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Vivitrol (naltrexone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to help prevent relapse to opioid dependence after a person has completed opioid detoxification.

How Vivitrol Works and How It’s Taken

Vivitrol is a type of medicine called an opioid antagonist. It blocks opioid receptors in the body, especially mu opioid receptors, which can reduce or block the effects a person feels from opioids.

Doctors prescribe Vivitrol when a person has completed opioid detoxification and needs help preventing relapse to opioid dependence. Before starting Vivitrol, a person should generally be opioid-free for at least seven to 10 days. Treatment with Vivitrol should also include counseling and other support.

Vivitrol is given as a deep injection into a muscle in the buttock. Vivitrol must be prepared and given by a healthcare provider. Do not try to inject Vivitrol yourself.

Typical Dosing for Prevention of Relapse to Opioid Dependence

The recommended dose of Vivitrol is 380 milligrams given as a deep injection into a muscle in the buttock every four weeks or once a month, alternating buttocks with each injection.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

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Vivitrol Side Effects

In a clinical study of Vivitrol, common side effects occurred in about 3 percent to 13 percent of people. These include:

  • Injection site pain
  • Increased liver enzymes on blood tests
  • Nasopharyngitis (coldlike symptoms)
  • Influenza (flu)
  • Insomnia (trouble sleeping)
  • Hypertension (high blood pressure)
  • Toothache
  • Headache

Serious Side Effects and Warnings

Vivitrol can cause serious side effects that may require immediate medical attention. These include:

  • Opioid overdose risk — After detoxification, opioid tolerance is lower. Overdose can happen if opioids are used near the end of a dosing interval, after a missed dose, or after stopping Vivitrol, and it can be fatal.
  • Severe injection-site reactions — These can include infection, cellulitis, abscesses, sterile abscesses, and necrosis (tissue death). Some reactions may require surgery and can cause scarring.
  • Precipitated opioid withdrawal — Sudden, severe withdrawal can occur if opioids are still in your system and may require hospitalization.
  • Liver injury — Hepatitis or other liver problems can occur.
  • Depression and suicidality — New or worsening depression, suicidal thoughts, or suicidal behavior can occur.
  • Eosinophilic pneumonia — This allergic-type pneumonia can cause shortness of breath, cough, or wheezing.
  • Serious allergic reactions, including anaphylaxis — Symptoms can include hives, swelling of the face or throat, or trouble breathing.

Get medical help right away if you think you are having a serious reaction.

If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or by using the online chat.

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How To Save on Vivitrol

Alkermes, the manufacturer of Vivitrol, offers the Vivitrol Co-pay Savings Program. Eligible people with commercial insurance may pay as little as $0 per prescription of Vivitrol.

To learn more, visit the Vivitrol Co-pay Savings Program or call 800-848-4876.

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What To Know Before Taking Vivitrol

Before starting Vivitrol, you should be opioid-free.

  • If you previously used short-acting opioids, you should usually be opioid-free for at least seven to 10 days before starting Vivitrol.
  • If you are switching from buprenorphine or methadone, you may still be at risk for sudden opioid withdrawal for up to two weeks.

Before starting Vivitrol, your healthcare provider may use a urine opioid test or a naloxone challenge test to help decide if it is safe for you to start Vivitrol.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Be sure to tell them about any medicine that contains an opioid.

Before taking Vivitrol, tell your healthcare provider if you:

  • Have liver problems
  • Have kidney problems
  • Have hemophilia or another bleeding problem
  • Use illicit drugs
  • Have any other medical conditions
  • Are allergic to naltrexone or any ingredient in Vivitrol
  • Are pregnant or plan to become pregnant
  • Are breastfeeding

Do not receive Vivitrol if you:

  • Are taking opioid pain medicines
  • Have a physical dependence on opioids
  • Are having opioid withdrawal
  • Have a positive urine opioid test
  • Have failed a naloxone challenge test
  • Have had an allergic reaction to naltrexone or certain ingredients in Vivitrol

Vivitrol may make you feel dizzy or sleepy. Do not drive, operate machinery, or do other dangerous activities until you know how Vivitrol affects you.

Vivitrol is also FDA-approved to treat alcohol dependence. People starting Vivitrol for alcohol dependence should be able to stop drinking before treatment and should not be actively drinking when they receive their first dose.

If you miss a dose, contact your healthcare provider and receive your next dose as soon as possible.

If you are pregnant, planning to become pregnant, or breastfeeding, talk with your healthcare provider about whether Vivitrol is right for you.

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Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Vivitrol for preventing relapse to opioid addiction?

In a 24-week study of people who had completed or recently completed opioid detoxification, people taking Vivitrol had more opioid-free weeks than people taking a placebo (an inactive treatment).

From week 5 through week 24, 36 percent of people taking Vivitrol stayed completely opioid-free at all weekly visits, compared with 23 percent of people taking a placebo. More people taking Vivitrol also stayed in the study than people taking a placebo.

How long does Vivitrol last for preventing relapse to opioid addiction?

Vivitrol is given every four weeks or once a month. It blocks the effects of opioids for about 28 days after each injection. After an injection, naltrexone levels in the blood reach an early peak at about two hours and a second peak about two to three days later.

The available information does not give a specific number of hours or days for when Vivitrol starts preventing relapse.

Does Vivitrol interact with other medicines?

Yes. Vivitrol can block the effects of medicines that contain opioids. For example:

  • Opioid pain medicines
  • Cough and cold medicines that contain opioids
  • Medicines for diarrhea that contain opioids

Because Vivitrol blocks opioid effects, these medicines may not work as expected while you are taking Vivitrol. Tell your healthcare provider about all medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.

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