.

What is Vivitrol?

Vivitrol is a long-acting injectable form of naltrexone, which is a medication used to treat two substance use disorders - opioid use disorder and alcohol use disorder (alcoholism). Vivitrol is used as part of a treatment program. It helps prevent people with alcohol or opioid dependence from feeling like they need to use these substances.

Vivitrol is an opioid antagonist, which works by blocking mu opioid receptors. It also suppresses the amount of alcohol you feel like drinking by changing how your hypothalamus, pituitary gland and adrenal gland work together. Vivitrol blocks the intoxication and euphoria or 'high' that alcohol and opioids cause. It also blocks the pain relief that opioids provide.

Vivitrol is an extended-release suspension that is injected into your gluteal muscle. Once injected, it slowly releases naltrexone (the active ingredient) for about a month.

Vivitrol was first approved by the US Food and Drug Administration in 2006.

What is Vivitrol used for?

Vivitrol is a prescription injectable medicine used to:

To be effective, treatment with Vivitrol must be used with other alcohol or drug recovery programs such as counseling. This treatment may not work for everyone.

It is not known if Vivitrol is safe and effective in children.

Important information

Vivitrol can cause serious side effects, including:

1. Risk of opioid overdose.

You can accidentally overdose in two ways.

2. Severe reactions at the site of the injection (injection site reactions). Some people on Vivitrol have had severe injection site reactions, including tissue death (necrosis). Some of these injection site reactions have required surgery. This medication must be injected by a healthcare provider. Call your healthcare provider right away if you notice any of the following at any of your injection sites:

3. Sudden opioid withdrawal.

Anyone who receives a Vivitrol injection must not use any type of opioid (must be opioid-free) including street drugs, prescription pain medicines, cough, cold, or diarrhea medicines that contain opioids, or opioid dependence treatments, buprenorphine or methadone, for at least 7 to 14 days before starting treatment with this medication. Using opioids in the 7 to 14 days before you start receiving Vivitrol may cause you to suddenly have symptoms of opioid withdrawal when you get your injection. Sudden opioid withdrawal can be severe, and you may need to go to the hospital.

You must be opioid-free before receiving Vivitrol unless your healthcare provider decides that you don't need to go through detox first. Instead, your doctor may decide to give your injection in a medical facility that can treat you for sudden opioid withdrawal.

4. Liver damage or hepatitis. Naltrexone, the active ingredient in Vivitrol, can cause liver damage or hepatitis.

Tell your healthcare provider if you have any of the following symptoms of liver problems during treatment with Vivitrol:

Who should not receive Vivitrol?

Do not receive Vivitrol if you:

What should I tell my doctor before receiving Vivitrol?

Before you receive Vivitrol, tell your healthcare provider if you:

How should I receive Vivitrol?

Whenever you need medical treatment, be sure to tell the treating healthcare provider that you are receiving Vivitrol injections and mention when you got your last dose. This is important because this medication can also block the effects of opioid-containing medicines that might be prescribed for you for pain, cough or colds, or diarrhea.

Carry written information with you at all times to alert healthcare providers that you are taking this medication, so that they can treat you properly in an emergency. Ask your healthcare provider how you can get a wallet card to carry with you.

What happens if I miss a dose?

If you miss your appointment for your Vivitrol injection, schedule another appointment as soon as possible. See 'Important information' above.

What should I avoid while receiving Vivitrol?

Do not drive a car, operate machinery, or do other dangerous activities until you know how Vivitrol affects you. It may make you feel dizzy and sleepy. See 'What are the possible side effects of Vivitrol?' below.

Dosing information

The recommended dose of Vivitrol is 380 mg delivered intramuscularly (IM) as a gluteal injection, every 4 weeks or once a month, alternating buttocks for each subsequent injection.

See Full Prescribing Information for further information about dosing.

What are the side effects of Vivitrol?

Serious side effects of Vivitrol include:

Common side effects of Vivitrol include:

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the side effects of Vivitrol. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Interactions

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Especially tell your healthcare provider if you take any opioid-containing medicines for pain, cough or colds, or diarrhea. See 'Important information' above.

If you are being treated for alcohol dependence but also use or are addicted to opioid-containing medicines or opioid street drugs, it is important that you tell your healthcare provider before starting Vivitrol to avoid having sudden opioid withdrawal symptoms when you start Vivitrol treatment.

Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Pregnancy and breastfeeding

Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known if Vivitrol will harm your unborn baby.

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. It is not known if naltrexone, the active ingredient in Vivitrol, passes into your milk when administered by IM injection, and if it can harm your baby. Naltrexone from tablets passes into breast milk. Talk to your healthcare provider about whether you will breastfeed or take Vivitrol. You should not do both.

Storage

Keep out of Reach of Children.

What are the ingredients in Vivitrol?

Active ingredient: naltrexone

Inactive ingredients: polylactide-co-glycolide (PLG)

Diluent ingredients: carboxymethylcellulose sodium, polysorbate 20, sodium chloride, sodium hydroxide and hydrochloric acid as pH adjusters, in water for injection.

Vivitrol is manufactured and marketed by Alkermes, Inc. 852 Winter Street Waltham, MA 02451-1420

Popular FAQ

Vivitrol (naltrexone), a medicine used for opioid or alcohol use disorder, has been reported as causing both weight gain and weight loss. In studies, it was reported to lead to a decreased appetite (anorexia) and other stomach side effects like nausea, vomiting, abdominal pain, or diarrhea, which could decrease your weight. Naltrexone is also approved to help with weight loss when used in combination with bupropion (brand name: Contrave).

Naltrexone blocks the feelings of intoxication (the “buzz”) from alcohol when you drink it. This allows people with alcohol use disorder to lessen their drinking behaviors enough to stay in treatment, avoid relapses, and take their medication. Over time, cravings for alcohol will decrease. However, naltrexone will not prevent you from becoming impaired while drinking alcohol. Do not use naltrexone so that you can drive or perform other activities under the influence of alcohol. Continue reading

Do NOT take opiates, including heroin or other prescription or illegal opiates while using naltrexone. Taking opiates with naltrexone increases your risk for an overdose, coma and death. Do not use naltrexone if you are dependent on opioids or if you are experiencing opioid withdrawal symptoms. Naltrexone should not be used before you complete a medically-supervised opioid withdrawal lasting at least 7 to 14 days. Continue reading

The manufacturer does not specify if you should take naltrexone tablets in the morning or at night. Take naltrexone exactly as your doctor orders it. Many patients take their medication in the morning to help affirm their continued treatment success for either opioid use disorder or alcohol use disorder. Taking naltrexone tablets after a meal (for example: breakfast) may help to lessen any stomach side effects such as nausea or pain. Continue reading

Oral naltrexone is well absorbed and will usually begin working within one hour after a dose. Intramuscular naltrexone is an extended-release formulation and has two peaks, first at 2 hours then again 2 to 3 days later, although its therapeutic effect lasts for one month Continue reading

Do not take Xanax (alprazolam) while on Vivitrol (naltrexone), unless it is prescribed by a healthcare professional who is aware of your treatment for addiction. Continue reading

Naltrexone is not classified as a controlled substance. It's a full opioid antagonist that blocks euphoric actions at the opioid receptor (meaning it can't lead to a "high" or addiction). It is used as one part of the treatment plan of patients with alcohol dependence or opioid use disorder, along with counseling. Continue reading

Vivitrol (naltrexone) starts to work on the first day it is injected, and its effects last for a month. The first peak of the drug in your blood occurs at about 2 hours after injection. Then the drug is slowly released over the remaining month. Continue reading

Vivitrol must be administered by a health care provider and is usually given every 4 weeks (once a month) as an intramuscular injection, into the muscle of your buttocks (butt). Alternating buttocks should be used for each subsequent injection. Continue reading

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.