The most common Vivitrol side effects are nausea, headache, dizziness, tiredness and soreness where the shot was given. Most are manageable. A few, like a severe injection site reaction, signs of liver trouble or thoughts of suicide, need medical attention right away. And there’s one risk that isn’t a side effect at all but matters more than any of them: what happens if you use opioids while it’s in your system, or after it wears off.
What Is Vivitrol?
Vivitrol is the brand name for extended-release naltrexone, given as an injection. According to SAMHSA, the injectable form is FDA-approved for both opioid use disorder and alcohol use disorder. MedlinePlus says it decreases the craving for alcohol and blocks the effects of opioids.
A healthcare provider gives it as a shot into the buttock muscle once every 4 weeks. It’s meant to be used alongside counseling and support, not on its own. It’s not an opioid, and it won’t get you high.
Common Vivitrol Side Effects
MedlinePlus lists these as the side effects people most often notice. Tell your provider if any are severe or don’t go away:
- Nausea, vomiting, diarrhea or stomach pain
- Headache
- Dizziness or feeling tired
- Decreased appetite or dry mouth
- Trouble sleeping
- Anxiety
- Joint pain or stiffness, muscle cramps or weakness
- Tenderness, redness, bruising or itching where the shot went in
Many people find these are worst in the days right after an injection and settle down from there, but everyone’s different. If something is bothering you, say so at your next appointment, or sooner.
Because Vivitrol can make you dizzy or drowsy, MedlinePlus advises not driving or doing anything dangerous until you know how it affects you.
Serious Vivitrol Side Effects
Get medical help right away for any of these, which MedlinePlus lists as serious:
Injection site reactions
Some soreness is normal. Pain that gets worse, hardness, swelling, lumps, blisters, an open wound or a dark scab at the injection site is not. These reactions can be serious and may need treatment.
Possible liver problems
Excessive tiredness, unusual bleeding or bruising, pain in the upper right part of your stomach, light-colored stools, dark urine or yellowing of the skin or eyes all need a call to your doctor. Make sure your provider knows if you’ve ever had liver disease before you start.
Allergic reactions
Hives, rash, swelling of the face, lips, tongue or throat, coughing, wheezing or shortness of breath. Chest pain also belongs on this list.
Depression and suicidal thoughts
MedlinePlus notes that Vivitrol doesn’t reduce the risk of self-harm. Early recovery is emotionally hard, with or without medication. If you feel deep sadness, worthlessness or have thoughts of hurting yourself, get help right away. You can call or text 988, the Suicide and Crisis Lifeline.
The Overdose Risk You Need to Understand
This is the part of Vivitrol safety that matters most, and it’s easy to miss.
Before your first shot, you need to be off opioids. MedlinePlus says to tell your doctor if you’ve taken opioids in the last 7 to 10 days, including street drugs like heroin; your doctor won’t give Vivitrol if you have. Naltrexone can bring on or worsen opioid withdrawal, so starting too soon can make you very sick.
While it’s working, Vivitrol blocks opioids. Some people try to “push through” by using more. MedlinePlus warns that taking large amounts of opioids to overcome the blockade may cause serious injury, coma or death.
After it wears off, or if you miss a shot, your tolerance is lower than it used to be. MedlinePlus warns you may be more sensitive to opioids than before. An amount you used to handle could now cause an overdose. If you use opioids at all after treatment, don’t use alone, and keep naloxone nearby.
In any emergency, including someone who’s collapsed, had a seizure, is struggling to breathe or can’t be woken, call 911. Poison Control is at 1-800-222-1222.
Vivitrol and Alcohol
For alcohol use disorder, Vivitrol works by reducing cravings. It doesn’t make you sick if you drink, the way some other medications do. That’s a strength, but it also means some people test it by drinking more to feel something. The medication can’t do the work alone, and the old patterns are still there.
Is Vivitrol Right for You?
Vivitrol is one tool, and it works best inside a real recovery plan. MedlinePlus is clear that counseling and support are part of how it’s used. It stays in your body for about a month and can’t be removed early, so it’s worth talking through with a doctor who knows your full history.
For many people, recovery starts with a medically supervised detox and continues in residential inpatient treatment, where medication decisions can be made carefully. Ongoing relapse prevention matters with or without medication. If opioids are the issue, our heroin addiction page has more, and for drinking, see alcoholism treatment.
Frequently Asked Questions
What are the most common Vivitrol side effects?
Nausea, headache, dizziness, tiredness, trouble sleeping, joint or muscle aches and soreness or bruising where the shot was given.
How long do Vivitrol side effects last?
Many people find common side effects ease in the days after each shot, but it varies. Tell your provider about anything that’s severe or doesn’t go away.
Can you overdose while on Vivitrol?
Yes. Trying to override the blockade with large amounts of opioids can cause coma or death, and after treatment ends you may be more sensitive to opioids than before.
Does Vivitrol make you sick if you drink?
No. It reduces cravings for alcohol rather than causing a reaction. Talk to your provider about how it fits your recovery plan.
Get Help at Covenant Hills
Covenant Hills is a Christian residential treatment center in Orange County for people recovering from alcohol and opioid addiction. Our team can talk with you about whether medication belongs in your plan, and about everything else recovery takes. If you’re ready, call 800-662-2873 for a free, confidential assessment.
