Vivitrol (naltrexone) is treatment for opioid use disorder and alcoholism that can precipitate opioid withdrawal symptoms in people who have opioid drugs in their system.
This includes drugs such as:
- heroin
- fentanyl
- oxycodone
- codeine
- morphine
Precipitated withdrawal is a severe form of opioid withdrawal syndrome. To avoid this, Vivitrol should not be taken until at least seven to 14 days after a person’s last opioid use.
Learn more about using Vivitrol in addiction treatment
How Does Vivitrol Cause Precipitated Withdrawal?
Vivitrol is a type of drug known as an opioid antagonist. This means it blocks off opioid receptors in the brain that other opioid drugs will try to bind to.
If Vivitrol is taken after recent use of an opioid drug, this could trigger a rapid onset of severe opioid withdrawal symptoms, as a result of Vivitrol’s blockade effect.
Opioid withdrawal, while typically not dangerous, may require hospitalization if it is precipitated by the use of an antagonist medication like Vivitrol or naloxone (Narcan).
Signs And Symptoms Of Precipitated Withdrawal From Vivitrol
Precipitated withdrawal is a form of drug withdrawal that can be more severe than standard instances of a person getting off opioid drugs.
That is, while detoxing from opioids like heroin or OxyContin can be highly uncomfortable, precipitated withdrawal from the early use of Vivitrol can have additional complications.
Symptoms of precipitated opioid withdrawal might include:
- excessive vomiting
- severe diarrhea
- stomach pain
- fever
- altered level of consciousness
- agitation
- rapid heartbeat
- dilated pupils
- bone and muscle pain
- full-body pain
- seizures
How Long Do You Need To Be Off Opioids To Begin Vivitrol?
Before taking Vivitrol, individuals should be opioid-free for at least seven days, or up to 14 days.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA):
- For short-acting opioids: at least seven days
- For long-acting opioids: at least 10 to 14 days
Long-acting opioids, such as methadone, stay in the body longer than short-acting drugs.
For this reason, someone who has taken a long-acting opioid will need to wait longer before starting Vivitrol for opioid or alcohol treatment.
How To Avoid Precipitated Withdrawal From Vivitrol
The rule of thumb for preventing precipitated withdrawal is to be fully detoxed from opioids before starting Vivitrol treatment and to avoid using opioids during treatment.
Vivitrol treatment is not recommended for people who:
- are physically dependent on opioids
- are taking an opioid analgesic
- have a positive urine screen for opioids
- have relapsed to opioid use
Before getting a Vivitrol shot, be sure to tell your healthcare provider if you have taken an opioid drug within the past one to two weeks.
Find Help For Opioid Dependence Today
Vivitrol is a medication that can support individuals in recovery from alcohol and opioid addiction, alongside additional behavioral and social support services.
For more information about Vivitrol, or how to find addiction treatment, call us today to connect with a specialist to discuss available treatment options.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Journal of IMAB — Precipitated Withdrawal Reaction to Opiates in Cases of Improper Use of Naltrexone
https://www.journal-imab-bg.org/statii-07/vol07_1_75-77str.pdf - Substance Abuse and Mental Health Services Administration (SAMHSA) — Naltrexone
https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone - U.S. Food & Drug Administration (FDA) — List of Extended-Release and Long-Acting Opioid Products Required to Have an Opioid REMS
https://www.fda.gov/drugs/information-drug-class/list-extended-release-and-long-acting-opioid-products-required-have-opioid-rems - U.S. Food & Drug Administration (FDA) — VIVITROL (naltrexone for extended-release injectable suspension)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021897s015lbl.pdf - U.S. National Library of Medicine: PubMed — Severe opioid withdrawal precipitated by Vivitrol
https://pubmed.ncbi.nlm.nih.gov/29605483/
