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Vivitrol

This content was written by: Justin Baksh, LMHC, MCAP, Chief Clinical Officer

vivitrol-logo, Vivitrol, Foundations Wellness CenterOne of the biggest barriers to overcoming addiction is the body’s continued cravings for drugs. Those cravings persist in early recovery, the time that is most vulnerable to relapse. A study published in the Journal of the American Medical Association found the first six months to be the most critical.

Enter Vivitrol. Vivitrol reduces cravings and prevents relapse. Combining it with counseling and social support offers a significantly better chance of completing addiction treatment and establishing a solid foundation in recovery.

Vivitrol is administered as a part of Foundations Wellness Center’s MAT (medication assisted treatment) program, along with counseling, biofeedback, neurofeedback, social support and more. Our clients and their families often have questions regarding the medications used in our MAT program. Following are answers to the most commonly asked ones that we receive about Vivitrol.

What is Vivitrol and how does it work?

Alkermes, Inc., manufactures Vivitrol (generic name, naltrexone). A non-addictive, extended release medication, Vivitrol is given by a healthcare professional via intramuscular gluteal injection once a month.

As an opioid antagonist, Vivitrol blocks the effects of opioids. It does this by binding to opioid receptors, preventing them from being activated.

Vivitrol also blocks the pleasurable effects of alcohol, although the exact mechanism by which it does this is unknown.

Vivitrol should not be given alone, but administered along with comprehensive addiction treatment with counseling and psychosocial support.

Naltrexone, the active ingredient in Vivitrol, also comes in pill form under the brand name Revia. Revia is a daily medication, typically prescribed at 50 milligrams per day. As with any daily medication, compliance can be an issue: Sometimes it is hard to remember to take your pill. Your healthcare provider can also order a higher dose of Revia be taken every few days, at their discretion.

Revia has not been proven to be beneficial therapeutically unless it is delivered as part of an addiction treatment plan.

Naltrexone also comes in the form of an implant that is inserted under the skin and lasts from two to six months. However, the FDA has not approved the implant for use in the United States.

When was Vivitrol approved by the FDA?

Vivitrol was approved by the FDA to treat opioid dependence on October 13, 2010. It had previously been approved for alcohol dependence on April 13, 2006.

Is Vivitrol a controlled substance?

No, Vivitrol is not a controlled substance.

Is Vivitrol a narcotic?

No, Vivitrol is not a narcotic.

Does Vivitrol work?

Vivitrol helps people who are addicted to alcohol or opiates in a variety of ways.

First, while on Vivitrol, those who take an opioid or drink alcohol will not feel their euphoric effects. Because users cannot achieve a “high” while taking opioids or drinking alcohol, they are much less likely to relapse.

When it comes to opioid recovery, a clinical study comparing treatment with Vivitrol with counseling versus counseling alone found that those who received both experienced:

  • A 55% decrease in cravings
  • A 17 times reduced likelihood of relapse
  • A higher likelihood of staying in treatment longer (Over 50% were still opioid-free at 168 days, versus 50% dropping out by 96 days)

When it comes to alcohol, Vivitrol has much the same results. A study of alcohol dependent patients in an outpatient setting found that:

  • Subjects treated with 380 milligrams of Vivitrol per month (the standard dose) and psychosocial support were able to achieve a greater reduction in heavy drinking days (five or more drinks for men, four or more drinks for women) than those not given Vivitrol.
  • Patients who did not drink for a week prior to their first 380-milligram Vivitrol dose also had greater reductions in drinking days (heavy or not) and were more likely to stay sober throughout their treatment.

How soon can I take Vivitrol?

Opioid-dependent patients should wait at least seven to 10 days – and until they have successfully completed opioid medical detox – before starting Vivitrol treatment, as per Vivitrol’s prescribing information. Starting Vivitrol too soon can cause severe and sudden (precipitated) opioid withdrawal.

If used to treat alcohol addiction, you should stop drinking and successfully complete alcohol detox before starting Vivitrol. In fact, Vivitrol’s prescribing information indicates that it should be used only by those who are able to stay sober in an outpatient setting prior to initiating treatment with Vivitrol.

Using cocaine with Suboxone also increases overdose risk. Because Suboxone is a depressant, it blunts cocaine’s stimulating effects. Users wrongly feel they can use more cocaine and can wind up overdosing.

Does Vivitrol help with withdrawal?

Vivitrol is indicated for use after opioid and alcohol detoxification, which is when the most acute withdrawal phase occurs. It does help reduce the cravings characteristic of the post-acute withdrawal stage, however.

How long does Vivitrol last?

Vivitrol’s half-life – the time it will take to eliminate half of the drug from your system – is five to 10 days. In general, about five half-lives are needed to completely eliminate a drug from your body. Therefore, Vivitrol can still be present in your system anywhere from 25 to 50 days.

The recommended dosing schedule for a Vivitrol shot is 380 mg every four weeks.

Who can administer Vivitrol?

Any healthcare provider that is licensed to prescribe medications can prescribe Vivitrol. You may need to inform your provider in advance that you are seeking Vivitrol treatment, as it must be administered by a healthcare professional and they may need to order it for you.

How is the Vivitrol shot given?

The Vivitrol shot is injected by a healthcare professional intramuscularly, via the gluteal muscles. Alternating buttocks should be used each time Vivitrol is administered.

Under no circumstances should Vivitrol be delivered intravenously (through the veins) or subcutaneously (under the skin).

If a dose is missed, the next dose should be given as soon as possible.

What are the side effects of Vivitrol?

As with any medication, Vivitrol treatment does carry a risk of side effects. They include the following. The list below includes side effects or adverse events discovered during clinical trails or afterward, in the post-marketing surveillance period (at least two years after its release on the market):

    • Risk of Opioid Overdose Following Treatment

Vivitrol treatment reduces your opioid tolerance. This means that, after treatment, if opioids are used, there is a greater risk of accidental overdose. For example, patients may try to use the same amount of opioids they did before treatment, and their lowered tolerance can lead to overdose.

Using opioids after a missed dose can also lead to overdose.

Attempting to overcome Vivitrol with opioids can also lead to fatal overdose. Overcoming the Vivitrol barrier with large amounts of opioids can bring on a sudden, life-endangering opioid intoxication.

    • Reaction at Injection Site

Self-administration of Vivitrol is not recommended. Instead, Vivitrol must be prepared and administered by your treatment provider.

One reason why is so is the possibility of an injection site reaction, which may be severe in some cases, even requiring surgery.

Let your healthcare provider know immediately if any of the following occurs at the injection site:

          • Hardening of the area
          • Severe pain
          • Swelling
          • Blistering
          • Lumps
          • Formation of an open wound or a dark scab

Your provider should also know about any other reaction you experience at the injection site, especially if it worsens or doesn’t improve within two weeks.

    • Hypersensitivity

Hypersensitivity reactions have been reported with Vivitrol treatment.

These reactions can include anaphylaxis, a severe allergic reaction that involves the entire body. With anaphylaxis, there is a danger of anaphylactic shock, a condition in which blood pressure suddenly drops and airways narrow.

Anaphylaxis can occur within minutes and up to half an hour or longer after exposure (or, in this case, injection). Signs include:

          • Low blood pressure
          • Hives, itching, flushing, going pale or other skin reaction
          • Tightening of your airways
          • Swollen throat or tongue
          • Wheezing or trouble breathing
          • Rapid, weak pulse
          • Fainting/dizziness

If anaphylaxis occurs, an epinephrine injection can be administered by your healthcare provider. A follow-up trip to the emergency room is recommended after the epinephrine shot is administered. If you are on your own and do not have access to epinephrine shot, go to directly to the emergency room.

    • Precipitated Opioid Withdrawal

The minimum time from last opioid use to starting Vivitrol is seven to 10 days.

There is a danger of precipitated (sudden, intense) opioid withdrawal that may require hospitalization if Vivitrol treatment is started before opioids are out of your system.

The minimum time from last opioid use to starting Vivitrol is seven to 10 days.

There is a danger of precipitated (sudden, intense) opioid withdrawal that may require hospitalization if Vivitrol treatment is started before opioids are out of your system.

A negative urine test for opioids is not sufficient for ensuring a patient is free of opioids. In this case, a naloxone challenge test can be administered if your healthcare provider feels there is a risk of precipitated withdrawal.

    • Hepatotoxicity

Both hepatitis and “clinically significant” liver dysfunction have occurred during Vivitrol treatment. It is recommended that treatment with Vivitrol be suspended with any signs of acute hepatitis. Let your healthcare provider know if you experience any of the following symptoms of hepatitis while on Vivitrol:

          • Sudden nausea or vomiting
          • Fatigue
          • Joint Pain
          • Muscle Pain
          • Loss of appetite
          • Abdominal pain/discomfort (beneath your ribs on your upper right side, especially)
          • Fever (low-grade)
          • Intense itching
          • Dark-colored urine
          • Bowel movements that are clay-colored (pale or light)
          • Yellowing of the whites of your eyes or skin

Vivitrol treatment is not indicated for use in patients with liver failure or acute hepatitis. Those with acute liver disease should notify their healthcare provider, who should carefully weigh the hepatotoxic effects of Vivitrol with any perceived benefit.

It has been noted that excessive doses of Naltrexone (the active ingredient in Vivitrol) can cause injury to liver cells.

    • Depression & Feeling Suicidal

While taking Vivitrol, you should let your healthcare provider know about any signs of depression or suicidal thoughts you may have.

Signs of clinical depression include:

          • Trouble with concentration, decision-making, or recalling details
          • Loss of interest in things you used to enjoy
          • Persistent feelings of sadness, feeling empty or anxious
          • Feelings of guilt, hopelessness, helplessness, worthlessness and pessimism
          • Insomnia, sleeping too much, or early morning wakefulness
          • Restlessness
          • Fatigue
          • Irritability
          • Loss of appetite or overeating
          • Aches and pain that do not go away
          • Problems with digestion that do not improve with treatment
          • Thoughts of suicide or suicidal attempts
    • Rapid accumulation of white blood cells in the lungs (Eosinophilic pneumonia)

In clinical trials for Vivitrol, a diagnosed and a suspected case of eosinophilic pneumonia occurred, both of which required hospitalization. Both cases resolved after antibiotic and corticosteroid treatment.

Seek immediate medical attention if you develop shortness of breath or other pneumonia symptoms while taking Vivitrol. Symptoms of pneumonia include:

          • Shortness of breath
          • Coughing, may produce phlegm
          • Pain in the chest when breathing or coughing
          • Fever
          • Sweating
          • Shaking Chills
          • Fatigue
          • Nausea, diarrhea or vomiting

Adults 65 or over may experience:

          • Lower than normal temperature (may also occur in those with weakened immune systems)
          • Confusion/changes in mental awareness
    • Blood and Lymphatic System Disorders

Increases in white blood cell count have been reported with Vivitrol treatment. High white blood cell counts are typically seen when the body is  working to fight an infection. High white blood cell counts could also be a sign of stress, whether physical or emotional.

Swollen lymph nodes (lymphadenopathy) and inflammation of a gland in the neck (cervical adenitis) have also been reported with Vivitrol use.

    • Cardiac Disorders

The following cardiac conditions have been reported with Vivitrol treatment:

          • Angina Pectoris (chest pain or discomfort caused by coronary heart disease)
          • Angina Unstable (chest pain or discomfort caused by inadequate blood flow through the heart)
          • Atrial Fibrillation (irregular or “quivering” heartbeat)
          • Cardiac Failure Congestive (heart muscle not pumping blood as well as it should)
          • Coronary Artery Atherosclerosis (plaque buildup in the arteries that supply the heart with blood)
          • Myocardial Infarction (heart attack)
          • Palpitations (heart beating too hard, too fast, fluttering, or feeling like it has skipped a beat)
    • Eye Disorders

Blurry vision and conjunctivitis (commonly called pink eye) have been reported with Vivitrol use.

    • Gastrointestinal Disorders

A range of GI problems have been reported in those receiving Vivitrol treatment:

          • Abdominal discomfort
          • Colitis (inflammation of the tissues that line the large intestine)
          • Constipation
          • Flatulence (buildup of gas in the digestive system)
          • Gastroesophageal reflux disease (acidic fluids or food back up into the esophagus from the stomach)
          • Gastrointestinal hemorrhage (digestive tract bleeding, which may show in stool or vomit)
          • Hemorrhoids
          • Acute pancreatitis (sudden inflammation of the pancreas)
          • Paralytic Ileus (blockage of the intestines without a physical obstruction)
          • Perirectal abscess (pus collection near the anus)
    • General Disorders and Administration Site Conditions

The following have been reported in Vivitrol patients:

          • Chest pain
          • Chest tightness
          • Chills
          • Facial swelling (Face Edema)
          • Irritability
          • Lethargy
          • Fever (Pyrexia)
          • Rigors (shivering associated with fever)
    • Gallbladder, Bile Ducts or Bile Disorders (Hepatobiliary Disorders)

The following conditions have been observed and/or reported with Vivitrol use:

          • Acute cholecystitis (inflammation of the gallbladder)
          • Cholelithiasis (gallstone formation)
    • Immune System Disorders

Seasonal allergy and hypersensitivity reactions have been reported with the use of Vivitrol.

Hypersensitivity reactions include angioneurotic edema (swelling beneath the skin) and urticaria (rash consisting of round, red welts that itch and can be accompanied by swelling).

    • Infections and Infestations

The following have also been reported in patients treated with Vivitrol:

          • Bronchitis
          • Gastroenteritis
          • Laryngitis
          • Pneumonia
          • Sinusitis
          • Tooth abscess
          • Upper respiratory tract infection
          • Urinary tract infection
          • Advanced HIV disease (in HIV-infected patients)
    • Weight Changes

Both weight gain and weight loss have been reported in Vivitrol patients.

    • Metabolism and Nutrition Disorders

Some Vivitrol patients have experienced the following:

          • Increased appetite
          • Dehydration
          • Heat exhaustion
          • Hypercholesterolemia (High cholesterol)
    • Musculoskeletal and Connective Tissue Disorders

The following side effects affecting the muscles, bones, ligaments, tendons and connective tissues have also been reported in Vivitrol patients:

          • Joint stiffness
          • Muscle spasms
          • Myalgia (aches and pains in muscles, ligaments, soft connective tissue of the muscles, organs, bones, tendons and facia)
          • Limb pain
    • Nervous System Disorders

The following nervous system disorder symptoms have been observed and/or reported in Vivitrol patients:

          • Cerebral arterial aneurysm (brain aneurysm)
          • Convulsions
          • Disturbance in attention
          • Dysgeusia (distorted sense of taste)
          • Mental impairment
          • Migraine
          • Ischemic stroke
          • Paresthesia (burning or prickling sensations, usually in the hands, feet, arms or legs)
    • Pregnancy, Puerperium, and Perinatal Conditions

A type of miscarriage in which the fetus dies or doesn’t form, yet the embryonic tissues and placenta remain in the uterus, has been reported with Vivitrol use.

    • Psychiatric Disorders

The following psychiatric disorders have been observed and/or reported in Vivitrol patients:

          • Abnormal dreams
          • Agitation
          • Alcohol withdrawal syndrome
          • Euphoric mood
          • Delirium
          • Decreased libido (sex drive)

Rxlist also includes “impotence” and “difficulty having an orgasm” as two side effects of Vivitrol.

    • Respiratory, Thoracic (Chest), and Mediastinal (Membrane separating the lungs) Disorders

The following chest, lung and breathing symptoms were observed and/or reported with Vivitrol treatment:

          • Chronic obstructive pulmonary disease (COPD)
          • Dyspnea (Trouble breathing)
          • Pharyngolaryngeal pain (pharynx and larynx pain)
          • Sinus congestion
    • Skin and Subcutaneous Tissue Disorders

The following adverse effects affecting the skin and tissues below the skin were reported with Vivitrol patients.

          • Night sweats
          • Pruritus (itchy skin)
          • Increased sweating
    • Vascular Disorders

The adverse vascular system effects below have been noted/observed in patients taking Vivitrol:

          • Deep venous thrombosis (blood clot in a vein deep inside the body)
          • Hot flushes
          • Pulmonary embolism (sudden blockage of a lung artery)
    • Increase in Eosinophil (a type of white blood cell) Count

Increases in eosinophil counts were noted during clinical trials for those taking Vivitrol versus placebo. Over several months, with continued Vivitrol use, eosinophil counts returned to a normal level.

    • Decreased Platelet (Blood Cells that Aid in Clotting) Count

Decreased platelet count was noted with 380-milligram doses of Vivitrol.

In alcohol dependent patients, Vivitrol patients experienced a mean decrease of 17.8 × 103 /µL versus 2.6 × 103 /µL for those on placebos during clinical trials.

In opioid-dependent patients, Vivitrol patients experienced a mean decrease of 62.8 × 103 /µL versus 39.9 × 103 /µL for those taking a placebo during clinical trials after 24 weeks of Vivitrol treatment.

Vivitrol was not found to be associated with an increase in “bleeding-related adverse events” in controlled, randomized trials.

    • Elevations in Certain Liver Enzyme Levels

Elevated ALT, AST, and GGT levels have been associated with Vivitrol treatment, especially in populations who have Hepatitis C and/or HIV.

ALT (alanine aminotransferase) is an enzyme mostly found in the liver. Higher than normal ALT levels can indicate liver disease. Very high levels of more than 10 times the normal level can be found in acute hepatitis.

AST (aspartate aminotransferase) is an enzyme that is found in your muscles and, mostly, in the liver. If the liver suffers damage, it can release AST into the bloodstream. High levels may indicate liver disease (cirrhosis, hepatitis, mononucleosis, etc.), pancreatitis, or heart problems.

Gamma-glutamyl transferase (GGT) is also an enzyme. It can be found in many organs, but is most highly concentrated in the liver. Elevated GGT levels can indicate damage to or a disease affecting the liver or the bile ducts.

Alcohol-Dependent Patients

Elevated AST (aspartate aminotransferase) levels were found in 1.5% of Vivitrol patients with an alcohol addiction in short-term, controlled trials.

This percentage is similar to that of oral naltrexone patients and slightly higher than the incidence occurring with those on a placebo of 0.9%.

Opioid- Dependent Patients

In a controlled trail of opioid-dependent subjects, 89% of whom had Hepatitis C and 41% had HIV, elevated ALT, AST, and GGT levels were observed frequently and more common in those receiving the standard dose of Vivitrol (380 milligrams) versus those receiving a placebo.

(It should be noted that patients were excluded from the trail if they had ALT or AST levels three times the upper normal limit prior to Vivitrol treatment).

Twenty percent of Vivitrol patients in this study experienced an increase of more than three times the upper limit of normal for transaminases levels, versus 13% of placebo patients.

          • A mean maximal increase of ALT levels of 61 IU/L were reported in Vivitrol patients in the study, versus 48 IU/L in placebo patients.
          • A mean maximal increase of AST levels of 40 IU/L were reported in Vivitrol patients in the study, versus 31 IU/L in placebo patients.
          • An increase in AST to over three times the upper, normal limit was also more commonly seen in the Vivitrol arm (14%) versus the placebo arm (11%).

Symptoms of liver damage also include:

          • Nausea and vomiting
          • Weight loss
          • Feeling weak
          • Fatigue
          • Frequent itching
          • Abdomen swelling and/or pain
          • Leg or ankle swelling
          • Yellowing of the skin and eyes (jaundice)
          • Dark urine and/or light stool
    • Abnormal Creatinine Phosphokinase Levels

Creatine phosphokinase (CPK) is an enzyme that can found in your brain, muscles and heart. CPK can get into your bloodstream through damaged muscle. High levels point to heart or muscle injury and/or stress.

Eleven percent of Vivitrol patients experienced an increase in CPK to abnormal levels versus those receiving a placebo (8%) in short-term, controlled trials studying alcohol-dependent patients.

Sixteen percent of alcohol-dependent patients receiving Vivitrol treatment for over six months had an increase in CPK levels, in open-label trials. While the most frequent increases were in the one to two times the upper limit of normal, increases as high as 35 times the upper limit of normal were reported. The incidence of CPK increases to three times the upper limit of normal or higher were the same in the Vivitrol and placebo groups.

In opioid-dependent patients receiving Vivitrol treatment, nearly two in five (39%) experience increases in CPK to abnormal levels compared to placebo patients (32%). Increases as high as 41.8 times the upper limit or normal the placebo group and 22.1 times the upper limit of normal in the Vivitrol treated group.

Some side effects can be more prevalent in those addicted to opioids versus alcohol. Case in point, here are the results from clinical trials in alcohol dependent patients versus a Russian study on opioid dependent patients.

    • Retinal Artery Occlusion With Other Intramuscular Drug Products Containing Polylactide-co-glycolide (PLG) Microspheres

Retinal artery occlusion has been reported when another PLG microsphere-containing drug is injected during Vivitrol treatment. This event has occurred with abnormal arteriovenous anastomosis (abnormalities in a vessel shunting blood from an artery to a vein and bypassing a capillary).

During clinical trials and post-marketing surveillance, no retinal artery occlusions were reported.

Vivitrol should be injected into the gluteal muscle (intramuscular injection). Caution must be taken so that Vivitrol is not injected into a blood vessel.

Adverse Effects in Alcohol-Dependent Patients

For patients being treated for alcohol dependence, the following side effects occurred in 5% or more of patients and more frequently in Vivitrol versus placebo patients during clinical trials:

          • Nausea (29% versus 11% placebo)
          • Any injection site reaction (65% versus 50%)
            • Injection site induration (30% vs. 8%)
            • Injection Site tenderness (45% vs. 39%)
            • Injection site pruritus (8% versus 0%)
            • Asthenic conditions (20% versus 12%)
            • Injection site pain (13% versus 7%)
            • Other injection site reaction (primarily nodules, swelling) (12% versus 4%)
          • Dizziness, syncope (13 versus 4%)
          • Insomnia (13% versus 2%)
          • Arthralgia, arthritis, joint stiffness (9% versus 1%)
          • Anorexia, appetite decreased NOS, appetite disorder NOS (11% versus 3%)
          • Abdominal pain (11% versus 4%)
          • Vomiting (12% versus 6%)
          • Muscle cramps (5% versus 1%)
          • Somnolence, sedation (5% versus 1%)
          • Diarrhea (13% versus 10%)
          • Rash (6% versus 3%)
          • Headache (21% versus 18%)
          • Anxiety (10% versus 8%)
          • Pharyngitis (13% versus 11%)
          • Depression (5% versus 4%)
          • Back pain, stiffness (6% versus 5%)
          • Dry mouth (5% versus 4%)

Please note that the incidence of the above side effects differed by Vivitrol dose. The numbers above reflect overall incidence.

It’s also important to know that most of the Vivitrol treated patients in this clinical trial experienced “mild” or “moderate” intensity of these side effects.

In those treated for Vivitrol for alcohol dependence for six months or less in clinical trials, nine percent had to discontinue treatment due to side effects.

Adverse Effects in Opioid Dependent Patients

In a long-term U.S. study, side effects were similar among both those addicted to opioids and those with an alcohol addiction.

Another study conducted in Russia showed the following side effects occurring in 2% of more of Vivitrol-treated, opioid-dependent patients at an incidence rate greater than that of the placebo-treated patients:

          • Aspartate Aminotransferase Increased (higher level of an enzyme mostly found in the liver and heart) (10% versus 2% placebo)
          • Alanine Aminotranferase Increased (higher level of an enzyme mostly found in the liver and kidneys)(13% versus 6%)
          • Nasopharyngitis (upper respiratory infection) (7% versus 2%)
          • Insomnia (6% versus 1%)
          • Gamma-glutamyltransferase increased (higher level of an enzyme found in the body highest concentration is in the liver) (7% versus 3%)
          • Injection Site Pain (5% versus 1%)
          • Hypertension (High Blood Pressure) (5% versus 3%)
          • Toothache (4% versus 2%)
          • Influenza (5% versus 4%)
          • Headache (3% versus 2%)

The intensity of all side effects in this study were rated as “mild” or “moderate.”

In opioid-dependent subjects, two percent had to drop out due to side effects. However, this percentage was the same in those being treated with a placebo.

Overall, nine percent of Vivitrol patients versus seven percent of placebo patients stopped treatment because of side effects in controlled trials lasting six months or less. Reasons leading to Vivitrol patients dropping out were:

        • Injection site reaction (3%)
        • Nausea (2%)
        • Headache (1%)
        • Pregnancy (1%)
        • Suicide-related events (0.3%)

For more information, see Vivitrol’s full prescribing information.

What does Vivitrol cost?

Your final cost for Vivitrol depends on whether you have insurance and if you take advantage of Vivitrol Co-Pay Savings Program or other prescription savings programs.

The retail cost ranges from $1,518 at Walmart to $2,726 at CVS Pharmacy,  according to GoodRx.com as of July 2020. The price with a GoodRx coupon is $1,377.07.

Vivitrol Co-pay Savings Program “covers up to $500/month of co-pay or deductible expenses for eligible patients with a Vivitrol prescription. You can learn more by visiting Vivitrol’s site. According to the website:

“A patient with a prescription for Vivitrol for alcohol or opioid dependence who is 18 years or older is eligible for the Vivitrol Co-pay Saving Program card. Eligible participants include: Patients with commercial health insurance, patients paying cash. Patients using federal or state healthcare programs to purchase their Vivitrol prescription or not eligible, including Medicare, including Medicare Part D or Medicare Advantage plans, Medicaid, Medigap, VA, Tricare, Department of Defense, state-funded programs.”


How do you reverse Vivitrol?

Vivitrol’s blockade can be overcome. It is strongly recommended that you do not try to do this, however. Taking large amounts of opioids in an attempt to break through Vivitrol is extremely dangerous and can result in fatal overdose.

The high concentration of opioids in the blood that will immediately kick in once Vivitrol is overpowered can be life-endangering, causing respiratory arrest and a collapse of the circulatory system.

If there is a need for pain management, during an emergency situation, for example, suggested alternatives are:

      • Regional analgesia
      • Conscious sedation using benzodiazepine
      • Non-opioid analgesics
      • General anesthesia


Can you use drugs while on Vivitrol?

You should not take opioids, sedatives, alcohol, tranquilizers or illicit drugs while on Vivitrol.You will not feel the pleasurable effects of opioids or alcohol while taking Vivitrol. While taking Vivitrol, you may feel the effects of any medicine that contains opioids. This includes cough and cold medication, pain relieving medicines, and anti-diarrheal preparations.

However, there is still a risk of overdose if the Vivitrol barrier is overcome.

Vivitrol’s prescribing instructions indicate that there haven’t been any clinical studies evaluating drug interactions with Vivitrol. Healthcare providers are instructed to weight the risks versus the benefits of using Vivitrol and other prescription medications.


What do the Vivitrol reviews say?

As of July 6, 2020, reviews of Vivitrol on drugs.com are 7.7 out of 10 with 106 ratings from 117 user reviews. Drugs.com states that these reviews “may be helpful, but are no substitute for the expertise, knowledge and judgement of healthcare practitioners.”

Vivitrol users have rated it 4.54 stars for effectiveness, 4.46 for ease of use, and 4.33 for satisfaction on WebMD.


Does Vivitrol show on a drug test?

No, Vivitrol will not show up on typical drug tests used by employers and others. Employers can choose to use a special test for Vivitrol, but many do not choose to do so. Even in the event that Vivitrol is tested for, and you are positive, you have a good reason to be taking it, and can get a note from your healthcare provider if need be.

According to medlineplus.gov, drugs most commonly tested for are:

  • Opioids
  • Marijuana
  • Amphetamines
  • Cocaine
  • Barbiturates
  • Steroids
  • PCP (Phencyclidine)

Vivitrol is not an opioid. You you will not test positive for opioids (or any of the above listed drugs) due to your Vivitrol treatment.


What are Vivitrol contraindications?

Vivitrol is not right for everyone.

Vivitrol is contraindicated in the following patients:

  • Those who are currently taking opioid analgesics
  • Those currently dependent on opioids
  • Those who are in acute withdrawal from opioids
  • Any who fails the naloxone challenge test
  • Anyone who tests positive for opioids in a urine screen
  • Those who have experienced hypersensitivity to naltrexone, carboxymethylcellulose, PLG or any other diluent components.

In addition, the Vivitrol manufacturer recommends caution in using it in patients with moderate to severe renal (kidney) impairment. Vivitrol has not been evaluated in patients who have severe hepatic (liver) impairment.

If you have moderate to severe renal impairment or severe hepatic impairment, please be sure to inform your physician prior to beginning Vivitrol treatment.

Vivitrol’s safety and effectiveness has not been established in children nor in geriatric patients.

No reproductive and developmental studies have been done for Vivitrol. It is considered a Pregnancy Category C drug, meaning that there have been no “adequate” studies in humans completed on Vivitrol, but studies in animals have shown adverse effects on the unborn fetus. If you are pregnant, the risks versus the potential benefits of Vivitrol treatment must be carefully weighed by your physician.


Does stopping Vivitrol cause withdrawal?

Although starting Vivitrol too soon after taking opioids can bring on precipitated withdrawal, there is no withdrawal period after stopping Vivitrol.


Can you overdose on Vivitrol?

Since Vivitrol is administered by a healthcare provider, you will only receive your prescribed dose. There is a risk of opioid overdose if you try to take the same amount of opioids you have in the past while on Vivitrol. This is because Vivitrol lowers your tolerance. You should also not take large amounts of opioids in an attempt to overcome the Vivitrol blockade, as this can also lead to overdose.


Vivitrol Treatment in Port St. Lucie, Florida

When it comes to addiction, there is no magic cure. However, Vivitrol is an invaluable tool in helping people recover from opioid or alcohol addiction. When administered as a part of a MAT (medically assisted treatment) program with counseling, psychological and social support, the chances of long-lasting sobriety are greater.

Midway between Orlando and West Palm Beach, along the Treasure Coast of Florida, Foundations Wellness Center is an addiction treatment center offering Vivitrol as a part of its MAT (medication assisted treatment) program.

Along with Vivitrol, clients receive individual and group counseling with Master’s level clinicians, neuro-psych testing, biofeedback, neurofeedback, yoga, massage and chiropractic sessions, sports/gym, nutritional classes with a Registered Dietitian, offsite excursions and more.

By living in a nearby sober living home, clients develop the skills they need to one day live on their own. Fellow residents offer support while a live-in house manager provides supervision and accountability. After treatment, clients can opt to continue living in the sober home for as long as is needed to solidify their new, addiction-free lives.

Vivitrol is a powerful tool that can help you get from where you are now to where you need to be. The time is now, don’t put it off another day.

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