Vivitrol is recommended for patients who are unable to abstain from alcohol and opioid use.
Vivitrol is not recommended if you are receiving opioid analgesics, have a current opioid dependence
or experiencing acute opioid withdrawal, have failed the naloxone challenge test, have a positive
urine screen for opioids, have exhibited hypersensitivity to naltrexone or any other components of
After opioid detoxification, patients are likely to have a reduced tolerance to opioids. Therefore,
any use of previously tolerated doses of opioids could result in potentially life-threatening opioid
intoxication such as respiratory compromise or arrest, circulatory collapse, etc.
Vivitrol injections may be followed by pain, tenderness, induration, swelling, erythema, bruising,
or pruritus; and severe reaction in some cases. The side effects seen most frequently in association
with Vivitrol therapy for alcohol dependence include nausea, vomiting, injection site reactions,
arthralgia, arthritis, or joint stiffness, muscle cramps, dizziness or syncope, somnolence or
sedation, anorexia, decreased appetite or other appetite disorders. The side effects seen most
frequently in association with Vivitrol in patients with opioid dependence include hepatic enzyme
abnormalities, injection site pain, nasopharyngitis, insomnia, and toothache. Cases of hepatitis,
clinically significant liver dysfunction, depression, suicidality, pneumonia, anaphylaxis, and
interference with laboratory tests have been observed.
Withdrawal may be precipitated abruptly by administration of an opioid antagonist to a patient with
opioid dependence, which may require hospitalization. An opioid-free interval of 7–10 days is
recommended. Patients transitioning from buprenorphine or methadone may be vulnerable to
precipitated withdrawal for as long as 2 weeks.