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Vivitrol

Vivitrol is a long-acting injection medication that helps treat alcohol and opioid use disorders, and is the only approved drug to treat addiction that is not addictive.

Vivitrolis one of several drugs that helps treat opioid and alcohol use disorders. As public awareness about the harmful consequences of addictive disorders has increased, more information about medications to treat addiction is now available. The usage of theVivitrol shothas introduced a new set of potential advantages, as well as some new drawbacks.

What Is Vivitrol?

Vivitrol is the trade name for a long-acting injectable form (a shot) of the opioid reversal agentnaltrexone. It is approved by the United States Food and Drug Administration (FDA) for the treatment ofopioid use disordersandalcohol use disorders.

AVivitrol shottakes the action of naltrexone, which is an opioid blocker taken once per day orally, and extends that action for one full month. AVivitrol shot is used fortreatingopioid addiction— which is the most severe form of an opioid use disorder — and for treating alcohol dependence.

Background & History

Naltrexone, the active ingredient in Vivitrol, earned FDA approval for the treatment of opioid use disorders in 1984 and for the treatment of alcohol use disorders ten years later.

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Thepharmaceutical company Alkermesbegan clinical trials on an injectable form of naltrexone in the late 1990s. Throughout the 1980s and 1990s, studies showed that oral naltrexone was highly effective as a medication. However, adherence to prescribed oral naltrexone regimens was typically poor.

The injectable long-acting form of the medication appeared to sufficiently address the problem, because once the Vivitrol shot was taken, its chemical action could not be discontinued for at least one month.Vivitrol’s FDAapproval for the treatment of alcohol dependencecame in 2006, withVivitrol’s FDA approval for treating opioid dependencearriving four years later.

Use in Treating Addiction

An increasing number of substance use disorder recovery programs, psychiatrists and primary care offices have madeVivitrol treatmentprogramsavailable. A significant advantage to usingVivitrol treatment for opioid dependenceis that Vivitrol has no addictive potential.

However, there are significant drawbacks toVivitrol treatment, including:

  • Vivitrol tends to be more expensive than other medications approved for the same purposes
  • Vivitrol cannot be taken if a person has recently used opioids and is dependent on them
  • Vivitrol does not treat any alcohol ordrug withdrawal symptoms

Vivitrol for Opioid Addiction

Vivitrol can bean effective optionfor treatment of opioid use disorders, and the FDA has approvedVivitrol for opiate addiction treatment. However,what happens when you take opiates while on Vivitrol?

Vivitrol has the current distinction of being the only medication approved to treat opioid use disorders that does not have addiction potential. Unlikemethadone(andSuboxone, to a lesser degree), Vivitrol will not increaseoverdose riskif an opioid is taken with it. In fact, the opposite is true: the naltrexone in Vivitrol can causewithdrawal symptomsif a person who is physically dependent on opioids takes an opioid. Patients must therefore abstain from opioid use for one week before taking a Vivitrol injection.

Vivitrol and Alcohol Abuse

While it may be intuitive that a medication that opposes the action of opioids could be used to treat an opioid addiction,Vivitrol was first used to treat alcohol use disorders, with the FDA approving theVivitrol shot for alcoholdependence treatment in 2006.

Vivitrol was likely first used for this purpose because alcohol consumption activates the opioid receptors in the brain as well. Healthcare providers and treatment centers increasingly prescribeVivitrol for alcohol abuse treatment.However,Vivitrol alcohol treatmentdoes have a significant limitation in that it does not treatalcohol withdrawal.

How Vivitrol Works

Vivitrol is clearly useful in the treatment of opioid and alcohol use disorders, buthow does Vivitrol work?Vivitrol works through the action of its primary component drug, naltrexone. Naltrexone is a long-acting antagonist, or opposing force, of the body’s primary opioid receptors. This capability helps naltrexone deactivate the effects of opioids. Thus, naltrexone can be thought of in a similar way to naloxone, or Narcan.

The primary difference between naltrexone products like Vivitrol and naloxone products like Narcan is that naltrexone does not act immediately, and the opioid-opposing effects of naltrexone last much longer.

One primary difference between oral naltrexone and Vivitrol is inhow Vivitrol is administered. Vivitrol is administered as an intramuscular injection by a healthcare provider, whereas oral naltrexone is swallowed.

How Long Does Vivitrol Last?

The other primary difference between oral naltrexone and Vivitrol is how long the Vivitrol shot lasts in the body. Vivitrol injections are effective for up to one month, at which point they must be repeated.

How long Vivitrol lasts in the body generally stays consistent from person to person. After a Vivitrol injection, levels of naltrexone begin declining in the bloodstream after two weeks, though exactlyhow long the Vivitrol shot does lastis dependent upon several individual factors, like metabolism or genetic variation.

Vivitrol Side Effects

Taking Vivitrol can result in the same side effects as taking oral naltrexone. CommonVivitrol side effectsinclude:

  • Nausea
  • Headache
  • Nervousness
  • Restlessness
  • Irritability

Additionally, liver toxicity is a rare but serious potential complication when taking any naltrexone product.

Additionally, problems with the skin at or near the injection site, such as redness, swelling, itchiness or infection can occur with the Vivitrol injection.

Taking Vivitrol While Pregnant

Animal research with Vivitrol has shown that the drug can potentially cause minor harm to animal fetuses. Human trials with the drug have been inconclusive.

Decisions about whetherto take Vivitrol while pregnantmust be made with a health care provider’s guidance. Overall, whether it’s safe for an expectant mother to take Vivitrol depends on whether the potential benefits outweigh the risks.

How Effective Is Vivitrol?

Studies on oral Naltrexone show an average reduction of drinking days per monthby up to 50 percent, a moderate effect size in terms of a drug’s capabilities.

However, those studies had to take into account the tendency for people who are still in active addiction to not take these medications regularly. Government-funded studies of Vivitrol, which are considered the most reliable and unbiased information source, currently allow for the most accurate picture ofVivitrol efficacy.

Get More Information on Vivitrol

At The Recovery Village, Vivitrol is used as a maintenance medication (as medically appropriate) for people who have completed treatment for opioid addiction or alcohol addiction. If Vivitrol maintenance therapy is part of a client’s aftercare plan, they can receive a monthly dose of Vivitrol, in addition to attending follow-up medical and counseling appointments.

For more information on the use of Vivitrol:

If you or someone you know struggles with an opioid or alcohol use disorder and could benefit from treatment with Vivitrol or other interventions,call The Recovery Village. Our network is ready to help you embrace recovery. We can help you find balance, restoration and a sustainable path forward from addiction.

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Sources

Anton, R. “Naltrexone for the management of alcohol dependence.” New England Journal of Medicine, published in 2009. Accessed April 16, 2019.

U.S. Department of Health and Human Services. “FDA pregnancy categories.” United States Food and Drug Administration, last updated September 2017. Accessed April 17, 2019.

Alkermes, Inc. “Vivitrol Official health care professional site.” (n.d.) Accessed April 17, 2019.

Ndegwa, S. et al. “Injectable extended release naltrexone to treat opioid use disorder.” U.S. National Library of Medicine, 2016. Accessed April 17, 2019.

CenterWatch. “Vivitrol (naltrexone for extended-release injectable suspension)” April, 2006. Accessed April 30, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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