If your doctor has recommended that you or a loved one start on naltrexone (Vivitrol), you may want to learn more about it. Here are the answers to some questions you may have about extended-release injectable naltrexone.
What Is Naltrexone (Vivitrol)?
Naltrexone is a medication used to help people who are recovering from opioid or alcohol use disorder. It helps lower your cravings for opiate drugs or alcohol, and it should be used as part of your broader treatment plan that includes counseling and social support.
How Does Naltrexone Work for Opioid Use Disorder?
Naltrexone is an opioid antagonist drug. It works by attaching to the same nerves in your brain that opioids attach to, blocking any opioids from attaching to those nerves and giving you the high you feel when using drugs. If you use opiate drugs while on naltrexone, you won’t feel their effects.
How Does Naltrexone Work for Alcohol Use Disorder?
Naltrexone does not block the effects of alcohol on your body, but studies show that it helps lower your desire to drink. We don’t know exactly why that is, but it is likely because the medication blocks certain chemicals in your brain, which are released when you drink alcohol, from attaching to the nerves that make you feel good, just like with opiate drugs.
How Do You Take Naltrexone?
You take extended-release naltrexone monthly as a shot in your buttocks. A health care provider must give you the shot.
Who Can Use Naltrexone?
Naltrexone may be helpful for you if you have stopped using opiate drugs or drinking alcohol and are working to stay free from opioids or alcohol.
You must be at least 7 to 14 days free from opioid use before you start naltrexone. If you have any opiate drugs in your system when you get your first dose, you could feel sudden withdrawal symptoms that can be serious enough to send you to the hospital.
If you have any opioid withdrawal symptoms, you will need to wait until they go away before you start naltrexone. Your doctor may give you a small dose of a shot called naloxone to test whether you still have a physical dependence on opioids.
If you have alcohol use disorder, you should not be regularly drinking at the time of your first dose and should be at a stage of recovery where you are able to avoid alcohol use.
To have the best chance of remaining sober with naltrexone, you should take part in other alcohol or drug recovery programs at the same time.
Naltrexone is not meant for children, and we don’t know whether it’s safe or works well for kids.
If you are pregnant or plan to become pregnant, or have liver problems, hemophilia, kidney problems, or any other medical conditions, tell your doctor and they will help you decide whether you should take naltrexone.
Can You Breastfeed While Using Naltrexone?
There isn’t much data on how extended-release naltrexone affects breast milk. Naltrexone taken by mouth has been found in breast milk, but in small amounts that probably don’t affect the baby. One case study reported that a 6-week-old breastfed baby had a very low amount of naltrexone in their system that was transferred from the milk and that the baby was not harmed by it.
Some experts believe the benefits of breastfeeding outweigh the chance of naltrexone hurting the baby.
You should discuss your decision whether to breastfeed while on naltrexone with your doctor. Each person’s situation is different, and your doctor can help you make the best decision for you and your baby.
How Long Does Naltrexone Last?
Extended-release naltrexone (Vivitrol) lasts for about 4 weeks. You receive one shot a month at your medical provider’s office.
How Long Does It Take For Naltrexone to Start Working?
Naltrexone starts to work shortly after you get the shot. The drug first peaks in your bloodstream about 2 hours after you get it, and it’s designed to slowly release over the next month or longer.
Is Naltrexone Addictive?
Naltrexone does not create a reward response in your brain, so it doesn’t make you crave it or depend on it. It isn’t addictive, and there’s no chance of it being abused.
How Do You Get Naltrexone?
Your doctor must prescribe naltrexone for you, and a health care provider must prepare and give you the shot.
Is It OK to Take Other Medications While on Naltrexone?
Naltrexone shouldn’t impact your ability to take other medications, but you should tell your doctor about any other medications you use.
Because naltrexone blocks opioids from affecting your body, it will interfere with any opioid pain management your doctor may normally prescribe if you have surgery or get injured while you’re on naltrexone. You should carry a card with you explaining that you are on naltrexone. There are non-opiate medications that you can use instead.
Some prescription cough medications contain opioids, and naltrexone will prevent them from working. There are many choices for cough medicine and pain management that you can use instead.
Can You Drink While on Naltrexone?
It won’t hurt you to drink alcohol while on naltrexone any more than when you’re not on the medication. Naltrexone lowers your desire for alcohol, but it does not block the effects of alcohol on your body. You still will feel the physical and mental effects of drinking.
The medication may lower your desire to continue drinking more if you do have a drink.
What Are the Potential Side Effects of Naltrexone?
Naltrexone is considered safe to use with few side effects.
Some of the more common and minor side effects you may have while on naltrexone include:
- Nausea (usually only after your first shot)
- Sleepiness
- Headache
- Dizziness
- Vomiting
- Lowered appetite
- Painful joints
- Muscle cramps
- Cold symptoms
- Trouble sleeping
- Toothache
Because naltrexone could make you dizzy or sleepy, you shouldn’t drive a car, operate machinery, or do anything dangerous until you know how it affects you.
There are a few serious potential side effects that you should know about before you take naltrexone. These include:
- Risk of opioid overdose. This can happen if you try to overcome the opioid-blocking effects of naltrexone by taking a large amount of opiate drugs. It can also happen if you stop naltrexone or miss a dose and then use opioids. You will be more sensitive to lower amounts of opioids after being on naltrexone than before treatment.
- Serious reaction at the spot where you got the injection. Tell your doctor right away if you notice any concerning problems around where you got your shot, including intense pain, blisters, an open wound, large area of swelling, a dark scab, or if the area feels hard. Talk to your doctor if you have a reaction that gets worse with time or doesn’t get better within 2 weeks.
- Sudden opioid withdrawal. If you have any opioids in your body when you get your first shot, you could have sudden symptoms of opioid withdrawal, which can be serious.
- Depression. You or someone close to you should call your doctor right away if you notice any signs of depression.
- Pneumonia. An allergic reaction to naltrexone can cause a certain type of pneumonia. Tell your doctor right away if you have shortness of breath, wheezing, or coughing that doesn’t go away.
- Serious allergic reaction. Get medical help right away if you have a skin rash, trouble breathing, wheezing, chest pain, dizziness, faintness, or swelling of your face, eyes, mouth, or tongue.
Naltrexone can cause liver damage or hepatitis. Tell your doctor if you have:
- Pain in your stomach area that lasts more than a few days
- Dark urine
- Yellowing of the whites of your eyes
