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Medication Management
Vivitrol
Vivitrol
We offer medication assisted treatment for alcohol and opioid dependence, combining medication and counseling services and monitoring usage over time as recommended by best-practice models. Vivitrol is an injectable medicine that can help you with alcohol and opioid dependence after you stop drinking alcohol or undergo detoxification. Treatment with Vivitrol makes your relapse prevention plan more effective.
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What is Vivitrol?
Vivitrol is a prescription injectable medicine that can help block the effect of opioid, such as heroin or opioid pain medicines, and prevent relapse to opioid or alcohol dependence*. It is administered by deep gluteal injection every four weeks or once a month. Our healthcare providers can help you decide if Vivitrol is right for you.
If you are trying to stop drinking or taking opioids, Vivitrol could be the right solution for you. Vivitrol must be used together with a recovery program, such as counseling, to be effective and it is required that you stop drinking or using opioids before you start receiving Vivitrol.
*It is not known if Vivitrol is safe and effective for children.
How Does It Work?
Vivitrol contains an opioid antagonist called Naltrexone that blocks opioid receptors and decreases the euphoric effects of opioids and alcohol. The dosage of Vivitrol is administered once a month as intramuscular injection in the buttocks. Since Vivitrol is non-narcotic, there is no potential for misuse.
Compliance Benefits
Choosing the shot versus the pills has considerable benefits when it comes to compliance since there is no way to remove Vivitrol from the body after the shot is administered. Additionally, most people experience no side effects from Vivitrol and those who do only report mild to moderate symptoms, including nausea, headache, depression, anxiety, and fatigue.
Side Effects
Depressed mood
Serious allergic reactions
Dizziness
Muscle cramps
Nausea and vomiting
Cold symptoms
Sleepiness
Decrease appetite
Toothache
Pneumonia
Headache
Painful joints
Suicidal thoughts
Suicidal behaviors
Dosage & Administration
Administration Requirements
- Must be prepared and administered by a healthcare provider
- Must only be administered as a deep intramuscular gluteal injection
- The recommended dose of Vivitrol is 380mg
Pre-Treatment Requirements
A minimum of 7-10 days opioid-free prior the initiation of Vivitrol is recommended to avoid precipitation of opioid withdrawal.
Important Facts
The second peak is around 2-3 days later
Concentration slowly declines around 14 days after dosing
Peak naltrexone plasma concentration is around 2 hours after injection
Total naltrexone exposure is three to four-fold higher in a single dose of Vivitrol 380mg compared to daily oral dosing of 50 mg
Significant Risks
- Risk of opioid overdose
- Severe reaction at the injection site
- Sudden opioid withdrawal
- Liver damage
- Hepatitis
Benefits
- Easy to administer
- Long acting
- No risk of abuse
- Little to no side effects
- No addictive
- Proven to be effective
- Does not cause withdrawals
Co-Pay Savings Program
Some patients may qualify for a co-pay or deductible expense up to $500/month. The patient must be 18 years or older, have a prescription for Vivitrol, have commercial health insurance or pay with cash.
Exclusions
Patients use federal or state healthcare programs, including Medicare Part D or Advantage plans, Medicaid Managed Care or Alternative Benefit Plans under the Affordable Care Act, Medigap, Veterans Administration, Department of Defense, TRICARE, State-funded programs are not eligible for saving programs. Other terms and conditions may apply.
This is only a summary of the most important information about Vivitrol.
Important Medical Information:
Contraindication
If you are using or have a physical dependence on opioid-containing medicines or opioid street drugs, such as heroin, do not use Vivitrol. Tell your healthcare provider if you have liver problems, hemophilia, kidney problems, or any other medical conditions. Call 9-1-1 or get emergency medical help right away in all cases of known or suspected opioid overdose, even if naloxone is administered.
Indications
Vivitrol is recommended for patients who are unable to abstain from alcohol or opioid use.
Contraindications
Vivitrol is not recommended if you are receiving opioid analgesics, have current opioid dependence or experiencing acute opioid withdrawal, have failed the naloxone challenge test, have a positive urine screen for opioids, have exhibited hypersensitivity to naltrexone or any other components of it diluent.
Vulnerabilities
After opioid detoxification, patients are likely to have a reduced tolerance to opioids. Therefore, any use of previously tolerated doses of opioids could result in the potentially life-threatening opioid intoxication, such as respiratory compromise or arrest, circulatory collapse, etc.
Side Effects
Vivitrol injections may be followed by pain, tenderness, induration, swelling, erythema, bruising, pruritus; and severe reaction in some cases. The side effects seen most frequently in association with Vivitrol therapy for alcohol dependence include nausea, vomiting, injection site reactions, arthralgia, arthritis, joint stiffness, muscle cramps, dizziness or syncope, sedation, anorexia, decreased appetite or other appetite disorders. The side effects seen most frequently in association with Vivitrol in patients with opioid dependence include hepatic enzyme abnormalities, injection site pain, nasopharyngitis, insomnia, and toothache. Cases of hepatitis, clinically significant liver dysfunction, depression, suicidality, pneumonia, anaphylaxis, and interference with laboratory tests have been observed.
Precipitations
Withdrawal may be participated abruptly by administration of an opioid antagonist to a patient with opioid dependence, which may require hospitalization. An opioid-free interval of 7-10 days is recommended. Patients transitioning from buprenorphine or methadone may be vulnerable to precipitated withdrawal for as long as 2 weeks.