If you have a dependence on either alcohol or opioids, your doctor may suggest treatment with Vivitrol. (With dependence, your body needs a certain substance for you to feel comfortable.)

It’s a prescription drug used in adults to:

  • treat alcohol dependence in people who have stopped drinking and aren’t in the hospital for treatment.
  • prevent opioid dependence in people who have detoxed from opioids. (During opioid detox, your body clears opioids from your system.)

Vivitrol should be used as part of a complete treatment program, along with counseling, education, and support groups.

To learn more about how Vivitrol is used for these conditions, see the “Is Vivitrol used for alcohol dependence?” and “Is Vivitrol used for other conditions?” sections below.

Vivitrol basics

Vivitrol contains the active drug naltrexone. Vivitrol isn’t available as a generic.

You’ll receive Vivitrol as an injection into a muscle of your buttock. A healthcare professional will give you this injection every 4 weeks.

Keep reading to learn more about Vivitrol’s side effects, uses, dosage, and more.

Like most drugs, Vivitrol may cause mild or serious side effects. The lists below describe some of the more common side effects. They don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Vivitrol. They can also suggest ways to help reduce side effects.

Keep in mind that side effects may vary slightly depending on the reason you’re taking the drug.

Mild side effects

Here’s a list of some of the mild side effects Vivitrol can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or you can see this article for details about its side effects. You can also read Vivitrol’s medication guide.

Mild side effects of Vivitrol that have been reported include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information about this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Vivitrol can occur, but they aren’t common. If you have serious side effects from Vivitrol, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Serious side effects of Vivitrol that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

SUICIDE PREVENTION

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Side effect focus

Learn more about some of the side effects Vivitrol may cause.

Long-term side effects

Treatment with Vivitrol can cause long-term side effects. These include:

Although these were rare in studies, they can be serious.

There may be other long-term side effects caused by Vivitrol, but more studies are needed to know for sure.

What might help

Watch for symptoms of liver problems while taking Vivitrol, including:

Call your doctor right away if you notice symptoms of liver problems. Sometimes liver problems can be treated to avoid long-term issues.

For information on Vivitrol and depression, see “Depression” just below.

Depression

It’s possible that Vivitrol could cause depression as a side effect. But this was very rare in people who were treated with the drug during studies.

Symptoms of depression can include:

  • feeling hopeless or sad
  • feeling angry or aggressive
  • losing interest in things you usually enjoy
  • sleeping a lot more or less than usual

What might help

Call your doctor right away if you notice changes in your mood or behavior while taking Vivitrol. (This includes any of the symptoms listed above.) Your doctor can suggest the best treatment for you. They may also prescribe treatment other than Vivitrol for your condition.

Nausea

It’s possible you’ll experience nausea as a side effect of taking Vivitrol. This was one of the most common side effects reported by people in Vivitrol studies.

Nausea is most common after your first Vivitrol injection. For many people, the nausea is mild and goes away on its own after a few days. It’s less likely you’ll feel nauseous with follow-up injections.

What might help

If you have nausea that won’t go away after a Vivitrol injection, or that is bothersome to you, talk with your doctor. Although nausea usually goes away on its own, this may not be the case for you. Your doctor may prescribe a medication to treat this side effect. Or they may decide that a treatment other than Vivitrol would be better for you.

Allergic reaction

Some people may have an allergic reaction to Vivitrol.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Vivitrol. But if you think you’re having a medical emergency, call 911 or your local emergency number.

It’s important to discuss your overall health and any medical conditions you have with your doctor before starting Vivitrol.

You should also tell your doctor and pharmacist about any medications you take. They can then check for any interactions with Vivitrol.

Interactions

Taking medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Vivitrol, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Vivitrol.

Interactions with drugs or supplements

Vivitrol can interact with several types of drugs. These include:

This list does not contain all types of drugs that may interact with Vivitrol. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Vivitrol.

Warnings

Vivitrol may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Vivitrol. Factors to consider include those in the list below.

  • Current or recent opioid use. You must stop any opioid or opioid-containing medications at least 7 to 14 days before you start Vivitrol. Starting Vivitrol while you have opioids in your body can cause severe opioid withdrawal. Also, taking any amount of opioids during Vivitrol treatment can increase the risk of opioid intoxication (overdose). Opioid withdrawal and opioid overdose are serious medical emergencies. They both require treatment in a hospital and may be life threatening. To help avoid withdrawal and overdose, it is very important to tell your doctor about any recent opioid use before starting Vivitrol.
  • Liver problems. Vivitrol can cause liver damage. You may have a higher risk for this if you already have liver problems, or if you drink a lot of alcohol. Your doctor can help determine whether your liver is healthy enough for treatment with Vivitrol.
  • Kidney problems. It’s not known if Vivitrol is safe for use in people with moderate or severe kidney problems. Your doctor can help determine whether your kidneys are healthy enough for treatment with Vivitrol.
  • Bleeding problems, such as hemophilia. Vivitrol is given as an injection into a muscle of your buttock. People with bleeding disorders, such as hemophilia, may have a higher risk of uncontrollable bleeding from this injection. Talk with your doctor if you have a bleeding disorder before you start treatment with Vivitrol. They may recommend a different medication for your condition.
  • Allergic reaction. If you’ve had an allergic reaction to Vivitrol or any of its ingredients, you should not take Vivitrol. Ask your doctor what other medications are better options for you.

Vivitrol and alcohol

You should not drink alcohol while you’re taking Vivitrol. Both alcohol and Vivitrol can cause liver damage, and combining the two may increase your risk of this side effect.

People taking Vivitrol for alcohol dependence should not consume alcohol. Dependence on alcohol is a condition that Vivitrol is used to treat. (With dependence, your body needs a certain substance for you to feel comfortable.)

If you drink alcohol and have questions about how to stop drinking before taking Vivitrol, talk with your doctor.

Pregnancy and breastfeeding

Read below to learn about Vivitrol and pregnancy and breastfeeding.

Vivitrol and pregnancy

It isn’t known whether Vivitrol is safe to take while pregnant. But it’s known that untreated opioid or alcohol dependence can cause harm to a pregnancy. And Vivitrol is used for these conditions.

If you’re pregnant or planning to become pregnant, talk with your doctor before you start treatment with Vivitrol. They can review the pros and cons of the medication with you. They can also discuss other treatments for your condition.

Vivitrol and breastfeeding

It isn’t known if it’s safe to take Vivitrol while breastfeeding. Taking Vivitrol while breastfeeding causes the drug to pass into breast milk. But it’s not known what effects this may have on a breastfed child.

Talk with your doctor about feeding options for your child if you’re being treated with Vivitrol. Your doctor can review the pros and cons of the options available to you.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. This includes questions such as whether the cost of the Vivitrol shot is covered by Medicare or not. You can also visit the Vivitrol manufacturer’s website to see if they have a coupon or other support options.

Find answers below to some commonly asked questions about Vivitrol.

Will I have withdrawal symptoms when starting or stopping Vivitrol?

If you start treatment with Vivitrol while opioids are in your system, you may have severe opioid withdrawal.

Keep in mind, the drug prevents opioid dependence after you’ve detoxed from opioids. (With dependence, your body needs a certain substance for you to feel comfortable. During opioid detox, your body clears the opioids from your system.)

Opioid withdrawal with Vivitrol can be serious and require treatment in a hospital. For this reason, you should not start treatment with Vivitrol unless it’s been at least 7 to 14 days since you stopped any opioids.

If you stop treatment with Vivitrol, you shouldn’t have withdrawal symptoms.

If you have more questions or are concerned about withdrawal from Vivitrol, talk with your doctor or pharmacist.

Is Vivitrol similar to disulfiram (Antabuse)?

Vivitrol and disulfiram are medications that may be prescribed to help with certain substance dependencies. With dependence, your body needs a certain substance for you to feel comfortable.

Vivitrol treats alcohol and opioid dependence. Disulfiram is used to treat alcohol dependence only.

A brand-name version of disulfiram called Antabuse used to be available but has been discontinued.

To learn more about how these medications are alike and different, talk with your pharmacist or doctor.

Does Vivitrol interact with Xanax, Adderall, or Wellbutrin?

No, Vivitrol isn’t known to interact with Xanax, Adderall, or Wellbutrin. Medications that can interact with Vivitrol are listed in the “What should be considered before taking Vivitrol?” section above.

If you have questions about drug interactions with Vivitrol, talk with your doctor or pharmacist.

Can Vivitrol cause weight gain or weight loss? Is it used for weight loss?

It’s possible. Weight gain and weight loss were each reported by people taking Vivitrol in studies. Both side effects were very rare.

Vivitrol can cause decreased appetite in some people, which may lead to weight loss. But Vivitrol isn’t approved for weight loss and should not be used for this purpose.

If you have questions or concerns about your weight while taking Vivitrol, talk with your doctor. They can recommend ways for you to maintain a healthy weight.

How does Vivitrol work? Is it a controlled substance?

Vivitrol is used in certain situations to treat or prevent dependence on alcohol or opioids. With dependence, your body needs a certain substance for you to feel comfortable.

When you drink alcohol or take opioids, dopamine is released in your brain. Dopamine is a chemical your body makes naturally. It creates pleasant feelings and sends signals that make your body want to drink alcohol or take an opioid again.

Vivitrol’s mechanism of action (how it works) is to block the sites in your body where alcohol or opioids attach. In doing so, Vivitrol stops dopamine from being released. This helps you have fewer cravings, which can help keep you from drinking alcohol or taking opioids again.

If you have additional questions about how Vivitrol works, talk with your doctor or pharmacist.

Vivitrol isn’t a controlled substance. These substances carry a risk for misuse, which means they may be taken in a way other than how they’re prescribed. Vivitrol doesn’t carry this risk, but opioids do. If you’d like to know more about this, ask your doctor or pharmacist.

Are there any reviews available from people who’ve taken Vivitrol?

The manufacturer of Vivitrol doesn’t provide any reviews of their medication for alcohol or opioid dependence.

Keep in mind, Vivitrol is used in certain situations for dependence on alcohol or opioids. (With dependence, your body needs a certain substance for you to feel comfortable.)

If you’d like to learn more about Vivitrol, talk with your doctor. They can review the pros and cons of using this medication for your condition. They can also discuss other treatments with you, and how they compare and contrast with Vivitrol.

Vivitrol and methadone are both prescribed for treating opioid dependence. (With dependence, your body needs a certain substance for you to feel comfortable.)

Vivitrol is also prescribed for dependence on alcohol. Methadone isn’t used for this.

Methadone can be used as a pain reliever in some people who don’t respond to certain other pain medications. Also, it’s important to note that methadone has boxed warnings about the risk of misuse and addiction to the drug, certain life threatening side effects, and serious drug interactions.

Methadone is a generic drug, whereas Vivitrol is a brand-name drug. A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

To learn more about how these medications are alike and different, talk with your pharmacist or doctor.

Vivitrol and Suboxone are both prescribed for treating opioid dependence. (With dependence, your body needs a certain substance for you to feel comfortable.)

But unlike Vivitrol, Suboxone isn’t used to treat alcohol dependence.

Vivitrol is given by a healthcare professional as a once-monthly injection into your buttock. Suboxone, on the other hand, comes as a film that dissolves in your mouth. (You place it either under your tongue or between your gums and cheek.)

Vivitrol and Suboxone have some similarities, but they have important differences as well. Here’s a side-by-side comparison of Vivitrol and Suboxone. Talk with your doctor if you’d like to know more about these drugs.

If you have alcohol dependence, your doctor may suggest treatment with Vivitrol.

It’s used to treat alcohol dependence in adults who have stopped drinking and aren’t in the hospital for treatment. With dependence, your body needs a certain substance for you to feel comfortable.

Vivitrol should be used as part of a complete treatment program, along with counseling, education, and support groups.

Vivitrol works by blocking binding sites in your body where alcohol attaches. In doing so, Vivitrol stops the release of dopamine (a chemical your body makes naturally). Dopamine creates pleasant feelings and sends signals that make your body want to drink alcohol again. Blocking dopamine release helps you have fewer cravings, which can help keep you from drinking alcohol.

If you have questions about how Vivitrol is used to treat alcohol dependence, talk with your doctor or pharmacist.

In addition to its use for alcohol dependence, Vivitrol is also prescribed for opioid dependence. To learn more, see “Is Vivitrol used for other conditions?” directly below.

If you have opioid dependence, your doctor may suggest treatment with Vivitrol. It’s used to prevent dependence after detoxing from opioids.

With dependence, your body needs a certain substance for you to feel comfortable. During opioid detox, your body clears the opioids from your system.

Vivitrol is given to help stop you from having opioid dependence again if you’ve used opioids in the past. For this use, Vivitrol should be used as part of a complete treatment program, along with counseling, education, and support groups.

Vivitrol works by blocking binding sites in your body where opioids attach. In doing so, Vivitrol stops the release of dopamine (a chemical your body makes naturally). Dopamine creates pleasant feelings and sends signals that make your body want to take opioids again. Blocking dopamine release helps you have fewer cravings, which can help keep you from being dependent on opioids.

Opioid dependence is possible with typical use of opioid medications, even when they’re prescribed by a doctor and taken as directed.

If you have questions about how Vivitrol treats opioid dependence, talk with your doctor or pharmacist.

In addition to this use, Vivitrol is prescribed for alcohol dependence. To learn more, see “Is Vivitrol used for alcohol dependence?” directly above.

Vivitrol and naltrexone are both prescribed for treating opioid and alcohol dependence. With dependence, your body needs a certain substance for you to feel comfortable.

Vivitrol is given by a healthcare professional as a once-monthly injection into your buttock. Naltrexone comes as a tablet that you swallow, usually once per day.

Both Vivitrol and naltrexone contain the same active drug: naltrexone. Since they contain the same active ingredient, Vivitrol and naltrexone are alike in many ways. But they also have some important differences.

Check out this detailed breakdown of Vivitrol and naltrexone. And ask your doctor if you have questions about which drug is right for you.

Your doctor will recommend the dosage of Vivitrol that’s right for you. Below are common dosages, but the dosage you receive will be determined by your doctor.

Form

Vivitrol comes as a liquid solution. You’ll receive it as an injection into a muscle of your buttock.

Recommended dosage

Most people get a Vivitrol injection once every 4 weeks, or once each month. You can see this article for more in-depth information about Vivitrol’s recommended dosage.

Questions about Vivitrol’s dosage

Below are some common questions about Vivitrol’s dosage.

  • What if I miss a dose of Vivitrol? If you miss a Vivitrol injection, call your doctor’s office to reschedule your appointment as soon as possible. It’s very important to get your Vivitrol doses on schedule, because levels in your body start to drop about 2 weeks after each dose.
  • Will I need to use Vivitrol long term? If you and your doctor agree Vivitrol is working well for you, you’ll likely use the drug long term.
  • How long does Vivitrol take to work? Vivitrol may start working as soon as 2 hours after you get an injection. The drug releases slowly into your body over 4 weeks. But after 2 weeks, Vivitrol levels in your body begin to drop.

Your doctor will explain how Vivitrol will be given to you. They will also explain how much you’ll be given and how often.

Receiving Vivitrol

You’ll receive Vivitrol as an injection into a muscle of your buttock by a healthcare professional. Typically, it’s given once every 4 weeks, or once each month.

Vivitrol must be given by a healthcare professional. You cannot give Vivitrol injections to yourself.

Questions about receiving Vivitrol

Below are answers to a couple of common questions about taking Vivitrol.

  • Can Vivitrol be chewed, crushed, or split? Vivitrol comes as a liquid solution. It can’t be chewed, crushed, or split.
  • Should I take Vivitrol with food? Vivitrol is given as an injection every 4 weeks. It isn’t affected by food or meals.
Questions for your doctor

You may have questions about Vivitrol and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Vivitrol affect my body, mood, or lifestyle?
    • How will I know if Vivitrol is working for me?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

If you have dependence on either alcohol or opioids, your doctor may suggest treatment with Vivitrol. (With dependence, your body needs a certain substance for you to feel comfortable.)

Vivitrol is prescribed in certain situations for alcohol and opioid dependence. If you have questions about treatment with Vivitrol, talk with your doctor.

Here are a few questions you may want to ask your doctor about Vivitrol:

  • Can Vivitrol cause hair loss?
  • Is it possible to overdose on Vivitrol?
  • Is there an oral dosage of naltrexone that’s equal to Vivitrol?

You may find this article on treating alcohol use disorder to be helpful.

You may also want to ask your doctor about other treatments for alcohol and opioid dependence.

Q:

What happens if during Vivitrol treatment I need pain medications in an emergency, such as after a car accident? Will doctors still be able to treat my pain?

Anonymous

A:

In an emergency, doctors will still be able to treat your pain during Vivitrol treatment. Depending on the situation, they may be able to treat your pain with medications that do not contain opioids. (Remember that Vivitrol works by blocking the binding sites where opioids attach in your body. And Vivitrol’s effects can last for a month after your last dose.)

If opioid pain medications are needed, doctors may first give you another type of drug that reverses the effects of Vivitrol. They’ll also carefully monitor your breathing and other vital signs such as heart rate while you’re getting opioid pain medications. This is because taking opioids with Vivitrol can increase the risk of serious side effects. These include sudden opioid withdrawal or opioid intoxication (overdose).

Because of these risks, it’s very important to always wear a medical alert bracelet or dog tag during Vivitrol treatment. Another option is to carry a patient safety card. These contain information that will let healthcare professionals know you’re taking Vivitrol. Then, they can recommend the best possible care in an emergency situation.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?

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.

Vivitrol Images