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Vivitrol for Alcohol Use Disorder

Vivitrol (the brand name of the generic drug naltrexone) is a monthly injection, which is used in the treatment of alcohol use disorder (AUD). This form of medication-assisted treatment (MAT) is meant to reduce cravings for alcohol, helping people to focus on the work they’re doing in therapy to build a healthier life.[1]

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The Basics of Vivitrol

Vivitrol (naltrexone) is an opioid antagonist, and it blocks the mu-opioid receptors in the brain. It changes how the adrenal gland, the hypothalamus, and the pituitary gland work together, suppressing the desire to drink alcohol. Vivitrol also blocks the pleasurable feelings that come with consumption of alcohol.[1] 

A Vivitrol dosage is injected into a person’s gluteal muscle (the three muscles that make up the buttocks). As an extended-release medication, Vivitrol gradually releases naltrexone (its main ingredient) into the body over the course of a month.[1]

This chart breaks down the basics about Vivitrol:[1] 

PurposeUsed for treating alcohol use disorder and opioid use disorder
InventionDeveloped by Alkermes, Inc.
FDA Approval Date2006
DosesAvailable as a monthly injection
Frequency of UseAdministered once a month

How Effective Is Vivitrol for Alcohol Use Disorder?

Vivitrol has been shown to be effective in managing AUD, as it can reduce the desire to drink.

The Therapeutics and Risk Management journal noted that “Vivitrol […] demonstrated efficacy at decreasing heavy drinking among alcohol-dependent males.”[2] Similarly, JAMA published the results of a study that found that Vivitrol “resulted in reductions in heavy drinking” among adults who participated in up to six months of therapy.[3] 

Another study, published in the American Journal of Psychiatry, yielded “impressive” results, where Vivitrol reduced drinking rates across the board: days and weeks with binge drinking, the number of drinks consumed, and reported cravings for more drinks.[4] The effects of Vivitrol among the study population were sustained at six months after treatment ended, with “quite high” rates of retention and engagement.[4] 

Other Benefits of Vivitrol

Other benefits of Vivitrol include contributing to the overall success rate of AUD treatment programs by reducing both cravings and the risk of relapse.[1] For this reason, Vivitrol is most effective when it is administered and used as part of a comprehensive treatment plan—one that includes components of behavioral therapy and counseling, peer-led support groups, and general lifestyle and environmental changes that are more conducive to sobriety and ongoing recovery. 

The Clinical Rheumatology journal also notes that naltrexone, in tablet form, is useful as an anti-inflammatory medication for chronic pain stemming from conditions like multiple sclerosis, Crohn’s disease, and fibromyalgia.[5] 

How Does Vivitrol Work? 

Vivitrol works by blocking key neurotransmitter receptors in the brain.[6] This, in turn, reduces cravings and diminishes the rewarding effects of alcohol or opioids. Vivitrol therapy typically begins after a person has completed detoxification and is no longer experiencing withdrawal symptoms from discontinuing their alcohol use. 

Side Effects of Vivitrol

Some of the common side effects associated with Vivitrol include nausea and vomiting, headache and dizziness, and reactions at the injection site. Allergic reactions and liver damage are also known to develop, but these side effects are quite rare.[7] 

Taking Vivitrol

Vivitrol has a half-life of about four hours.[8] After it is injected, it remains in the body for approximately 30 days, slowly decreasing in concentration over that time. 

Who Is Not a Candidate for Vivitrol?

People with allergies to naltrexone or any of the inactive ingredients in Vivitrol injections (carboxymethylcellulose sodium salt, polysorbate 20, and sodium chloride) should avoid taking it.[9]

Pregnant or breastfeeding women should not take Vivitrol. The safety of the drug during pregnancy or breastfeeding has not been tested.

Patients with severe liver issues may experience a buildup of naltrexone and the various inactive ingredients in their bodies since a compromised liver cannot effectively metabolize Vivitrol. As a result, patients with liver problems should not take Vivitrol.[7] 

Patients who are actively abusing alcohol or consuming opioids and are still physically dependent on either substance are not good candidates for Vivitrol. While Vivitrol will mitigate the euphoric effects of alcohol, it will not stop a person from becoming impaired if they drink. Someone drinking while on Vivitrol can become drunk without realizing it, deepening their AUD and potentially putting themselves and others at risk.[4] 

Unlike other medications for AUD, such as disulfiram, Vivitrol does not cause a severe reaction when combined with alcohol. However, some people may still experience headaches, dizziness, nausea, and flu-like symptoms. If you experience side effects, talk to your prescribing doctor.

FAQs About Vivitrol for Alcohol Use Disorder

These are some of the questions we hear most about Vivitrol:

Is Vivitrol the same as naltrexone?

Vivitrol is the brand name for the medication naltrexone. 

How is Vivitrol administered?

Vivitrol is administered via injection into the gluteal muscle (the buttocks) by a healthcare professional. 

Does Vivitrol cause weight gain?

Weight gain is not a common side effect of Vivitrol, but individual responses to Vivitrol (and any medication) will vary. If you are concerned about unwanted weight gain from Vivitrol, consult your doctor. 

Is Vivitrol a controlled substance?

Vivitrol is not a controlled substance. It was approved by the U.S. Food & Drug Administration for the treatment of alcohol use disorder in 2006. 

Can you experience Vivitrol withdrawal?

There is no documentation of withdrawal effects from discontinuing Vivitrol, but some people may experience mild side effects if they stop taking it. If you experience any concerning symptoms, consult your prescribing doctor promptly.

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated April 30, 2024
  1. Naltrexone. Singh D, Saadabadi A. StatPearls. Published 2020.
  2. Naltrexone long-acting formulation in the treatment of alcohol dependence. Johnson BA. Therapeutics and Clinical Risk Management. 2007;3(5):741-749.
  3. Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence. Garbutt JC, Kranzler HR, O’Malley SS, et al. JAMA. 2005;293(13):1617.
  4. Naltrexone and alcohol use. Avery J. American Journal of Psychiatry. 2022;179(12):886-887.
  5. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Younger J, Parkitny L, McLain D. Clinical Rheumatology. 2014;33(4):451-459.
  6. Chapter 4—Oral Naltrexone. Substance Abuse and Mental Health Services Administration (US); 2009.
  7. Naltrexone and liver disease. McDonough M, Crowley P. Australian Prescriber. 2015;38(5):150-151.
  8. Review of naltrexone, a long-acting opiate antagonist. Crabtree BL. Clinical Pharmacy. 1984;3(3):273-280.
  9. Naltrexone‐induced drug eruption. Heck J, Burda K, Hillemacher T, Bleich S, Stichtenoth DO, Groh A. Clinical Case Reports. 2020;8(10):2049-2050.
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