Vivitrol is an injectable form of the drug naltrexone, which is commonly used to treat opioid use disorder and alcohol use disorder. This long-acting formula is often used as part of a comprehensive treatment plan to prevent cravings and reduce the risk of relapse, but it’s not without risks and serious side effects.
Learn more about Vivitrol, its use in addiction treatment, and risks and side effects to be aware of it.
Key Points
- Vivitrol is a brand of injectable naltrexone used to treat opioid or alcohol dependence.
- Vivitrol works by binding to opioid receptors and preventing opioid drug use from causing euphoria or other desirable effects.
- There are common side effects and risks associated with Vivitrol, including injection site reactions.
- Using opioids while taking Vivitrol can significantly increase the risk of withdrawal and opioid overdose.
- Vivitrol can be effective in addiction treatment, but only when it’s combined with other interventions.
What is Vivitrol?
Vivitrol is the brand name for an injectable version of naltrexone, which is used to help with cravings from opioid or alcohol dependence. While naltrexone is available in different formulas, including an oral tablet, Vivitrol is an intramuscular injection once a month.
Like other forms of naltrexone, Vivitrol works by stopping the euphoria, sedation, and other effects that opioids and alcohol have on the central nervous system.[1] It binds to the opioid receptor sites and lasts for about four weeks.
Then, if you use opioids, they can’t bind to the opioid receptor sites and create euphoria. With alcohol, it suppresses the amount of alcohol you feel like drinking by changing how the hypothalamus, pituitary gland, and adrenal gland work together, blocking intoxication.
Vivitrol Side Effects
The common side effects of Vivitrol include diarrhea, upset stomach, restlessness, sleep disturbances, headache, and muscle or joint pain.[2] In some cases, Vivitrol can cause injection site reactions, such as hardness in the area, swelling, lumps, open wounds, blisters, dark scabs, and intense pain.[3]
There are more serious risks with Vivitrol, including eosinophilic pneumonia and liver toxicity, though rare.[4] The symptoms include stomach area pain, dark urine, yellowing of the whites of the eyes, and extreme tiredness.
Risks and Drug Interactions with Vivitrol
Vivitrol can be effective in treating opioid and alcohol dependence, but it’s inappropriate for everyone. It’s typically used 7 to 10 days after detoxing and maintaining abstinence. Otherwise, Vivitrol can cause withdrawal symptoms, some of which are severe and life-threatening.
If you’re using opioid drugs, prescription or illicit, and have a physical dependence or addiction, it’s important to wait to use Vivitrol to avoid withdrawal symptoms. Vivitrol is inappropriate if you’re currently experiencing opioid withdrawal symptoms like sweating, fever, goosebumps, shakiness, hot flashes, anxiety, muscle twitches, nausea, vomiting, or diarrhea.[5]
Tell your doctor if you are using or abusing opioid drugs or have bleeding problems, liver function, or kidney function. It’s best to disclose all other substances you’re taking, including any illicit drugs, to avoid adverse reactions.
Vivitrol Overdose Risks
While it’s unlikely to overdose on Vivitrol itself, Vivitrol can increase overdose risks in a few different ways. Because the drug blocks the effects of opioids, such as opioid pain medications, people can take high opioid doses to try to overcome the opioid-blocking effects.[6]
While the effects of Vivitrol last about a month, its potency decreases over time. If you relapse and use opioids at the doses you used before Vivitrol treatment, you can overdose because your body is no longer used to the drug.
The overdose symptoms include:[7]
- Trouble breathing
- Drowsiness
- Slowed breathing
- Faintness or dizziness
- Confusion
- Unresponsiveness
If you suspect someone is overdosing, call 911 or get emergency medical help as soon as possible. If you have naloxone, administer it while you wait for help to arrive.
Vivitrol in Alcohol and Opioid Addiction Treatment
Vivitrol for Alcohol Use Disorder
Vivitrol has been in use in addiction medicine for nearly a decade. It was approved by the FDA in 2006 to prevent relapse with alcohol use disorder because the drug can minimize alcohol cravings.[8] Unlike drugs like disulfiram, which discourages alcohol use by causing illness, Vivitrol is believed to block the endorphins from binding to their receptors, taking away the feel-good effects of alcohol use.
Vivitrol has been effective in helping alcohol addiction recovery when combined with other methods. According to one study, people in recovery using Vivitrol combined with counseling experienced a 25% reduction in their heavy drinking after treatment.[9] People in recovery with Vivitrol also experienced lower rates of relapse and longer abstinence periods.
Vivitrol for Opioid Use Disorder
In 2010, Vivitrol was approved by the FDA for treating opioid use disorders, or opioid addictions, after the drug showed improved treatment retention and a reduced risk of relapse during recovery.
Drugs like Vivitrol prevent the endorphin release from opioid use by binding to the opioid receptors in the brain. People who use Vivitrol with counseling to treat opioid addiction experienced 90% opioid-free weeks compared to 35% in the control group.[10]
Vivitrol can only be used after a detox program for opioids, however. Withdrawal symptoms may occur if you have any opioids left in your body. It can’t be used during detox, either, as it can stop drugs like buprenorphine from helping during medically assisted detox. This can lead to worsening withdrawal symptoms.
Vivitrol as Part of Addiction Treatment
While Vivitrol can help with crucial aspects of addiction recovery, like cravings and relapse risk, it’s not a single solution that can cure addiction on its own. Vivitrol must be used in conjunction with a comprehensive and integrated treatment plan on an inpatient or outpatient basis.
Addiction treatment is personalized to your unique needs and goals. However, it often includes a combination of different traditional and evidence-based treatment options like psychotherapy, group therapy, and behavioral therapies that address unhealthy behaviors, build social support, and uncover the causes of addiction.
Get Help for Opioid or Alcohol Addiction
Vivitrol is a helpful tool in treating opioid use disorder and alcohol addiction to relieve cravings and prevent relapse. However, Vivitrol is not a magic cure for addiction and carries some risks and side effects of its own. If you or a loved one is struggling with alcohol or opioid addiction, it’s important to undergo comprehensive addiction treatment to address the underlying causes of addiction.