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Is Vivitrol Reversible? Exploring the Long-Term Effects

Is Vivitrol Reversible? Exploring the Long-Term Effects

Vivitrol blocks opioids and is useful in the treatment of opioid and alcohol use disorder, but in emergencies, you may need to know how to reverse Vivitrol.

Vivitrol is an effective drug used in medication assisted treatment for opioid use disorder as well as alcohol addiction. This medication can help you to stop drinking or stop using opioids and stay committed to your recovery, but there may be situations in which you want to know how to reverse Vivitrol. Learn all about the Vivitrol shot, as well as information about treatment for opioid and alcohol misuse, below. 

What Is Vivitrol? 

Vivitrol is an injectable form of the medication naltrexone, and it is used to treat both opioid use disorder and alcohol use disorder. It is an extended intramuscular injection, meaning that it is taken via a shot, most often given in the buttocks, and its effects are long-lasting. Vivitrol is used in medication assisted treatment for both alcohol and opioid addiction, and many people using this medication also participate in counseling and other behavioral interventions to help them stay in recovery.

How Does Vivitrol Work?

Vivitrol works as an opioid antagonist, meaning that it blocks the effects of opioids. Opioids produce euphoric, sedative, and pain-relieving effects. By acting as an opioid blocker, Vivitrol stops these effects from happening. It binds to the body’s opioid receptors and also blocks opioid cravings. 

Vivitrol works for alcohol misuse the same way that it works for treating opioid addiction. When people consume alcohol, the body releases endorphins, which have a pleasurable effect. By acting as an opioid blocker, Vivitrol stops this rewarding effect of alcohol consumption. Vivitrol is effective against alcohol use disorder, because drinking causes the release of endogenous, or naturally occurring, opioids, which the medication is also able to block. 

Common Side Effects of Vivitrol

Vivitrol is beneficial for treating drug and alcohol misuse, but that does not mean it is without side effects. The following side effects are common with the Vivitrol shot:

  • Muscle cramping
  • Nausea and vomiting
  • Joint pain
  • Sleepiness
  • Headache
  • Reduced appetite
  • Sleep disturbances 
  • Dizziness
  • Toothache
  • Cold Symptoms 

Serious but rare side effects include depression, liver damage, pneumonia, severe allergic reactions, and pain or swelling at the injection site. 

Vivitrol Timeline 

Since the active ingredient in Vivitrol is naltrexone, understanding the Vivitrol timeline requires taking a look at the pharmacology of naltrexone. As experts explain, Vivitrol should not be started until someone has been opioid free for 7 to 10 days, because it will send a person into opioid withdrawal if they still have these drugs in their system.

Once Vivitrol is given as an injection, levels of the medication peak after two hours, and then again 2-3 days later. About 14 days after a dose of the medication, its levels in the body begin to decline, but it can be detected in the body for over a month. Given that Vivitrol stays in the body for so long, it is given as an injection once per month. You can expect Vivitrol to block opioids for a month, but concentrations of the medication do decline toward the end of the month. 

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Who Should Receive Vivitrol? 

Vivitrol is approved for the treatment of both opioid use disorder and alcohol use disorder. It is appropriate for people who have already detoxed from opioids or who are not actively drinking at the time of beginning the medication. A doctor can determine if you are an appropriate candidate for Vivitrol.

There are certain populations who should not take Vivitrol, because the medication places them at risk of complications. These populations include:

  • People with hepatitis or liver failure
  • Patients currently taking opioid medications for pain
  • People who are dependent upon opioid medications or who have a positive urine screen for opioids
  • Patients who have previously had severe reactions to naltrexone  

Vivitrol For Opioid Addiction 

Vivitrol is used in the treatment of opioid addiction or opioid use disorder, but patients must be detoxed from opioids before they begin taking Vivitrol. If they begin the medication before being completely detoxed, they will experience opioid withdrawal. In cases of opioid use disorder, Vivitrol encourages people to stay in recovery, as it blocks the effects of opioids and can reduce drug cravings. 

Vivitrol for Alcohol Addiction 

Vivitrol is also effective for treating alcohol addiction or alcohol use disorder. The makers of the medication state that it is intended to be used by patients who are able to remain abstinent from alcohol in an outpatient setting before starting on Vivitrol. 

Is Vivitrol Reversible?

The effects of Vivitrol last for about a month, and the medication is not intended to be reversed. However, there may be emergency situations in which you need to learn how to override Vivitrol. For example, some patients may need to reverse Vivitrol blockade of opioids for emergency pain management.

However, prior to reversing the Vivitrol shot for pain management, it is recommended that patients be treated with non-opioid pain medications. If this is not possible, such as in the case of a major surgery, a Vivitrol reversal is possible, but it should only be carried out by a trained physician.

A patient who undergoes Vivitrol reversal needs to be closely monitored, and medical staff need to be prepared to provide CPR or assisted ventilation if the effects of Vivitrol reversal result in respiratory depression. You should never attempt to override Vivitrol on your own. 

How Does Reversing Vivitrol Work? 

In emergency situations, such as during a surgery or treatment of a serious injury, a physician can reverse the effects of Vivitrol by administering high doses of opioids. This comes with serious risks, because it often requires a high dose of opioids to overcome the effects of the Vivitrol blockade. In high doses, opioids can cause respiratory depression, which can lead to a fatal overdose.

A type of opioid drug called Remifentanilhas been found to be effective when it is necessary to reverse Vivitrol blockade of opioids, because it is cleared from the body very quickly. 

Keep in mind that while a doctor can conduct a Vivitrol reversal in emergency situations, the medication is not meant to be reversed. You should never attempt to reverse Vivitrol on your own by taking high doses of opioid drugs, as this can result in a fatal overdose. 

What Are The Dangers Of Reversing Vivitrol?

As noted above, a Vivitrol reversal can result in an overdose, because it takes large doses of opioids to overcome the Vivitrol blockade. Reversing Vivitrol can cause respiratory depression, and patients may require assisted ventilation during this time. 

Trying to learn how to reverse naltrexone on your own is dangerous and should never be done. A Vivitrol reversal should only be conducted in emergency situations, and a trained physician should oversee the process. If you attempt to reverse Vivitrol on your own outside of a medical setting, you are at high risk of respiratory depression and a fatal overdose. 

Vivitrol Warnings And Precautions

In addition to the dangers of attempting to reverse Vivitrol blockade on your own, there are some warnings that come along with taking this medication in general. One warning regarding Vivitrol is that it has the potential to be toxic to the liver. At recommended doses, it does not seem to cause any risk of liver injury, but patients with pre-existing liver conditions should be cautious. 

Another precaution to keep in mind when taking Vivitrol is that you may experience pain, tenderness, and swelling at the injection site. In some cases this reaction can be severe and lead to scarring. To avoid severe reactions, it is important to use only the specialized needle supplied with your Vivitrol medication. It is also important to ensure that the medication is injected into the gluteal muscles, and not underneath the skin. If you have questions about how to take your medication to avoid injection site reactions, consult with your doctor. 

Other precautions involved in Vivitrol use include the risk of pneumonia or severe allergic reactions. While these risks are rare, it is important to be aware of your reaction to Vivitrol and monitor yourself for any serious side effects. If you show signs of pneumonia or an allergic reaction, seek immediate medication attention.

Finally, there is a risk of overdose after stopping Vivitrol, especially if you are taking this medication for opioid use disorder. Once you have been on Vivitrol, you will likely experience a reduced tolerance to opioids. This means that if you relapse to using again, you are at risk of overdose if you return to using your usual dose of opioids. 

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Vivitrol FAQs

If you’re seeking information on how to reverse Vivitrol, the answers to the following common questions are also helpful. 

Is There An Antidote For Vivitrol?

There is no magic antidote that reverses the effects of Vivitrol. The Vivitrol blockade is not intended to be reversed. Only in emergency situations, such as when a patient requires pain relief during surgery, should Vivitrol be reversed. This reversal should occur only under the supervision of a doctor in a full medical facility. The medication Remifentanil may be used to reverse Vivitrol, under medical direction. 

What Happens If You Get Vivitrol?

If you get Vivitrol, this medication will remain in your system for about a month, or 28 days. This means that your opioid receptors will be blocked for about a month, and you will not feel the sedating or pain-relieving effects of opioids for as long as Vivitrol is active in your body. 

When Should Vivitrol Be Discontinued?

Your doctor will help you to determine when Vivitrol should be discontinued, because each patient’s needs and situation are unique. If you experience severe adverse effects, such as pneumonia, liver injury, or an allergic reaction, seek medical attention immediately. Your doctor will provide you with guidance regarding discontinuing Vivitrol and treating adverse effects in this situation. 

How Long Can You Take Vivitrol?

Doctors and pharmacists have not yet determined the optimal length of time that a person should take Vivitrol. Your doctor will determine how long you should take Vivitrol and when you should discontinue it. 

In general, patients discontinue Vivitrol when they have achieved stability in their recovery and they have sources of support available, as well as a plan for staying committed to recovery. When patients decide to stop taking Vivitrol, they should be warned not to take any opioid medications for 30 days. They should also be warned of reduced tolerance and increased sensitivity to opioid drugs. 

Research with Vivitrol has shown that it is safe to take over the long-term, for periods of up to a year. 

How Long Does Vivitrol Shot Block Opioids?

The effects of the Vivitrol shot last for about a month, or 28 days. This means that the effects of opioids will be blocked for this amount of time. If you continue to receive Vivitrol shots, opioids will be blocked for as long as you are consistently using the medication. 

Can You Reverse Vivitrol? 

Vivitrol is not intended to be reversed. If there is an emergency situation, such as the need for pain relief during surgery, a physician may use fast-acting opioid medications in high doses to ensure pain relief. If this is the case, it is important for a patient to be monitored for respiratory depression. Patients should never attempt to reverse Vivitrol outside of a medical setting. Taking high doses of opioids to attempt to reverse Vivitrol blockade can lead to a fatal overdose. 

Treatments For Opioid Addiction And Alcohol Addiction 

Patients who live with opioid or alcohol addiction benefit from participating in medication-assisted treatment. This modality uses medications like Vivitrol, often in combination with behavioral techniques like counseling. Counseling may occur via individual or group sessions. Some people also participate in support groups to help them stay committed to recovery. 

Some patients participate in inpatient treatment, meaning they live on-site at a treatment facility. Others choose an outpatient program, which allows them to continue to live at home while attending appointments at a community-based treatment center. 

Consult With Confidant Health For Addiction Treatment 

If you’re seeking treatment for opioid or alcohol addiction, Confidant Health is here to help. We provide online medication assisted treatment, so you can participate in recovery from home. Download our app today to get started. We’re on both the Google Play Store and the App Store. 

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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