What Drugs Interact With Vivitrol?

Vivitrol is a medication used to treat opioid and alcohol addiction by blocking the effects of these substances in your brain. While Vivitrol is an effective recovery tool, it doesn’t work well with certain drugs and medications. Mixing Vivitrol with opioid painkillers, cough syrups containing codeine, or street drugs can create serious problems.

These interactions can go both ways. Sometimes other substances stop Vivitrol from doing its job of preventing cravings and blocking the high from opioids or alcohol. Other times, Vivitrol blocks medications you need, like prescription painkillers after surgery or injury. This means the pain medication won’t work even if you genuinely need it for a medical condition.

Learn more about the benefits of taking Vivitrol for addiction treatment

Drugs To Avoid While Taking Vivitrol

Before taking Vivitrol, be sure to tell your doctor about any medications, including supplements, you are currently taking. This may require adjustments to your treatment.

Below are the drugs that Vivitrol may interact with.

Opioid Pain And Cough Relievers

Vivitrol is an opioid antagonist medication that can precipitate withdrawal symptoms if a person takes Vivitrol with opioids in their system. This can cause physical sickness.

Examples of opioid pain and cough relievers include:

• morphine
• codeine
• oxycodone (OxyContin)
• hydrocodone (Vicodin)
• fentanyl (Duragesic)
• oxymorphone (Opana)
• hydromorphone (Dilaudid)
• tramadol (Ultram)
• meperidine (Demerol)
• methadone (Methadose, Dolophine)
• Tylenol with codeine

Dextromethorphan (DXM)

Dextromethorphan, also known as DXM, is an ingredient in some cough syrups, including Robitussin, Wal-tussin, and Robafen Cough.

Dextromethorphan should be avoided, if possible, while taking Vivitrol or naltrexone for alcohol or opioid use disorder in order to prevent any sort of drug interaction.

Antidiarrheal Medications

Some medications approved to help relieve diarrhea contain opioids or opioid derivatives, which can interact with Vivitrol shots.

Antidiarrheal medications that can interact with Vivitrol include:

• loperamide (Imodium)
• diphenoxylate
• difenoxin

Taking Vivitrol with this type of drug could precipitate opioid withdrawal symptoms and prevent the beneficial effects of the antidiarrheal medication.

Blood Thinners

Certain blood thinners, also known as anticoagulants, can interact with Vivitrol.

This includes:

• warfarin (Jantoven, Coumadin)
• enoxaparin

Street Drugs

Street drugs, such as heroin, should be avoided while taking Vivitrol. Mixing Vivitrol with illicit drugs could lead to an adverse reaction, including a rapid onset of opioid withdrawal symptoms.

Alcohol Use Disorder Medications

Vivitrol may negatively interact with disulfiram, also known as Antabuse, which is another medication commonly used to treat alcohol use disorder.

Taking disulfiram with Vivitrol could increase the risk of experiencing liver problems, including acute liver injury.

Other Medications For Opioid Use Disorder

Vivitrol is one of three medications currently approved to treat opioid use disorder, with the others being methadone and buprenorphine. Both are used for maintenance therapy.

Other names for these medications include:

• Methadose
• Dolophine
• Subutex
• Suboxone
• Zubsolv
• Suboclade
• Bunavail
• Probuphine

Because both methadone and buprenorphine are opioid agonist medications, combining them with Vivitrol should be avoided to prevent a negative interaction.

Factors The Influence Drug Interactions With Vivitrol

Not everyone reacts to Vivitrol the same way, especially when other medications or substances are involved. Several personal and medical factors can affect how Vivitrol interacts with other drugs in your system. Learning about these factors helps your doctor create the safest treatment plan for you.

Key factors that influence drug interactions include:

• Other Medications You’re Taking: prescription drugs, over-the-counter medicines, and supplements can all interact with Vivitrol
• Your Liver and Kidney Function: these organs process medications, so any damage or disease affects how drugs work together
• History of Opioid Use: how long you used opioids and when you last used them impacts Vivitrol’s effectiveness and safety
• Alcohol Consumption: drinking while on Vivitrol can cause dangerous liver problems and other complications
• Overall Health Conditions: diseases like hepatitis, diabetes, or heart problems can change how your body handles multiple medications
• Body Weight and Metabolism: your size and how fast your body processes drugs affects medication levels in your system
• Age: older adults often process medications differently and may be more sensitive to drug interactions

Before starting Vivitrol, it’s crucial to tell your doctor about everything you’re taking and any health conditions you have. Being honest about your medical history, current medications, and substance use helps prevent dangerous interactions. Your doctor can then monitor you properly and adjust your treatment if needed to keep you safe throughout your recovery.

Written by the Addiction Resource Editorial Staff