Vivitrol (naltrexone) is a brand-name injectable suspension that’s prescribed to treat alcohol or opioid dependence. Vivitrol has interactions with some other drugs. Examples include some pain medications, diphenoxylate/atropine (Lomotil), and guaifenesin/codeine.
Vivitrol is used to treat alcohol dependence (also called alcohol use disorder) or opioid dependence (also known as opioid use disorder) in adults. It’s available as an extended-release injectable suspension. An extended-release drug releases slowly into your body over time so that you can take the medication less often.
An interaction occurs when one substance causes another substance to have a different effect than expected.
To learn more about Vivitrol’s interactions, keep reading. For additional information about Vivitrol, including details about its uses, see this article.
In some cases, factors or conditions could prevent your doctor from prescribing Vivitrol due to the risk of harm. These are known as contraindications. The contraindications of Vivitrol include:
Having opioid dependence or being in opioid withdrawal
If you’re currently dependent on opioid medications or are experiencing opioid withdrawal, you should not take Vivitrol. Opioid dependence (also known as opioid use disorder) can occur when you need a drug to feel as usual. And opioid withdrawal can occur when you suddenly stop taking an opioid drug. If you’re dependent on opioids or if you’re in opioid withdrawal, taking Vivitrol may cause withdrawal symptoms to occur, or become worse. In some cases, this can be serious. Due to this risk, doctors will recommend waiting 7–14 days after stopping opioid medications before you start treatment with Vivitrol.
Taking opioid drugs
You should not take opioid drugs if you’re taking Vivitrol. Vivitrol works by blocking opioid drugs from working. So, if you take an opioid drug, taking Vivitrol may cause it to be less effective or not work at all. It’s not safe to try to take more of an opioid drug if it’s not working for you. In fact, this can be life threatening. Your doctor will recommend stopping opioid drugs for 7–14 days before starting Vivitrol.
Having had an allergic reaction to Vivitrol or any of its ingredients
If you’ve had an allergic reaction to Vivitrol or any of its ingredients, including polylactide-co-glycolide or carboxymethylcellulose, your doctor will likely not prescribe Vivitrol. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Note: Before you start treatment with Vivitrol, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Vivitrol.
It’s not recommended to drink alcohol while taking Vivitrol. This is because drinking alcohol while taking Vivitrol may make side effects of the drug worse. Vivitrol and alcohol can cause:
- liver problems
Drinking alcohol while taking Vivitrol can increase the risk of these side effects occurring. Although there aren’t any known interactions between Vivitrol and alcohol, drinking alcohol may make side effects of Vivitrol worse.
It’s important to note that if you’re taking Vivitrol to treat alcohol dependence (also called alcohol use disorder), you should not drink alcohol during your treatment. This is because of the way Vivitrol works. The drug reduces cravings for alcohol, so you may have less of a desire to drink.
If you have additional questions about consuming alcohol while taking Vivitrol, talk with your doctor or pharmacist.
Before you start treatment with Vivitrol, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Vivitrol interacts with supplements, herbs, or vitamins, see the “Vivitrol and other interactions” section below.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Vivitrol. Keep in mind that this table doesn’t include all drugs that may interact with Vivitrol. Some of these interactions are described in detail just below in “Drug interactions in depth.”
|Drug class or drug name
|Interaction result with Vivitrol
|certain pain medications
|• tramadol (Conzip)
• oxycodone (Roxicodone)
|can make pain medications less effective
|can make diarrhea treatment less effective
|can make cough medications less effective
Here’s a closer look at certain drug interactions of Vivitrol.
Certain pain medications
Certain pain medications contain opioid drugs. Opioids can interact with Vivitrol.
Interaction result. Vivitrol can block the pain-relieving effects of opioid pain medications.
Interaction explained. Vivitrol works by blocking opioid drugs from working. If you take an opioid medication, it usually won’t work to treat your pain. It’s not safe to take more opioid pain medication to treat your pain. In fact, this can be life threatening.
Examples of opioid pain drugs. Here are some opioid pain medications that may interact with Vivitrol:
Steps you or your doctor may take. You should not take any pain medications containing opioid drugs while taking Vivitrol. If you need pain medication during your treatment with Vivitrol, your doctor may recommend a different pain medication that doesn’t contain an opioid drug. Examples include ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).
Interaction result. Vivitrol can block the diarrhea relieving effects of Lomotil.
Interaction explained. Vivitrol works by blocking opioid drugs from working. If you take a drug that works on the opioid receptor, such as Lomotil, taking Vivitrol may cause it to be less effective or not work at all. It’s not safe to take more Lomotil to treat your diarrhea.
Steps you or your doctor may take. If you’re taking Vivitrol and you need treatment for diarrhea, your doctor will likely recommend a different medication other than Lomotil. For example, they may recommend taking loperamide (Imodium) to treat your diarrhea.
Guaifenesin/codeine is prescribed to treat cough.
Interaction result. Vivitrol can cause guaifenesin/codeine to be less effective, or not work at all.
Interaction explained. Vivitrol works by blocking opioid drugs from working. If you take an opioid drug, taking Vivitrol may cause it to be less effective or not work at all. Guaifenesin/codeine contains the opioid drug codeine. It’s not safe to take more guaifenesin/codeine to treat your cough. In fact, this can be life threatening.
Steps you or your doctor may take. If you’re taking Vivitrol, your doctor will recommend a different cough medication for you instead of guaifenesin/codeine. For example, they may recommend taking dextromethorphan (Delsym) or guaifenesin (Robitussin) to treat your cough.
Vivitrol may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information doesn’t include all other possible interactions with Vivitrol.
Vivitrol and supplements
It’s possible for drugs to interact with supplements such as vitamins and herbs.
Vivitrol and herbs
There are no specific reports of herbs interacting with Vivitrol. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Vivitrol treatment.
Vivitrol and vitamins
There are no specific reports of vitamins interacting with Vivitrol. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Vivitrol.
Vivitrol and food
There were no reports of food interactions with Vivitrol. If you’d like to learn more about eating certain foods during treatment with Vivitrol, talk with your doctor.
Vivitrol and vaccines
There aren’t any known interactions between Vivitrol and vaccines. Talk to your doctor or pharmacist to see whether you’re due for any vaccines.
Vivitrol and lab tests
Vivitrol isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.
NALTREXONE AND CANNABIS OR CBD
Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), haven’t been specifically reported to interact with Vivitrol. However, certain cannabinoids, such as dronabinol (Marinol, Syndros) and nabilone (Cesamet) may increase your risk of side effects when taken with Vivitrol. As with any drug or supplement, talk with your doctor before using cannabis with Vivitrol.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Vivitrol. Before you take this drug, be sure to talk with your doctor about your health history. Vivitrol may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Vivitrol include:
- Liver problems. It’s possible for Vivitrol to cause liver damage to occur. If you already have a liver problem, taking Vivitrol may make your condition worse. Your doctor can help determine whether Vivitrol may be a safe treatment option for you.
- Bleeding disorders. Tell your doctor if you have a bleeding disorder, such as hemophilia or von Willebrand’s disease, before starting treatment with Vivitrol. If you have a bleeding disorder and you take Vivitrol, you may be at a higher risk of uncontrolled bleeding. Your doctor can help determine whether Vivitrol may be a safe medication for you to take.
- Kidney problems. It’s not known if Vivitrol is safe to take if you have moderate to severe kidney problems. If you have a condition that affects your kidneys, such as chronic kidney disease, tell your doctor before starting Vivitrol. They can help determine how severe your kidney condition is and whether Vivitrol may be safe for you.
- Taking opioids or recently taking opioids. You should not take Vivitrol if you’re taking opioids or if you’ve taken an opioid medication within the last 7–14 days. This is because using opioids within 7–14 days of taking Vivitrol may cause you to have symptoms of opioid withdrawal, which can be serious. Your doctor can help determine when you should start treatment with Vivitrol.
- Pregnancy. It’s not known if Vivitrol is safe to take while pregnant. If you’re pregnant or planning to become pregnant, talk with your doctor before taking Vivitrol.
- Breastfeeding. Before taking Vivitrol, talk with your doctor if you’re breastfeeding. Naltrexone, the active ingredient in Vivitrol, is present in breast milk. However, it’s not known what effects the drug may have on a breastfed child. Your doctor can help advise you on the best way to feed your child.
- Allergic reaction. If you’ve had an allergic reaction to Vivitrol or any of its ingredients, your doctor will likely not prescribe Vivitrol. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
You can take certain steps to help prevent interactions with Vivitrol. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list, which your doctor and pharmacist can help you fill out.
It’s also important to read the Vivitrol label and other
If Vivitrol doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Vivitrol by taking it exactly as your doctor prescribes.
Besides learning about interactions, you may want to find out more about Vivitrol. These resources might help:
- Overview of Vivitrol. For a general overview of Vivitrol, you can see this article.
- Side effects. If you’re interested in the side effects of Vivitrol, see this article. Another option is to refer to the Vivitrol prescribing information.
- Dosage specifics. To learn about the dosage of Vivitrol, see this article.
- Drug comparison. Learn about how Vivitrol compares with Sublocade, Suboxone, and naltrexone.
- Facts about your condition. To learn more about dependance on opioids or alcohol, see this list of articles.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.