Naltrexone Injection Treatment
WHAT IS NALTREXONE?
Naltrexone is a prescription injectable medicine used to treat alcohol dependence, and to prevent relapse to opioid dependence, after opioid detoxification. You should stop drinking before starting Naltrexone. To be effective, treatment with Naltrexone must be used along with other alcoholism or drug recovery programs such as counseling. Naltrexone may not work for everyone. Naltrexone has not been studied in children under the age of 18 years.
How does Naltrexone work?
Naltrexone blocks the opioid receptor (it is an antagonist to the receptor) and prevents any effects of opiates. It offers no stimulation of the receptor (agonist activity) and thus has no pain properties. There are NO cravings and your head is clear. You will be given a shot each 4 weeks. There is a test dose to determine that you are opioid free before you begin treatment on the day you start. Naltrexone works well also as after care from Suboxone treatment.
WHO SHOULD NOT TAKE NALTREXONE?
Do not take VIVITROL if you are using or have physical dependence on opioid street drugs, such as heroin, or opioid-containing medicine, such as prescription pain medicine. You must not take opioid-containing medicines or opioid street drugs for 7 days before you start taking Naltrexone. You should not take Naltrexone if you have opioid withdrawal symptoms or are allergic to Naltrexone or any of the ingredients in the liquid used to mix Naltrexone (diluent). Click here to read the full medication guide to find out more about opioid withdrawal symptoms and to see a complete list of ingredients in Naltrexone and the diluent.
SERIOUS SIDE EFFECTS
SEVERE REACTIONS AT THE SITE OF INJECTION
Some people on Naltrexone treatment have had severe reactions at the site of injection (injection site reactions), including tissue death (necrosis). Some of these injection site reactions have required surgery. Call your doctor right away if you have any of the following things happen at your injection site: intense pain, the area feels hard, large area of swelling, lumps, blisters, an open wound or dark scab.
LIVER DAMAGE OR HEPATITIS
Naltrexone, can cause liver damage (including liver failure) or hepatitis, if you take more than the recommended dose. Tell your doctor if you have any of the following symptoms of liver problems during treatment with Naltrexone: stomach area pain lasting more than a few days, dark urine, yellowing of the whites of your eyes, or tiredness. Your doctor may need to stop treating you with Naltrexone if you get signs or symptoms of a serious problem.
RISK OF OPIOID OVERDOSE
If you have used opioid-containing medicines or opioid street drugs in the past, you may be more sensitive to lower doses of opioids after Naltrexone treatment stops, when your next Naltrexone dose is due or if you miss a dose of Naltrexone. Using opioids in amounts you used before treatment with Naltrexone can lead to overdose and death. You may not feel the usual effects if you use or abuse heroin and other illegal (street) drugs while on Naltrexone. Do not take large amounts of opioids, including opioid-containing medicines, such as prescription pain pills, or heroin, to overcome effects of Naltrexone. This can lead to overdose including serious injury, coma, or death. You may not feel the usual effects of opioid-containing medicines including medicines for pain, cough and diarrhea while on VIVITROL. It is important that you tell your family and the people closest to you of this increased sensitivity to opioids and the risk of overdose. You or someone close to you should get emergency medical help right away if you: have trouble breathing; become very drowsy with slowed breathing; have slow, shallow breathing (little chest movement with breathing); feel faint, very dizzy, or have unusual symptoms.
SEVERE ALLERGIC PNEUMONIA
Some people on VIVITROL treatment have had severe allergic pneumonia. Call your doctor right away if you experience shortness of breath or coughing that does not go away. You may need to go to the hospital for treatment with antibiotic and steroid medicines.
SERIOUS ALLERGIC REACTIONS
Serious allergic reactions can happen during or soon after an injection of VIVITROL. Tell your doctor or get medical help right away if you have any of these symptoms of a serious allergic reaction: skin rash, swelling of your face, mouth or tongue, trouble breathing or wheezing, chest pain, feeling dizzy or faint.
OTHER POSSIBLE SIDE EFFECTS
VIVITROL can cause other serious side effects, such as depressed mood that can sometimes lead to suicide, suicidal thoughts and suicidal behavior. You should tell your family members and the people closest to you if you are taking VIVITROL. Call your doctor right away if you experience signs of depression. Click here to find out more about some symptoms of depression.
Common side effects of VIVITROL include nausea, tiredness, headache, vomiting, decreased appetite, painful joints and muscle cramps. In addition, common side effects in people taking VIVITROL for opioid dependence also include cold symptoms, trouble sleeping, and toothache.
Robertson D. Ward, MD FAAFP