Jeffrey Panko NP Psychiatry · Patient education
Naltrexone
Generic tablets / Vivitrol monthly injection
A guide for adults taking naltrexone.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Oral tablets and a monthly deep intramuscular injection have different initiation and adherence plans. Vivitrol is administered by a healthcare professional.
What it is used for
Naltrexone treats alcohol use disorder and helps prevent return to opioid use after detoxification. It works alongside counseling and recovery support. It does not treat acute alcohol or opioid withdrawal.
How it works
It blocks opioid receptors, reducing the rewarding effects of alcohol for some people and blocking opioid effects. It does not provide opioid-like effects itself.
What to expect over time
Track drinking, cravings, recovery goals, and adverse effects over weeks and months. Oral treatment for alcohol use disorder and injection initiation have different abstinence considerations; follow your specific plan.
Taking your medication
- Before starting, disclose every opioid. A minimum opioid-free interval is usually 7–10 days after short-acting opioids; methadone or buprenorphine can require longer. Your provider determines readiness.
- Take oral doses on the agreed schedule; food may help nausea. Do not double a missed dose.
- Keep injection appointments and call promptly if one is missed.
- Carry medication information for emergency pain treatment. Do not try to override blockade with extra opioids.
When to get help
Emergency symptoms. Call 911 for suspected overdose, slow breathing, collapse, or a severe allergic reaction. Severe precipitated opioid withdrawal also needs urgent medical care.
Prompt medical advice. Report liver symptoms, worsening injection-site reactions, severe depression, or persistent vomiting promptly.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Nausea, abdominal discomfort, or reduced appetite
- Headache, dizziness, or fatigue
- Injection-site pain or swelling with Vivitrol
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Your provider may check liver tests. Report jaundice, dark urine, or upper abdominal pain. Watch injection sites for worsening pain, hardening, blisters, or skin breakdown.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss current opioid use, withdrawal, liver disease, kidney disease, depression, and planned surgery.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Opioid pain, cough, and diarrhea medicines may not work normally and can trigger serious problems. Emergency opioid treatment requires specialist monitoring.
Review medicines that can injure the liver. Naltrexone does not make drinking harmless or prevent alcohol withdrawal.
Everyday tips
Make an emergency pain-treatment plan and tell dentists about naltrexone.
Keep recovery support and opioid-reversal medicine available.
Your questions answered
Why is overdose risk higher after stopping?
Opioid tolerance falls. A previously tolerated amount can become fatal after stopping, missing an injection, or near the end of an injection interval. Keep opioid-reversal medicine available.
Is a return to drinking a reason to quit treatment?
Contact your provider to review the plan. Do not abandon care or change doses on your own.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.