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What is Vivitrol? How does naltrexone Vivitrol work?

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By Daisy Duddy
Jun 16, 2021

What is Vivitrol?

Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component. To date, there are three medications that are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. All brand name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolv. There are unique characteristics and side effects associated with each medication. This page focuses specifically on the brand name Vivitrol

Vivitrol is the brand name for naltrexone. The FDA approved the use of naltrexone to treat both alcohol use disorder (AUD) and OUD. Naltrexone comes in the form of a pill and in the form of an injection. The injection is specifically designed to treat OUD and prevent individuals from misusing opioids. Naltrexone (Vivitrol) is an extended-release, intramuscular injection. The injection is administered by a healthcare provider into the muscle of the buttocks every four weeks. Naltrexone (Vivitrol) should not be injected intravenously (into the vein) or subcutaneously (beneath the skin). 

Naltrexone has a clear role in the care of patients with alcohol use disorder (AUD). Evidence shows that the naltrexone injection helps patients struggling with AUD reduce the amount of alcohol they consume.

Brian Clear, MD, FASAM, Medical Director at Bicycle Health

How does Vivitrol work?

As previously mentioned, naltrexone is one of the three FDA-approved medications used to treat OUD. Unlike buprenorphine or methadone, naltrexone (Vivitrol) is not an opioid agonist. In fact, naltrexone is an opioid antagonist, meaning it binds and blocks the opioid receptors. By binding to the opioid receptors, naltrexone (Vivitrol) prevents opioids, like heroin or fentanyl, from producing a euphoric and/or sedative effect. As a result, naltrexone (Vivitrol) reduces opioid and alcohol cravings. Because naltrexone (Vivitrol) is an opioid antagonist, there is no risk of dependence or addiction. Similarly, there is no risk of withdrawal when an individual stops taking the medication. However, naltrexone (Vivitrol) presents certain side effects and conditions that individuals should be aware of and discuss with their healthcare provider. 

Individuals taking naltrexone (Vivitrol) are particularly vulnerable to opioid overdose should they return to using opioids. There are two reasons why this is: (i.) Individuals attempt to override the blocking effects of naltrexone (Vivitrol) by increasing the amount of opioids they take. This is extremely dangerous and can result in serious injury, coma, or death. (ii.) The blocking effect of naltrexone (Vivitrol) lasts for approximately four weeks. Opioid tolerance tends to lower after a month of blocked opioid receptors. This lower opioid tolerance means that an individual may be at risk of overdose should they return to using opioids in the same amounts used before starting naltrexone (Vivitrol).   

It is also important to understand when to start naltrexone (Vivitrol). An individual must be opioid-free for a minimum of 7 - 10 days before starting naltrexone (Vivitrol) treatment. Naltrexone (Vivitrol) will cause sudden opioid withdrawal if it is administered too soon after the last opioid intake. This sudden opioid withdrawal is often referred to as “acute abstinence syndrome” or “precipitated withdrawal.” To avoid sudden opioid withdrawal, an individual should have no opioids in their system, including prescribed MOUDs containing buprenorphine or methadone. 

Learn more

Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.

Picture courtesy of Fotoblend on Pixabay

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