- Addiction & recovery
Vivitrol Side Effects

Nzinga Harrison
June 29, 2021

Vivitrol is an injectable form of naltrexone approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD) and alcohol use disorder (AUD). Vivitrol is used as part of comprehensive maintenance treatment to decrease the risk of relapse. This medication is injected intramuscularly into the buttocks once a month by a healthcare provider.
Vivitrol contains naltrexone as an active ingredient and belongs to the opioid antagonist (inhibitor) class of drugs. This medication possesses a low potential for misuse due to its non-addictive and non-narcotic nature. It’s prescribed for individuals who have abstained from opioids for at least 7-14 days. However, Vivitrol can be used by individuals who are actively using alcohol. People who use Vivitrol along with counseling and therapy have a 90% chance of maintaining abstinence.
How Does Vivitrol Work?
Vivitrol helps people tackle substance use disorder in a variety of ways. Vivitrol reduces cravings by altering the way the brain responds to the effects of alcohol when used as part of alcohol addiction treatment. It blocks the endorphins released by alcohol from binding to their receptors. Although there may be a few signs of intoxication, the pleasure of drinking will be considerably low when alcohol is taken while on Vivitrol.
When used as part of an opioid dependence treatment program, Vivitrol works by directly attaching itself to the opioid receptors in the brain and blocking other effects of opioids from interacting with them. This reduces cravings and the risk of a relapse. And as such, Vivitrol is a more effective treatment option for opioid use disorder than for the treatment of alcohol addiction.
Vivitrol isn’t a complete cure for opioid dependence or alcohol use disorder. It’s merely a medication used in conjunction with other elements of a comprehensive treatment program to help individuals in recovery avoid relapses, reduce cravings, and maintain long-term abstinence.
How Long Vivitrol Stays In Your System
The length of time Vivitrol stays in your system is determined by many factors, such as:
- Metabolism
- Weight
- Age
- Gender
- Medical history
- Levels of exercise
Vivitrol effects timeline:
- The active ingredient in Vivitrol, naltrexone, will hit its first peak two hours after injection.
- The medication will peak once again two to three days after injection.
- Naltrexone levels begin to decline seven days after injection.
Who Should Not Receive Vivitrol?
Vivitrol is an effective medication for opioid and alcohol maintenance treatment, but it may not be the best choice for certain people.
Vivitrol is not recommended for people who are:
- Receiving opioid analgesics for medical conditions.
- Actively using illicit opioids.
- Undergoing opioid withdrawal.
- Allergic to naltrexone, polylactide-co-glycolide (PLG), carboxymethylcellulose, or any other ingredients used in Vivitrol.
- Diagnosed with severe liver disease or hepatitis.
Consuming opioids or opioid-containing medications while on Vivitrol can lead to serious injury, coma, or death. So make sure to inform your healthcare provider of your medical history and current use of any opioids.
Common Side Effects of Vivitrol
Vivitrol is generally well-tolerated. However, it does carry some risk of side effects. Some of the common side effects of Vivitrol are:
- Nausea
- Vomiting
- High blood pressure
- Headache
- Dizziness
- Stomach pain
- Muscle cramps and muscle aches
- Joint pain
- Insomnia
- Tiredness
- Anxiety
- Loss of appetite
- Nervousness
- Decreased sex drive
- Irritability
Inform your healthcare provider if the side effects persist or worsens. Your physician can decrease your dosage or provide you with an alternative medication.
Serious Side Effects of Vivitrol
Vivitrol can cause severe side effects in certain people, including the risk of severe injection site reactions. According to the Food and Drug Administration (FDA), symptoms of injection site reactions includes:
- Cellulitis
- Induration
- Hematoma
- Abscess
- Sterile abscess
- Necrosis
Most of such injection site reactions are usually mild and disappear on their own. However, certain adverse reactions, such as tissue death, can require surgery.
Other serious side effects of Vivitrol can include depressed mood, pneumonia (cough, shortness of breath, and wheezing), liver damage, and severe allergic reaction.
Depression caused by Vivitrol can sometimes turn severe and lead to suicidal behaviors and thoughts. As such, it’s important to seek medical attention if you feel sad, hopeless, helpless, or have thoughts of suicide or self-harm.
Other Risks of Vivitrol Treatment
According to the FDA Center for Drug Evaluation and Research (CDER), Vivitrol is safest for people who maintain an opioid-free period of at least 7-14 days before receiving Vivitrol treatment. When Vivitrol is taken while under the influence of other opioids, it will remove the drugs from their receptors and stop their effects abruptly. This can cause Sudden Opioid Withdrawal Syndrome (SOWS) and trigger effects such as:
- Sweating
- Fever
- Chills
- Diarrhea
- Vomiting
- Shaking
- Body pain
- Sleeping troubles
- Hot or cold flushes
- Restlessness
- Goosebumps
- Blurred vision
- Runny nose
Another potential risk of Vivitrol is the risk of an opioid overdose. Accidental opioid overdose can take place in two ways:
- Since Vivitrol blocks certain brain receptors once administered, attempting to overcome this blockade by consuming large amounts of opioids can lead to an overdose.
- The Vivitrol treatment makes you sensitive to the effects of lower doses of opioids due to a period of abstinence. And as such, consuming the same dose as before treatment can lead to an overdose.
Overdoses can be fatal in most instances, so it’s recommended that you seek immediate medical attention when experiencing an overdose.
Medications to Avoid During Vivitrol Treatment?
Other medications, such as prescription and over-the-counter medications, vitamins, and herbal products, can interact with naltrexone. Vivitrol is known to interact with a total of 312 medicines.
Vivitrol may interact with medications such as:
- Warfarin
- Enoxaparin
- Codeine
- Hydrocodone
- Abilify
- Albuterol
- Clonidine
- Cymbalta
- Fluoxetine
- Gabapentin
- Suboxone
- Wellbutrin
Such interactions may change how Vivitrol works or increase the risk of serious side effects. Hence it’s important to keep track of the medications being currently used and communicate it to healthcare professionals before undergoing Vivitrol treatment.
If you are seeking help with your loved one’s addiction, contact us today or complete our quick contact form below, to speak with an addiction treatment specialist.
If you need help with your substance use disorder, we are here to help you build your confidence and momentum towards the future you want. We provide treatment services for adults with alcohol, opioid, and other substance use disorders. We are currently located in Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas, and Washington.
Eleanor Health
Recovery for life
Our mission at Eleanor Health is to help people affected by addiction live amazing lives. We deliver whole-person, comprehensive care and are passionate about transforming the quality, delivery, and accessibility of addiction & mental health treatment. Our actions are rooted in respect for each member's values, culture, and life experiences, and our commitment to their wellbeing is unwavering and without judgement.
Reach out today
781-487-1070All fields marked with an asterisk (*) are required.