Vivitrol (naltrexone) is a prescription drug used for alcohol use disorder and opioid use disorder. It can interact with other drugs, including medications that contain opioids. Examples include some drugs for pain relief, cough, and cold symptoms.
Vivitrol is used in adults to treat:
- alcohol use disorder (previously called alcohol dependence or alcoholism)
- opioid use disorder (previously called opioid addiction)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Vivitrol’s possible interactions. And for more information about Vivitrol, including details about its uses, see this article.
Certain health conditions or other factors could raise your risk of harm if you take Vivitrol. In such cases, your doctor may not prescribe Vivitrol for you. These are known as contraindications. The list below includes contraindications of Vivitrol.
If you’re currently taking an opioid medication. Receiving Vivitrol while you’re currently taking an opioid medication can cause opioid withdrawal. In rare cases, this can be severe and require treatment in a hospital.
For this reason, your doctor likely won’t prescribe Vivitrol if you’re currently taking an opioid medication. Usually, they’ll wait until it’s been at least 7–10 days since you last took an opioid before prescribing Vivitrol.
If you have a dependence on opioids. For people who have a dependence on opioids, receiving Vivitrol can cause opioid withdrawal. (With dependence, a person’s body needs a drug in order to feel and function as usual.) In rare cases, this can be severe and require treatment in a hospital.
Due to this risk, your doctor likely won’t prescribe Vivitrol if you currently have a dependence on opioids. Usually, they’ll wait until it’s been at least 7–10 days since you last took an opioid before prescribing Vivitrol.
If you are in acute opioid withdrawal. If you receive Vivitrol while experiencing opioid withdrawal, your condition could worsen. As a result, you may need treatment in a hospital. Due to this risk, your doctor will likely wait until your withdrawal symptoms go away before prescribing Vivitrol.
If you’ve had an allergic reaction. If you’ve had an allergic reaction to Vivitrol or any of its ingredients, your doctor likely won’t prescribe Vivitrol. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start using Vivitrol, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Vivitrol is safe for you to take.
People taking Vivitrol for alcohol use disorder should not drink alcohol during treatment. Doing so could cause Vivitrol to not work for treating this condition. Doctors usually won’t prescribe Vivitrol for alcohol use disorder to people who are still consuming alcohol.
In addition, both Vivitrol and alcohol can cause liver damage. Combining the two may increase your risk of this side effect.
If you drink alcohol and have questions about how to stop drinking before you begin treatment with Vivitrol, talk with your doctor.
Before you start Vivitrol treatment, tell your doctor or pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Vivitrol interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Vivitrol?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The chart below lists drugs that may interact with Vivitrol. Keep in mind that this chart does not include all drugs that may interact with Vivitrol. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug type or drug name | Drug examples | What can happen |
| opioids for pain relief | • methadone (Methadose) • hydrocodone (Hysingla ER) | can make opioids less effective than usual |
| opioid antagonists for constipation | • methylnaltrexone (Relistor) • naldemedine (Symproic) • naloxegol (Movantik) | can increase the risk of side effects from opioid antagonists and Vivitrol |
| cold and cough medications that contain an opioid | • codeine/ chlorpheniramine (Tuxarin ER) | can make opioids less effective than usual |
| cannabinoids taken by mouth | • dronabinol (Marinol, Syndros) • nabilone (Cesamet) | can increase the risk of side effects from cannabinoids taken by mouth |
| disulfiram | — | can increase the risk of side effects from Vivitrol and disulfiram |
| diphenoxylate/atropine (Lomotil) | — | can make diphenoxylate/atropine less effective |
Learn more about certain drug interactions that can occur with Vivitrol.
Interaction with opioids for pain relief or illegal opioids
Vivitrol interacts with medications that are part of a group of drugs called opioids.
Some opioids are prescribed for relieving moderate to severe pain. Other opioids, such as heroin, are illegal. Some medications prescribed for constipation or cold symptoms contain an opioid.
This section refers to opioids prescribed for pain relief as well as illegal opioids. To learn more about Vivitrol interactions with constipation medications that contain an opioid, see the “Interaction with opioid antagonists used for constipation” section below.
Opioids have a high risk of addiction, which can lead to serious health problems or even be life threatening. Vivitrol is prescribed to treat opioid use disorder.
Examples of opioid medications include:
What could happen
Vivitrol works by blocking the effects of opioids, including opioids for pain relief. These medications may not work if you’re receiving Vivitrol.
If you’re still taking an opioid for pain relief when starting Vivitrol treatment, you may experience withdrawal. For more information, see the “When should I avoid Vivitrol?” section above.
What you can do
Opioids for pain relief likely won’t work if you’re taking Vivitrol. Because of this interaction, doctors are likely to prescribe other medications for your pain instead.
Do not use illegal opioids while you’re taking Vivitrol. Using unknown or large amounts to try to get around Vivitrol’s opioid-blocking effects may cause serious side effects, including coma. It can even be fatal.
As a precaution, your doctor may recommend keeping naloxone (Narcan) nasal spray at hand. It’s a drug used in emergency situations to treat a suspected or known opioid overdose. Narcan reverses the effects of opioids, including respiratory depression (dangerously slow breathing).
You can request Narcan at your local pharmacy, or your doctor can write you a prescription for it.
If you have questions or concerns about opioid interactions with Vivitrol or about Narcan, talk with your doctor or pharmacist.
Interaction with disulfiram
Vivitrol can interact with disulfiram, which is a medication prescribed to treat alcohol use disorder. Vivitrol is also used to treat this condition. But combining these medications to treat alcohol use disorder isn’t recommended.
What could happen
Both Vivitrol and disulfiram can cause liver damage. Combining the two could increase your risk of serious liver damage.
What you can do
Due to the risk of liver damage, doctors may avoid prescribing Vivitrol and disulfiram together unless the benefits of using both outweigh the risks.
If your doctor recommends that you take Vivitrol and disulfiram together, they’ll likely check your liver health using blood tests before you start treatment. During treatment, they’ll continue ordering these tests to closely monitor your liver health for signs of damage.
If your doctor notices signs of liver damage during Vivitrol treatment, they can discuss the best treatment plan for your alcohol use disorder. This may include stopping treatment with either Vivitrol or disulfiram, or with both drugs.
Interaction with opioid antagonists used for constipation
Vivitrol can interact with certain medications used for constipation, called opioid antagonists. Though these medications contain an opioid, they are different from opioids used for pain relief, which are described above.
Examples of these opioid antagonists include:
- methylnaltrexone (Relistor)
- naldemedine (Symproic)
- naloxegol (Movantik)
What could happen
Vivitrol works by blocking the effects of opioids in your body. Other opioid antagonists, including ones used for constipation, work the same way.
Taking Vivitrol with another opioid antagonist can increase the effect of both drugs and increase your risk of side effects. This can include opioid withdrawal.
What you can do
Due to this interaction, doctors will usually avoid prescribing Vivitrol and an opioid antagonist together. If you have constipation that’s bothersome, your doctor can suggest other treatments for this condition. Or they may recommend a treatment other than Vivitrol for substance use disorder.
Vivitrol may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Vivitrol.
Does Vivitrol interact with supplements?
Vivitrol isn’t known to interact with any supplements. Even so, before you start using Vivitrol, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions that are discovered later.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Vivitrol and herbs
There are currently no reports of Vivitrol interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Vivitrol.
Vivitrol and vitamins
There are currently no reports of Vivitrol interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Vivitrol.
Does Vivitrol interact with food?
There are currently no reports of Vivitrol interacting with food. If you have questions about eating certain foods during your treatment with Vivitrol, talk with your doctor.
Does Vivitrol interact with vaccines?
Vivitrol isn’t known to interact with any vaccines.
Talk with your doctor if you have questions about whether any medication you take could interact with a vaccine.
Does Vivitrol interact with lab tests?
Vivitrol may produce a positive result in a urine test used to detect opioids. Before having an opioid urine test, be sure to tell your healthcare professional if you’re taking Vivitrol. This information will help them interpret your test results accurately.
Does Vivitrol interact with cannabis or CBD?Certain cannabis products, specifically oral cannabinoids (those taken by mouth), have been reported to interact with Vivitrol. (Cannabis is also referred to as marijuana.)
But it’s unclear whether other cannabis products, such as cannabidiol (CBD), can interact with Vivitrol.
Before you start treatment with Vivitrol, tell your doctor and pharmacist if you take oral cannabinoids. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Vivitrol. Before using Vivitrol, talk with your doctor about your health history. They’ll determine whether Vivitrol is right for you.
Health conditions or other factors that might interact with Vivitrol include:
Current use of opioids, dependence on opioids, or opioid withdrawal. You should not receive Vivitrol if you’re using opioids, have a dependence on opioids, or are experiencing opioid withdrawal. For more information, see the “When should I avoid Vivitrol?” section above.
Kidney problems. It’s not known if Vivitrol is safe for people who have moderate or severe kidney problems. If you have a kidney problem, tell your doctor before starting Vivitrol treatment. They will discuss with you the benefits and the risks of receiving Vivitrol based on your kidney health. They may recommend other treatments as safer options for you. If your doctor prescribes Vivitrol, they may closely monitor your kidney health during treatment.
Liver problems. It’s not known if Vivitrol is safe to use in people who have severe liver problems. Before you start receiving Vivitrol, tell your doctor if you have a liver problem. This will help them determine whether Vivitrol is a safe treatment for you. They may recommend another treatment as a safer option. If they prescribe Vivitrol, they may closely monitor your liver health during treatment.
Bleeding problems, such as hemophilia. Vivitrol is given by an injection into the muscle of one of your buttocks. If you have a bleeding disorder, such as hemophilia, you may have a higher risk of uncontrolled bleeding from this injection.
Tell your doctor about any bleeding problems you have before starting Vivitrol treatment. They will let you know whether Vivitrol is a safe treatment for you based on your condition.
Pregnancy. It’s not known whether it’s safe to receive Vivitrol while pregnant. If you are pregnant or planning to become pregnant, talk with your doctor before you start receiving Vivitrol.
Breastfeeding. It isn’t known whether it’s safe to breastfeed during Vivitrol treatment. If you’re breastfeeding or planning to breastfeed, talk with your doctor before you start Vivitrol.
Allergic reaction. If you’ve had an allergic reaction to Vivitrol or any of its ingredients, your doctor will likely not prescribe Vivitrol. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Vivitrol. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Whether you use illegal drugs, such as heroin.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Vivitrol treatment.
It’s also important to understand Vivitrol’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Using Vivitrol exactly as prescribed can also help prevent interactions.
If you still have questions about Vivitrol and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Should I tell you if I start taking another medication or supplement during my Vivitrol treatment?
- Do other medications that could treat my condition have similar interactions?
- If I take Vivitrol and have certain health conditions, will I be monitored more closely during treatment?
To learn more about Vivitrol, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.