Generic Name: naltrexone (injection) (nal TREX own)
Brand Names: Vivitrol
What is naltrexone injection?
Naltrexone blocks the effects of narcotic medicines and alcohol.
Naltrexone injection is used to treat addiction to alcohol or narcotic drugs. It is also used to prevent narcotic addiction relapse.
Naltrexone injection may also be used for purposes not listed in this medication guide.
What is the most important information I should know about naltrexone injection?
Do not use narcotic drugs or alcohol while you are being treated with naltrexone injection. Never try to overcome the effects of the medication by using large doses of narcotic drugs or alcohol. Doing so could result in dangerous effects, including coma and death. Ask your doctor before using any prescription or over-the-counter medicine to treat a cold, cough, diarrhea, or pain during your treatment with naltrexone injection. These medicines may contain narcotics or alcohol. Naltrexone injection may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
You may notice pain, redness, bruising, swelling, or a hard lump where the medication was injected. Call your doctor if you have this type of reaction to the shot, especially if it does not clear up or gets worse within 2 weeks.
Wear a medical alert tag or carry an ID card stating that you use naltrexone injection. Any medical care provider who treats you should know that you are receiving this medication.
Additional forms of counseling and/or monitoring may be recommended during treatment with naltrexone injection.
What should I discuss with my health care provider before receiving naltrexone injection?
Do not receive this injection if you are allergic to naltrexone, or if you have:
an addiction to narcotics;
a history of alcohol or narcotic drug use within the past 7-10 days; or
drug or alcohol withdrawal symptoms.
To make sure you can safely use naltrexone injection, tell your doctor if you have any of these other conditions:
- kidney disease;
- liver disease; or
- a bleeding disorder such as hemophilia.
FDA pregnancy category C. It is not known whether naltrexone injection will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether naltrexone injection passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How is naltrexone injection used?
Naltrexone injection is injected into a muscle. This injection is usually given once a month (every 4 weeks) and can be given only by a doctor or nurse in a clinic.
It is important to receive your naltrexone injections regularly to get the most benefit.
You may notice pain, redness, bruising, swelling, or a hard lump where the medication was injected. Call your doctor if you have this type of reaction to the shot, especially if it does not clear up or gets worse within 2 weeks.
Wear a medical alert tag or carry an ID card stating that you use naltrexone injection. Any medical care provider who treats you should know that you are receiving this medication.
Additional forms of counseling and/or monitoring may be recommended during treatment with naltrexone injection.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment to receive your naltrexone injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include nausea, stomach pain, dizziness, or seizure (convulsions).
What should I avoid while using naltrexone injection?
Naltrexone injection may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not use narcotic drugs or alcohol while receiving naltrexone injection. Never try to overcome the effects of the medication by using large doses of narcotic drugs or alcohol. Doing so could result in dangerous effects, including coma and death. Ask your doctor before using any prescription or over-the-counter medicine to treat a cold, cough, diarrhea, or pain while you are being treated with naltrexone injection. These medicines may contain narcotics or alcohol.
Naltrexone injection side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
blurred vision or eye problems;
fast heartbeat;
wheezing, difficulty breathing;
mood changes, hallucinations (seeing or hearing things), confusion, thoughts of hurting yourself;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
ear pain, ringing in your ears;
feeling light-headed, fainting;
skin rash or itching; or
pain, redness, bruising, itching, swelling, oozing, skin changes, or a hard lump where the medication was injected.
Less serious side effects may include:
feeling anxious, nervous, restless, or irritable;
increased thirst;
muscle or joint aches;
weakness or tiredness;
sleep problems (insomnia); or
decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Naltrexone Dosing Information
Usual Adult Dose for Alcohol Dependence:
Oral Tablets:
50 mg orally once a day
Extended-release injectable suspension:
380 mg every 4 weeks (or once a month) via intramuscular gluteal injection, alternating buttocks
Usual Adult Dose for Opiate Dependence:
Treatment should not be attempted unless the patient has remained free of opioids for at least 7 to 10 days. Opioid abstinence should be verified by analysis of urine for absence of opioids. The patient should not be manifesting withdrawal signs or reporting withdrawal symptoms. If there is any question of occult opioid dependence, perform a naloxone challenge test and do not initiate naltrexone therapy until the naloxone challenge is negative. The naloxone challenge test should not be performed in a patient showing clinical signs or symptoms of opioid withdrawal, or whose urine contains opioids. The naloxone challenge can be repeated in 24 hours.
Initial dose: 25 mg orally one time.
Maintenance dose: If no withdrawal signs occur, 50 mg orally once a day may be started.
Alternative dose schedules: (to improve compliance) 50 mg orally on week days and 100 mg orally on Saturday; or 100 mg orally every other day; or 150 mg orally every third day.
Extended-release injectable suspension: 380 mg every 4 weeks (or once a month) via intramuscular gluteal injection, alternating buttocks
What other drugs will affect naltrexone injection?
The pain-relieving effects of any narcotic pain medications you use will be blocked if you use them during your treatment with naltrexone injection. Harmful side effects could also occur.
Tell your doctor about all other medicines you use, especially:
buprenorphine (Buprenex, Subutex);
butorphanol (Stadol);
codeine (Tylenol with codeine);
hydrocodone (Lortab, Vicodin);
hydromorphone (Dilaudid);
levorphanol (Levo-Dromoran);
meperidine (Demerol);
methadone (Dolophine, Methadose);
morphine (Kadian, MS Contin, Roxanol);
nalbuphine (Nubain);
naloxone (Narcan);
oxycodone (OxyContin, Roxicodone, Percocet);
oxymorphone (Numorphan); or
propoxyphene (Darvon, Darvocet).
This list is not complete and other drugs may interact with naltrexone injection. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More naltrexone resources
- Naltrexone Side Effects (in more detail)
- Naltrexone Dosage
- Naltrexone Use in Pregnancy & Breastfeeding
- Drug Images
- Naltrexone Drug Interactions
- Naltrexone Support Group
- 17 Reviews for Naltrexone - Add your own review/rating
Compare naltrexone with other medications
- Alcohol Dependence
- Fibromyalgia
- Opiate Dependence
- Trichotillomania
Where can I get more information?
- Your doctor can provide more information about naltrexone injection.
See also: naltrexone side effects (in more detail)
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