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Side Effects of Vivitrol

Side effects of Vivitrol include nausea, fatigue, headache, muscle aches, insomnia, depression, reduced appetite, and sexual dysfunction.[1]

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Vivitrol, a brand name for the drug naltrexone, can treat both opioid use disorder (OUD) and alcohol use disorder (AUD). When treating alcohol abuse, Vivitrol can block endorphin receptors in the body, making alcohol use less rewarding. It’s also known that the drug blocks the effects of opioid medications, which makes them less appealing to abuse. 

While Vivitrol has side effects, like all medications do, it isn’t a controlled substance.

Breaking Down the Side Effects of Vivitrol

Vivitrol is approved by the FDA for use in the treatment of both OUD and AUD, and it is generally considered safe. However, it still can have some notable physical, psychological, behavioral, and sexual side effects. This chart breaks down what to expect:[1-4]

Notable Side Effects
Physical Side EffectsNausea, sleepiness, headache, dizziness, vomiting, joint pain, muscle cramping, cold symptoms, trouble sleeping, and toothache
Psychological Side EffectsDepressed mood
Behavioral Side EffectsDecreased appetite
Sexual Side EffectsSexual dysfunction, especially in men

Physical Side Effects

Most side effects associated with Vivitrol or naltrexone are physical. This medication can cause joint pain, cramping, toothache, and general discomfort. It may make sleeping harder, while also making a person more tired. Furthermore, nausea, dizziness, and vomiting have been frequently reported.[1] 

Even though these symptoms are common, they should still be reported to a doctor if they seem severe, long lasting, or significantly impact your quality of life.[2]

Psychological Side Effects

It’s been reported that naltrexone can cause a depressed mood in users, which has the potential to be serious and warrants talking to a doctor.[2] There are scattered and mostly older reports of some individuals on naltrexone attempting suicide, although there doesn’t appear to be strong data on how common this is. 

As a general rule, it seems severe depression on this medication is uncommon. However, any lowering of mood should be considered serious enough that you should talk with a professional as soon as possible, especially if you think about self-harm or suicide.[2]

Behavioral Side Effects

There aren’t many behavioral side effects directly associated with Vivitrol use, although other side effects the medication can cause, such as lower energy levels and sexual dysfunction, may lead to behavioral changes as a result. Individuals on Vivitrol may experience a decreased appetite, eating less, although it isn’t entirely clear how much of this can be attributed to physical side effects like nausea.[2]

Sexual Side Effects

In one study of male patients receiving buprenorphine and naltrexone maintenance therapy for opioid dependence, it was found that about 90% of men on naltrexone reported at least one sexual dysfunction symptom.[3] Common symptoms included premature ejaculation, erectile dysfunction, and a reduction in sexual desire. 

A more general study of both men and women also linked sexual dysfunction to naltrexone treatment. The medication was found to reduce sexual urges in many study participants, blunt orgasm, and reduce respiration rate during masturbation.[4]

What Are the Short-Term vs. Long-Term Side Effects of Vivitrol?

In the short term and long term, there are a few effects (both positive and negative) to watch for when on Vivitrol.[2]

Short-Term EffectsLong-Term Effects
Reduced cravings to engage in alcohol and/or opioid useContinuing sobriety significantly easier with ongoing use of the medication
Some level of unwanted but not dangerous symptoms, including joint pain, cramping, and nauseaLikely a reduced tolerance for the drug of abuse, increasing a person’s risk of a fatal overdose if they don’t account for this in the event of a relapse
Potentially more serious, concerning symptoms, including severe mood changes, allergic reaction, or problems at the injection sitePotentially more serious symptoms, including those mentioned previously as well as liver damage

Short-Term Effects

In the short term, Vivitrol can cause some unwanted symptoms that can disrupt quality of life. If side effects occur, talk with your doctor about what is considered normal and what warrants real concern. 

Some common signs of a serious problem include rashes, swelling, scabs that don’t heal, and intense pain. Most people taking their medication as prescribed won’t experience these serious symptoms. Vivitrol is generally considered a safe prescription drug.

Long-Term Effects

In the long term, with continued treatment, you will likely find Vivitrol helps you avoid drug abuse. The medication is most effective when combined with other addiction treatments like cognitive behavioral therapy. 

As a result of avoiding opioid abuse, be aware that your tolerance for opioids will be lowered. If you relapse and immediately go back to your standard dose, that dose may cause an intense, life-threatening effect when it previously hadn’t. Overdose is more likely if relapse occurs, and this could be fatal.

The Need for Medical Supervision

Throughout the process of taking Vivitrol, pay attention for signs of any serious symptoms, which can occur at any point during treatment. Initially, the main concerns will likely be problems at the injection site, a serious allergic reaction, or a significant depressive mood change. Concerning symptoms that can manifest later include stomach area pain that lasts multiple days, dark urine, yellowing of the whites of the eyes, and severe tiredness, which can signal liver damage.[5]

As is always true with any treatment, any symptom that seems concerning should be reported to a doctor. If symptoms seem severe, call 911 or seek emergency medical treatment.

Updated April 10, 2024
Resources
  1. What Is Vivitrol? UAMS Psychiatric Research Institute. Accessed March 28, 2024.
  2. Naltrexone. Substance Abuse and Mental Health Services Administration. Published January 30, 2024. Accessed March 28, 2024.
  3. Ramdurg S, Ambekar A, Lal R. Sexual dysfunction among male patients receiving buprenorphine and naltrexone maintenance therapy for opioid dependence. The Journal of Sexual Medicine. 2012;9(12):3198-3204.
  4. Incoronato N, Biedermann SV, Roth L, Müller JC, Fuss J. The influence of opioid blockage on the sexual response cycle: A randomized placebo-controlled experiment with relevance for the treatment of compulsive sexual behavior disorder (CSBD). Psychoneuroendocrinology. 2023;147:105968.
  5. McDonough M, Crowley P. Naltrexone and liver disease. Australian Prescriber. 2015;38(5):150-151.
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