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What Is Vivitrol? | 16 Answers To Questions About Vivitrol 

Updated 27 October 2022 Written by Clint MallyMedically Reviewed by Sahar Wahed, RN
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What Is Vivitrol?

what is naltrexone aka vivitrol text with an image of concerned looking man
Injecting Vivitrol

What Is Vivitrol Used For?

Vivitrol is a medication-assisted treatment (MAT) option for treating alcohol use disorder (AUD) and opioid use disorder (OUD).

Naltrexone, the active ingredient in Vivitrol, was approved by the Food and Drug Administration (FDA) in 2006 to treat both AUD and OUD.  Vivitrol can be part of a treatment plan to treat alcohol and opioid addiction.

Vivitrol is not a cure for addiction but can be helpful for your addiction treatment. If you struggle to stay sober when beginning treatment, Vivitrol can help you stay sober and overcome physical dependence on alcohol or opioids.

For those with opioid and alcohol dependence, Vivitrol reduces cravings by blocking the “feel-good” chemicals released in your brain when drinking. 

If you struggle managing cravings and urges during early addiction recovery, Vivitrol injections can help you. During detox, you might have painful withdrawal symptoms. You might be tempted to use substances again to avoid these symptoms.

Vivitrol can be used after detox and should not be used if you are currently having withdrawal symptoms from heavy drinking or opioid use. You would use Vivitrol after alcohol and opioid detoxification to help maintain sobriety during early recovery.

Vivitrol stays in your system to help you manage these cravings as you learn healthy coping skills while in a drug or alcohol treatment program.

Vivitrol treatment can be part of your addiction treatment if you are at risk of relapse due to painful withdrawal symptoms during detox. Even after detox, you might be at a higher risk of relapse if you engaged in heavy drinking or opioid use.

Vivitrol is not approved by the FDA for people under the age of 18.

Brain On Vivitrol

What Happens If You Take Opiates While On Vivitrol?

You are at a higher risk of overdose if you take opiates while on Vivitrol.

According to the FDA, patients treated with Vivitrol “may respond to lower doses of opioids than previously used,” which can result in an overdose “if a patient uses opioids at the same dose they previously used, after taking Vivitrol and as the blockade wanes or after missing a dose or discontinuing treatment.”

Taking opiates, whether in the form of legal drugs, like pain medication or in the form of street drugs like heroin, is dangerous because:

  • Vivitrol blocks the effects of opioids. If you take opiates while on Vivitrol, you will not experience the same “high” as you normally would. You might use more opioids than usual to counteract the effect of Vivitrol.
  • While Vivitrol helps create a blockade of the opioid receptors in the brain, you might overcome this blockade by consuming large amounts of opiates. You would need much more opiates than usual, which increases the risk of overdose.
  • The effects of Vivitrol diminish over time before you get your next injection. If you take opiates a few days after your injection, the Vivitrol will be working much better than the week before your monthly shot.
  • If you take opiates a few days after a Vivitrol injection, you might take more than usual. You might then be accustomed to this amount, which can have a greater effect when taken just before your next injection when the opioid blockade is at its weakest.

The active ingredient in Vivitrol sets up a blockade of the “feel-good chemicals” released while using opioids. 

If you use opiates while on Vivitrol, you won’t feel the same effect and are at risk of using varying amounts of the drug that you are not used to. Additionally, your tolerance might be lower after detox, meaning you are at a higher risk of overdose if you relapse.

chemical structure of vivitrol

How Does Vivitrol Work?

Vivitrol works by setting up a blockade of endorphin and opioid receptors in the brain to reduce the euphoric effect of alcohol and opioids.

When you use alcohol or opioids, you become addicted to the “high” and the good feelings created by these substances. Your brain responds to these substances by releasing “feel good” chemicals, like opioids and endorphins.

These “feel good” chemicals are part of your brain’s natural response to certain events and feelings. Natural opioids and endorphins are often released by the brain when you feel pain or experience something pleasurable.

When opioid receptors are activated in the brain, you are being “rewarded” by these feel-good chemicals telling you to continue the behavior that caused their release.

Opioids and opioid receptors occur naturally as part of the central nervous system’s response to external stimuli. When you feel good after doing something like exercise or helping others, you get a natural reward of endorphins.

Natural opioids, like heroin and codeine, or a synthetic type of opioid, like fentanyl, methadone, and buprenorphine, can “hijack” this reward system. By taking a pill or injecting these substances, you get the reward without effort.

Drinking alcohol can also release these “feel-good” chemicals, creating an alcohol addiction to continue these good feelings by drinking.

Naltrexone, whether used in pill form or Vivitrol injection, acts as an opioid antagonist. An opioid antagonist blocks the effects of opioids in the brain. When you drink or use opiates while on Vivitrol, your brain does not release these feel-good chemicals.

By blocking the opioid receptors, naltrexone helps to reduce your cravings for alcohol or opioids.

person drinking soda

Can You Drink On Vivitrol?

It would be best if you did not drink while you are on Vivitrol.

While Vivitrol and alcohol do not interact, you still should not drink while in addiction treatment. You will not get sicker or have worse effects from alcohol while on Vivitrol. You will have similar symptoms of drinking as you normally would.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “Naltrexone [Vivitrol] does not reduce the effects of alcohol that impair coordination and judgment,” and “may reduce your feeling of intoxication and the desire to drink more, but it will not cause a severe physical response to drinking.”

Though there is no danger of drug interaction or hazardous side effects, drinking alcohol while on Vivitrol will not help your addiction treatment. 

Abstinence and long-term sobriety is the goal when treating alcohol dependence. While drinking on Vivitrol will not put you in danger, you will be working against your treatment plan if you do not stop drinking while taking Vivitrol.

vivitrol vials

How Long Does Vivitrol Last?

Vivitrol injections last about four weeks for most people.

Your healthcare provider might set you up on a different schedule for your injections. Most people get a Vivitrol injection once per month. You might have a different dose of Vivitrol compared to others for maximum benefit.

The effects of Vivitrol are at their height during the first few weeks following injection. The strength of Vivitrol will lessen over time, meaning that during the week before your next injection, Vivitrol will not work as effectively as it would during the first week.

You need to continue with monthly injections if taking Vivitrol as part of your treatment program.

If you skip a monthly injection, you might lose the effect of Vivitrol. You might have cravings and urges again, especially during early addiction treatment.

Always talk to your treatment team about going off of Vivitrol. You want to be sure to have other coping mechanisms for cravings in place before ending your treatment with Vivitrol.

stop sign

Is Vivitrol A Controlled Substance?

According to the U.S. Drug Enforcement Agency (DEA), “is FDA approved for relapse prevention in detoxified opioid users” and “is not a controlled substance.”

While the DEA has no oversight on the use of Vivitrol and naltrexone, it is still regulated by the FDA, like most medications. Along with other medications, like naloxone, methadone, and buprenorphine, Vivitrol is legal to use for treating opioid use disorder.

hundred dollar bills in wallet

How Much Does Vivitrol Cost?

Vivitrol injections can cost between $1000 to $1500 for cash payments, though your insurance plan might cover some of the costs.

Vivitrol can be a costly way of treating alcohol and opioid use disorders. It would be best to have a comprehensive treatment plan involving support, therapy, and other activities.

Medication-assisted treatment (MAT) like Vivitrol is often more expensive and might only be used to treat severe opioid or alcohol addiction. While taking Vivitrol, it would be best to focus on other aspects of addiction treatment for long-term recovery.

Vivitrol can be used to get you to the point of clarity or help you during the first stages of treatment when you are most at risk of relapse. Talk to your health care professional about using Vivitrol and get recommendations for other forms of treatment.

A comprehensive treatment plan will help you wean off Vivitrol as you recover from your addiction and will include:

  • Mental health treatment
  • Support groups, like Alcoholics or Narcotics Anonymous (AA) and (NA), or SMART Recovery
  • Family therapy
  • Holistic approaches, like mindfulness, yoga, and exercise
  • Vocational and academic support
  • Social skill and relationship training

Vivitrol is not meant to be a cure and can be quite costly over time. You should seek addiction treatment from a facility that provides several forms of treatment in addition to MAT.

emt giving medicine to a patient on the street

Can You Overdose On Vivitrol?

You can overdose on opioids while taking Vivitrol for opioid dependence.

While Vivitrol itself does not have a risk of overdose itself, you can overdose on other substances while taking Vivitrol. The active ingredient in Vivitrol called naltrexone blocks the pleasurable effects of opioids.

You might take more than your usual amount of opioids while on Vivitrol to counteract the effect of naltrexone on your brain’s reward system.

Vivitrol injections are only performed by a healthcare professional.  You will need to schedule your injections with a healthcare provider and will not be given injections to take at home without supervision.

Always be honest with your provider about any cravings, urges, or use of opioids while you are taking Vivitrol. Your healthcare provider can make adjustments or recommendations for successful addiction treatment when you are honest about the effects of Vivitrol.

hands exchanging a medical bottle

Does Vivitrol Show On A Drug Test?

 Vivitrol is unlikely to show up on a standard drug test.

Since Vivitrol is approved by the FDA, you are protected by the Americans with Disabilities Act when you take Vivitrol as prescribed for opioid or alcohol use disorder.

Your healthcare provider might ask you to take regular drug tests while on Vivitrol to ensure that the treatment is effective. They might be testing for opioids or other substances to make sure that you are sober while taking Vivitrol.

Abstaining from drug or alcohol use while on Vivitrol will reduce the risk of overdose and other complications.

Vivitrol will not “block” other substances from showing up on a drug test. If you take opioids or other drugs while on Vivitrol, the other substances will still show on a standard drug screening.

bottles of vivitrol

Who Makes Vivitrol?

The pharmaceutical manufacturer Alkermes makes Vivitrol injections for the treatment of alcohol and opioid dependence.

Alkermes produces the brand name of the injectable version of naltrexone known as Vivitrol. While naltrexone is available in pill form as a generic drug, the injections are only available as the brand name Vivitrol.

paper that says possible side effects

What Are The Side Effects Of Vivitrol?

Common side effects of Vivitrol for alcohol dependence:

  • Reactions at the injection site, like soreness, swelling, or redness
  • Nausea, vomiting, or diarrhea
  • Stomach pain
  • Tiredness
  • Muscle cramps
  • Anxiety
  • Headache
  • Decreased appetite

Side effects for those taking Vivitrol for opioid dependence include:

  • Toothache and headache
  • Sleeping problems
  • Cold or flu symptoms
  • Increase in blood pressure

While serious side effects of Vivitrol are not common, you might also have some of the following:

  • Liver problems like hepatitis is a rare but serious side effect of Vivitrol. Talk to your healthcare provider if you experience the following while on Vivitrol:
    • Stomach pain lasting more than a few days
    • Dark urine
    • Tiredness that lasts more than a few days
    • Yellowing of the white parts of your eyes
  • You might also have some of the following rare, but serious side effects, including:
    • Opioid withdrawal symptoms
      • Can include depression and suicidal thoughts
      • Common during opioid detoxification
    • Severe injection site reactions, including any allergic reactions to your injection
    • Pneumonia
    • Chest pain

Always talk to your healthcare professional if you experience any of these side effects. Also, speak to your provider about any common, less serious side effects that do not seem to go away within a few weeks.

patient getting a shot of vivitrol

How Long Do Vivitrol Side Effects Last?

Most side effects of Vivitrol will go away after a few days or weeks.

Much like any medication, Vivitrol carries the risk of side effects. Most side effects are not life-threatening or dangerous. However, it is always best to talk with your health care provider about any concerns about side effects before and while taking Vivitrol.

pregnant woman getting a shot

Can You Get The Vivitrol Shot While Pregnant?

You can get the Vivitrol shot while pregnant or breastfeeding; however, you should make sure the benefits outweigh the risks.

Not much research has been done to show the safety of taking Vivitrol while pregnant. But the harm of substance abuse and opioid use while pregnant is well-known. You and your healthcare provider can weigh the benefits and risks before receiving Vivitrol injections.

While research on Vivitrol and pregnancy has been conducted, this research might be incomplete and more studies are needed.

According to a study published in Drugs, “The use of implant naltrexone [Vivitrol] during pregnancy was not associated with higher rates of negative birth outcomes compared with methadone- and buprenorphine-exposed neonates.”

This study, however, was not controlled, as noted by National Institute on Drug Abuse (NIDA) Director Dr. Nora Volkow. Being opioid-free will significantly reduce the risk of adverse effects while pregnant.

Always consult with your healthcare professional before beginning any treatment to determine the best course of action.

box of suboxone

Can You Take Suboxone And Vivitrol Together?

Taking Suboxone and Vivitrol together is not recommended for the treatment of opioid use disorder and other substance abuse issues.

Suboxone is a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, meaning that it has some of the euphoric effects of an opioid.

Vivitrol would block the effects of Suboxone, making treatment by Suboxone ineffective if combined with the blockade effects of naltrexone.

medical room

Where Can I Get Vivitrol Treatment?

Sandstone Care offers Vivitrol treatment as part of our medication-assisted treatment program for individuals that have been assessed and for whom it may benefit.

Vivitrol injections might help those who struggled with severe withdrawal symptoms during alcohol and opioid detoxification. Sandstone Care is here to support young adults with alcohol and opioid use disorders. Call (888) 850-1890.