Understanding Vivitrol Side Effects: Health Implications to Consider

Vivitrol, more commonly known as naltrexone, is the brand name for the medication that blocks the effects of opioids. When taking this medication as directed, users can reduce the risk of opioid abuse. However, it is also used to treat alcohol use disorder.

Vivitrol is an extended-release formulation of naltrexone, approved by the Food and Drug Administration (FDA) in 2010. To date, it is the only approved medication for opioid dependence.[1]

While this opioid receptor antagonist offers many advantages during addiction treatment, there are common side effects of Vivitrol. These side effects can cause potential health implications that all users and healthcare providers must remain mindful of. Understanding these potential side effects can help individuals weigh the advantages and risks more effectively to make more informed decisions.

This guide covers the possible health implications of taking Vivitrol — but also highlights how it is a beneficial addition to many treatment plans.

The Advantages of Vivitrol for Addiction Treatment

Before assessing the potential side effects of Vivitrol, you should consider the role it plays during addiction treatment. The FDA has approved it for both opioid use disorder (OUD) and alcohol use disorders (AUD). While you can get naltrexone in a pill form, Vivitrol is offered as an injectable.

This formulation is taken once monthly (compared to the pill form, which is taken daily). For many, that is a benefit, as taking one dose a month is easier, ensuring greater compliance. It’s more likely to skip a daily pill than a monthly injection — especially if you’re working closely with your healthcare team.

When you take Vivitrol, it blocks the effects of opioids and alcohol, eliminating the “feel good” effects of being high or drunk. Studies report that Vivitrol is successful at decreasing heavy drinking among alcohol-dependent users. Data shows that taking Vivitrol vs. a placebo led to fewer heavy drinking days (11.7% vs 25.3%, respectively).[2]

When studying opioid use disorder, Vivitrol has been shown to decrease opioid abuse. However, many who start Vivitrol discontinue treatment prematurely, which reduces its full clinical potential. This medication also appears to be most effective when users have already fully detoxed from opioids.[3]

Vivitrol is non-addictive, so it does not cause withdrawal symptoms following discontinued use. However, there are some safety precautions and the possibility of both common and serious side effects. Patients must discuss their options with healthcare practitioners, although most are good candidates — especially those suffering from opioid addiction (and are serious about overcoming this substance use disorder). In 2022, over 80,000 opioid overdose deaths were recorded in the United States.[4] Vivitrol helps protect against overdose, contributing to the fight against the opioid epidemic.

Some of the core advantages of Vivitrol include:

• Vivitrol is easy to administer, and since it is only needed once a month, it is an ideal option for medication-assisted treatment (MAT). It is effective, does not cause withdrawal effects, and is intended when total abstinence is the goal.
• This shot is administered in a medical setting and has no potential for misuse, making it an ideal medication during treatment — especially since it is long-lasting. Once the shot is administered, individuals will experience the effects for 30 days, reducing the risk of non-compliance, which is much more likely when taking medication daily.
• Most patients respond well to this medication, experiencing minor Vivitrol shot side effects. However, although rare, more severe side effects can result following administration, as discussed below.

What Are the Side Effects of Vivitrol?

As reported by the FDA, adverse events do occur.

When treating alcohol dependence, ≥5% experience:[5]

• Nausea
• Vomiting
• Reactions at the injection site (swelling, nodules, etc.)
• Muscle cramps
• Dizziness
• Sedation
• Decreased appetite

When treating opioid use disorder, ≥2% experience:[5]

• Elevated liver enzymes
• Pain at the injection site
• Common cold symptoms
• Insomnia
• Toothache

Certain side effects, like nausea, tend to improve within a few days after the first injection and become less likely with future injections. If you experience any abnormal Vivitrol shot side effects, you must tell your physician or care team immediately.

Discussing your customized treatment plan with your healthcare team is important, especially if you have a pre-existing condition.

What About Serious Side Effects?

In some cases, Vivitrol does cause serious side effects.

These adverse effects include:[5]

• Severe reactions at the injection site, including intense pain, lumps, open wounds, and significant swelling. If an injection site reaction worsens or does not get better after two weeks, consult a healthcare professional.
• Liver damage or hepatitis, which is most commonly associated with a higher than recommended dose. This side effect is linked to stomach pain, dark urine, yellowing of the eyes, and tiredness.
• Risk of opioid overdose after vivitrol treatment stops or if you miss a dose, as you will become more sensitive to opioids if you discontinue use. If you take doses of opioids similar to those before treatment, you could experience an overdose.
• Some individuals have experienced severe allergic pneumonia, resulting in coughing that does not go away without treatment, wheezing, and shortness of breath.
• A depressed mood is possible, which can be troublesome for individuals living with depression or other mood disorders. If you have a dual diagnosis or a history of mental illness, discuss your concerns with your care provider.

Some users will also have mild allergic reactions, which should be discussed with healthcare professionals to ensure continued use. Serious allergic reactions, such as swelling and trouble breathing, require emergency attention. There have also been rare case studies where reactions surface 10+ days after the initial injection.[6]

The Risks of an Opioid Overdose When Taking Vivitrol

It is highly recommended that anyone taking Vivitrol communicate with family members and people that they are close to so that they know of the increased sensitivity to opioids and associated overdose risk.

When taking Vivitrol, although the medication does not cause an overdose directly, an accidental incident could occur. Since Vivitrol blocks the effects of opioids, some users may take excessive amounts of opioids when seeking a high. Unfortunately, coma or death can result. Those treated with Vivitrol also become more sensitive to opioids. If they relapse, they face a higher risk of an overdose.[7]

So, when there are complications, it is often when the next Vivitrol dose is due, when a dose of Vivitrol is missed, or when you discontinue treatment.

How to Avoid Side Effects of Vivitrol

It is important to follow the recommended dose when administering Vivitrol, which is 380 mg, delivered intramuscularly every four weeks. A healthcare professional should administer this injection, as it must be given intramuscularly — not intravenously or subcutaneously (which is under the skin).

Individuals who are at risk of complications are those:[5]

• Living with acute hepatitis or liver failure
• Taking opioid analgesics, like tramadol, methadone, or buprenorphine
• Who have previously shown hypersensitivity to naltrexone
• Taking excessive doses in a way other than intended by healthcare professionals

It is recommended that you tell your healthcare provider if you:

• Have liver problems or kidney issues
• Use illegal street drugs — disclosing doses
• Have bleeding issues
• Are pregnant, plan on becoming pregnant, or are breast-feeding
• Have any medical condition
• Are taking any other medications, including non-prescription medicines, vitamins, or herbal supplements

Being aware of the possible serious side effects of Vivitrol is critical, so treatment centers often provide a Vivitrol medication guide. One important consideration is the last time you used the substances you’re being treated for. For example, if you plan on beginning Vivitrol treatment, you must be completely opioid-free. The recommended period is seven to 14 days before you start using Vivitrol, or else you could experience symptoms of opioid withdrawal.[8]

Avoiding Opioid Withdrawal When Taking Vivitrol

Sudden opioid withdrawal can be severe. Some individuals must go to the hospital, so honesty with your care team is important. The same process applies to alcohol — you should stop drinking alcohol before your first injection. For those who have a physical dependence on medications or street drugs, like heroin, you can ask for the naloxone challenge test. A small injection will be administered to see if you experience symptoms of withdrawal before a full dose is given.

The most common symptoms of opioid withdrawal include:[7]

• Anxiety
• Sleeplessness
• Runny nose
• Shakiness
• Hot or cold flashes
• Fever
• Yawning
• Muscle aches
• Nausea
• Stomach cramping
• Vomiting
• Diarrhea

Want to learn more about how to support yourself or a loved one? Contact the team at Southeast Detox in Georgia to learn more about medical detox support and our residential treatment programs today!