If you’re considering medication-assisted treatment, you may be wondering if Vivitrol is safe. This extended-release injectable suspension has become an increasingly common option for treating opioid and alcohol use disorder. This article explores what you need to know about Vivitrol’s safety profile, potential side effects, and how to minimize risks during treatment..
What Vivitrol Does in Your Body
Vivitrol works by blocking opioid receptors in your brain, preventing substances from producing the euphoric effects that fuel addiction. You’ll receive this extended-release medication as a monthly injection in your buttock muscle. The medication doesn’t produce a “high” or create physical dependence, making it fundamentally different from other treatment options.
Even with medications like Vivitrol available, many people who could benefit from them never receive medication-based care. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only about 17% of people with opioid use disorder received medications for treatment in the past year, despite strong evidence that these approaches improve outcomes. This treatment gap is one reason medications like Vivitrol are increasingly used as part of comprehensive, medically supervised recovery plans.
Safety Steps Before Starting Vivitrol
Preparing for your first Vivitrol injection requires careful planning with your treatment team. You’ll usually need to be opioid-free for at least 7–10 days (and sometimes up to two weeks, especially after buprenorphine or methadone) before starting Vivitrol. Taking Vivitrol with opioids still in your system triggers severe precipitated withdrawal that can be medically dangerous.
This waiting period protects you from withdrawal symptoms far more intense than normal. Once you start treatment, the opioid blocking effects prevent standard pain medications from working. You’ll need medical alert identification so emergency responders know they cannot use opioid analgesics to treat your pain.
Medical Conditions Your Provider Needs to Know About
Your complete medical history determines whether Vivitrol is appropriate for you. Certain conditions require extra monitoring or may make treatment unsafe:
- Current or previous liver disease or impaired liver function
- Kidney problems that affect medication processing
- History of depressed mood, suicidal thoughts, or mental health disorders
- Bleeding disorder or blood-thinning medication use
- Recent head injury or brain conditions
Be transparent about all medical conditions during your assessment. Your healthcare provider will order baseline liver function tests before suggesting Vivitrol as part of your treatment plan.
How Other Medications Interact With Vivitrol
Drug interactions represent an important safety consideration when taking Vivitrol. The medication blocks opioid receptors, creating challenges if you need pain management.
| Medication Type | Interaction Risk | What You Need to Know |
| Opioid Pain Relievers | Cannot use | Codeine, hydrocodone, morphine, and other opioid analgesics will not work while taking Vivitrol |
| Mental Health Medications | Monitor closely | Some medications may work differently; your provider will adjust doses if needed |
| Blood Thinners | Extra monitoring | Inform your provider if you have a bleeding disorder or take anticoagulants |
| Over-the-Counter Pain Relief | Safe alternatives | Non-opioid options like acetaminophen or ibuprofen can be used for pain management |
Every healthcare provider you see needs to know you’re receiving Vivitrol treatment. The FDA warns that attempting to overcome the medication’s blocking effects with large amounts of opioids can result in serious injury or fatal overdose.
Considerations for Different Populations
Vivitrol affects different groups in ways that require special attention from your healthcare team. Pregnant women or those planning pregnancy need careful discussion about risks and benefits. It’s not known whether Vivitrol passes into breast milk, though oral naltrexone has been found to, so pregnancy/breastfeeding decisions should be individualized with a provider. Limited research exists on Vivitrol’s effects during pregnancy.
Mental health considerations are equally important when evaluating treatment options. The prescribing information warns clinicians to monitor for depression or suicidal thinking in people receiving Vivitrol shots. Your treatment team will monitor you closely if you have a history of mental health disorders.
Serious Side Effects and When to Seek Medical Attention
While most people tolerate Vivitrol well, certain severe reactions require immediate attention. Recognizing these warning signs ensures you receive appropriate care quickly.
Severe Injection Site Reactions
Beyond typical tenderness, some people develop complications that indicate infection or tissue damage. Contact your doctor immediately if you notice increasing warmth, spreading redness, or drainage from the injection site. Severe pain that worsens or hardness extending beyond the immediate area may signal problems needing evaluation.
Allergic Reaction Warning Signs
A serious allergic reaction constitutes a medical emergency requiring immediate attention. Symptoms include difficulty breathing or swallowing, severe rash spreading across your body, swelling of your face or throat, or chest pain with rapid heartbeat. Call 911 rather than waiting to contact your regular healthcare provider.
Liver Damage and Liver Problems
Your liver processes Vivitrol, making function monitoring critical throughout treatment. You may be required to undergo baseline tests before starting and periodic monitoring during treatment. Watch for dark urine resembling tea, yellowing skin or eyes, severe stomach pain in the upper right area, or unusual fatigue with decreased appetite.
Monitoring Your Safety During Treatment
Regular check-ins with your healthcare provider form the foundation of safe treatment. Monthly injection appointments create natural opportunities to discuss concerns or health changes. These visits allow your treatment team to track progress and identify potential problems early.
Your provider will order periodic blood tests to monitor liver function. If you notice chest pain, unexplained weight gain, persistent nausea, or other troubling symptoms between appointments, contact your healthcare provider immediately.
Frequently Asked Questions About Vivitrol Safety
Is naltrexone a high-risk medication?
Naltrexone, the active ingredient in Vivitrol, is not considered high-risk when used appropriately. However, it requires careful monitoring for liver problems and can cause serious complications if taken before completing opioid withdrawal. Your healthcare provider will assess whether you’re a suitable candidate based on your medical history and current health status.
What are the risks of taking Vivitrol?
The main risks include severe injection site reactions, liver damage, allergic reactions, and precipitated withdrawal if opioids remain in your system. You also face increased sensitivity to opioids after treatment ends, making relapse potentially fatal. Mental health side effects like depressed mood or suicidal thoughts require close monitoring throughout Vivitrol treatment.
What to avoid while on Vivitrol?
Avoid all opioid medications, including prescription pain relievers and heroin, as Vivitrol blocks their effects, and attempting to override this can cause overdose. You should also avoid alcohol use during treatment. Always inform healthcare providers about your Vivitrol injections before any medical procedures or emergency treatment to prevent complications.
The Bottom Line: Weighing Vivitrol’s Benefits and Risks
So, is Vivitrol safe? For most people with opioid use disorder or alcohol use disorder, the answer is yes when administered properly under medical supervision. Your decision about starting Vivitrol should involve a thorough discussion with your treatment team and consideration of your complete medical history. With the right support system and careful monitoring, Vivitrol can be a safe, effective tool in your recovery journey when combined with evidence-based therapies.
If you’re considering Vivitrol as part of your recovery, we’re here to support you. At New Chapter Recovery, we provide evidence-based outpatient addiction treatment, including Vivitrol MAT and flexible PHP, IOP, and outpatient programs designed to address both substance use and mental health needs. To learn more or get started, visit our contact page to speak with our team.
