Vivitrol: How It Works,
Uses, and Side Effects

Vivitrol: How It Works,
Uses, and Side Effects

Vivitrol is an injectable, extended-release form of naltrexone, a medication designed to prevent relapse when a person struggles with alcohol abuse or opioid addiction. A rehabilitation expert may discuss the option of receiving Vivitrol injections as an alternative option to taking medications such as Suboxone or methadone. 4 All these medicines can be a part of a comprehensive treatment program to help a person quit drinking or abusing opioids.

What Does Vivitrol treat?

The U.S. Food and Drug Administration (FDA) approved Vivitrol to treat alcohol dependence in 2006.4 Pharmaceutical manufacturers developed Vivitrol to provide a longer-acting solution to taking naltrexone on a daily basis. Vivitrol also contains the inactive ingredient polyactide-co-glycolide as well as sodium chloride and water for injection.3

Doctors may also prescribe Vivitrol to reduce opioid dependence, especially after a person has participated in a detox program from opioids. 2 The FDA approved the use of Vivitrol for opioid addiction treatment in 2011.

Since its FDA approval, the use of Vivitrol has expanded in the United States. For example, in 2012, there were 15 programs using Vivitrol as an addiction treatment option across nine states, according to “The New York Times”. 4 In April 2017, there were 450 Vivitrol programs in 39 states. Also, Vivitrol sales increased by 33 percent from 2016 to 2017, totaling $58.5 million.

Common Misconceptions About Vivitrol

A common misconception about Vivitrol is that a person who is alcohol- and opioid-dependent can receive Vivitrol injections. If a person is dependent on opioids, getting Vivitrol injections can cause a rapid withdrawal of opioid medications. Therefore, a person shouldn’t get Vivitrol injections until they’ve been opioid-free for at least seven to 10 days. Also, if a person takes medications such as Suboxone to treat opioid addiction, they can’t use naltrexone as Suboxone or methadone will be ineffective.1 Also, if a person anticipates they will need opioid medications as some point in time in the next 30 days, they shouldn’t receive Vivitrol.

Another misconception about Vivitrol is that it costs the same as the oral form of naltrexone. Unfortunately, injectable Vivitrol is typically more expensive than taking the oral naltrexone form. As a result, it’s important to talk with a doctor or rehabilitation specialist about the potential costs associated with taking Vivitrol to ensure the medication is affordable.

What Does Vivitrol Do to the Body?

When a person abuses alcohol, the alcohol consumed causes the brain to release neurotransmitters that opioids activate.1 These include enkephalins, endorphins, and dynorphins. Naltrexone is an opioid antagonist. This means that when a person has naltrexone in their system, the naltrexone blocks the opiate receptors. If a person were to take an opiate medication, use heroin, or drink, they wouldn’t experience the same effects. A person wouldn’t have the euphoria or feel-good emotions associated with using the medication or drinking.2

Doctors give Vivitrol as an injectable medication. After the medication is injected, the concentration starts to peak after about two hours.1 About seven days after injection, the doses in the blood remain steady for about four weeks. The way the body handles Vivitrol administered intramuscularly is different from the way it handles oral dosages of the medication. As a result, a doctor will administer less Vivitrol (about 380 milligrams) than when compared to taking oral Vivitrol, which would be about 1,500 milligrams a month.

Once a person receives a Vivitrol injection, it can’t be reversed in the body.2 This means that once a person gets the injection, the medication won’t leave their body for at least a month. As a result, a person may not be able to effectively take some opioid medications. However, there are alternatives to help control a person’s pain.

What Are the Side Effects of Vivitrol?

Most people can usually receive Vivitrol safely. 1 Oral naltrexone can be hard on the liver, but injectable Vivitrol usually has less of an impact on the liver. However, the FDA has still issued a black-box warning that Vivitrol can cause liver toxicity.

Some people can experience unwanted side effects related to a skin reaction at the injection site. This is more likely to occur if the person injecting the medication injects it subcutaneously (under the skin) instead of into the muscle. If a person does experience this side effect, they may have a lump at the site where the medication was injected.

It’s possible that a person can be allergic to Vivitrol. Some of the signs that a person is experiencing a severe allergic reaction to Vivitrol include having trouble breathing or breaking out in a skin rash. A person can also experience chest pain, dizziness, or wheezing if they are experiencing an allergic reaction to Vivitrol.

Other potential side effects associated with naltrexone include:

  • Back pain
  • Decrease in appetite
  • Fatigue
  • Headache
  • Nausea
  • Stomach pain
  • Vomiting

A person is more likely to experience stomach upset the first one or two times they receive Vivitrol injections.2 For example, a person may have nausea for one to two days. However, with subsequent injections, there is less likely to have stomach-related side effects associated with receiving Vivitrol injections.

The FDA hasn’t approved Vivitrol for use in adolescents or children. Doctors also don’t know if women who are pregnant or breastfeeding can safely receive Vivitrol.

In very, very rare instances, patients have reported experiencing adverse events associated with severe depression and thoughts of suicide.1 An estimated 1 percent of patients experienced suicidal thoughts compared to those patients who received a placebo.

How Effective Is Vivitrol?

A number of studies exist regarding the effectiveness of Vivitrol. Some of the highlights from these major research studies include:1

  • A study from the FDA Center for Drug Evaluation and Research found that Vivitrol and other injectable Naltrexone forms are most effective in people who are abstinent from alcohol at baseline. As a result, many doctors recommend this approach after a person has quit using alcohol.
  • A 2005 study conducted a six-month trial to test how effective and well-tolerated Vivitrol is over the course of several months. Patients who received 380 milligrams of injectable Vivitrol, plus participated in psychological counseling experienced a 25 percent decrease in the occurrence of heavy drinking days compared with participants who received a placebo injection. Patients who received a lower or half dose of Vivitrol reported a 17 percent decrease in the rate of heavy drinking days.
  • A 2008 study that evaluated previously collected data regarding Vivitrol found that patients who had an abstinence rate of at least four days (the average amount of time it may take a person to detox from alcohol) were more likely to experience good treatment outcomes compared to patients who were not abstinent from alcohol four days before they started their Vivitrol injections.

Considerations for Vivitrol

Vivitrol alone isn’t likely to be an effective way to overcome alcohol addiction.1 Most rehabilitation experts recommend attending a rehabilitation program or other alcohol addiction management program. They also recommend attending self-help programs, participating in therapy sessions, and participating in 12-step programs. Doctors also recommend a person who receives Vivitrol injections carry a safety identification card that would let medical professionals know the person is taking Vivitrol injections.

Where Can A Person Find More Information About Vivitrol?

If you or a loved one is considering medications to enhance a rehabilitation treatment plan to stay sober, talk to a doctor or therapist about Vivitrol. You can also visit Vivitrol’s website and search for organizations in your city and state to determine who and were Vivitrol injections are offered. 4