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Naltrexone (Revia®, Vivitrol®): Basic information

Naltrexone (oral: Revia® and generic; injectable: Vivitrol®) is an opioid antagonist. It blocks the effects of opioids by competitive binding at opioid receptors. Here is key information about this medication.


FDA-approved indications

1. Treatment of alcohol dependence

2. Blockade of effects of exogenously administered opioids in comprehensive treatment of opioid dependence


Dosage

A. Alcohol dependence

Oral: 50 mg once daily

Injectable: 380 mg IM every 4 weeks or once a month

B. Opioid dependence

Oral (standard regimen): 25 mg initially, and if no withdrawal symptoms occur then administer 50 mg next day and thereafter

Oral  (supervised regimen):
a) 50 mg every weekday and 100 mg on Saturday or
b) 100 mg every other day or
c) 150 mg every third day

Injectable: 380 mg IM every 4 weeks or once a month

Patients (including those being treated for alcohol dependence) should be off all opioids, including opioid-containing medicines, for a minimum of 7 to 10 days before starting naltrexone in order to avoid precipitation of opioid withdrawal. Patients transitioning from buprenorphine or methadone may be vulnerable to precipitation of withdrawal symptoms for as long as two weeks. In some cases it may be helpful to perform naloxone challenge test to confirm that the patient has had an opioid-free period.


Dosage forms and strengths

Oral tablets: 50 mg scored (Revia® and generic); 25 mg and 100 mg (generic only)

Extended-release injectable suspension: 380 mg of naltrexone in a microsphere formulation and 4 mL diluent

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.


Related Pages

Tips on using naltrexone extended-release injectable (Vivitrol®)

How to order, store, and administer naltrexone extended-release injection (Vivitrol®)

Five pearls for avoiding misuse or diversion of buprenorphine

Tips for opioid dependent patients

False positive urine drug screen results: Principles and a table for reference


References

Naltrexone (Revia®) Prescribing Information

Naltrexone (Vivitrol®) Prescribing Information


Copyright 2016, Rajnish Mago, MD. All rights reserved. May not be reproduced in any form without express written permission.

Disclaimer: The content on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified health care professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.

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