Key takeaways

  • Common side effects of Vivitrol (naltrexone) include nausea, decreased appetite, and injection site reactions, such as pain or tenderness. However, side effects may vary depending on the condition you’re receiving Vivitrol to treat.
  • Serious side effects from Vivitrol are uncommon but possible. For example, Vivitrol can cause liver damage and suicidal thoughts or behaviors. Vivitrol may also cause sudden opioid withdrawal if you receive it too soon after taking an opioid drug.
  • Before you start receiving Vivitrol injections, be sure to talk with your doctor about your health history. This includes any past or current health conditions, as well as any medications you take. Your doctor will let you know whether Vivitrol is safe for you.

If you have certain substance use disorders, your doctor might suggest Vivitrol as a treatment option for you. It’s a prescription medication used in adults to:

  • treat alcohol use disorder in people who have stopped drinking alcohol and aren’t in the hospital for treatment
  • prevent opioid dependence in people who have detoxed (had opioids cleared from their system)

Vivitrol comes as a liquid suspension that a healthcare professional injects into a muscle. The active ingredient in Vivitrol, naltrexone, is also available as a tablet (pill).

You and your doctor will decide how long your treatment with Vivitrol will last.

For more information about Vivitrol, including details about its uses, see this in-depth article.

Like other drugs, Vivitrol can cause mild to serious side effects. Keep reading to learn more.

Some people may have mild to serious side effects during their Vivitrol treatment. Below are just a few of the more common side effects reported by people who took Vivitrol in studies. These side effects can vary depending on what condition the drug is being used to treat.

More common side effects in people using Vivitrol for alcohol use disorder include:

More common side effects in people using Vivitrol for opioid use disorder include:

For more information about injection site reactions, see “Can a Vivitrol shot cause injection site reactions?”

To learn more about certain other side effects of Vivitrol, see the “Side effects explained” section.

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Like most medications, treatment with Vivitrol may cause mild side effects. Some of these are more common than others.

Examples of mild side effects that have been reported with Vivitrol include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop using Vivitrol unless your doctor recommends it.

Vivitrol may cause mild side effects other than the ones listed above. See Vivitrol’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while receiving Vivitrol injections and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

While not common, treatment with Vivitrol can cause serious side effects.

Serious side effects that have been reported with Vivitrol include:

If you develop serious side effects while being treated with Vivitrol, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

To learn more about some of these side effects, see the “Side effects explained” section.

Vivitrol shots can cause injection site reactions. While these are usually mild, they can be serious in rare cases.

Vivitrol is given as an injection into a muscle in your buttocks by a healthcare professional.

Injection site reactions possible with Vivitrol (naltrexone) shots include:

In rare cases, injection site reactions may be severe, such as necrosis (death of skin tissue). This may leave scars or require surgery to treat.

Mild injection site reactions typically go away on their own. But if you have severe symptoms or reactions that don’t go away after 2 weeks, call your doctor. They’ll likely want to see your symptoms in person, which can help them determine the best treatment.

Below are answers to some common questions about Vivitrol’s side effects.

Side effects from Vivitrol can vary from person to person. This includes the timeline for side effects.

For example, nausea is most likely to follow your first Vivitrol injection. But this side effect can occur at any time during your Vivitrol treatment.

In most cases, mild side effects should be temporary. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist.

How long Vivitrol side effects last can vary. Most side effects are temporary and don’t last for a long time. But treatment with Vivitrol can cause long-term side effects. These include:

  • scarring from injection site reactions

These side effects don’t always last a long time when they occur. Liver damage such as hepatitis (liver inflammation) can heal in several months, for example. If hepatitis isn’t treated, however, it may become a long-term issue. And treatments and other support is available for depression and any suicidal thoughts or behaviors.

Vivitrol is a long-acting drug, so side effects can last until the drug wears off, which takes at least a month.

To learn more about these side effects, see “Side effects explained” below.

Talk with your doctor if you have additional questions about Vivitrol and long-term side effects.

Vivitrol may cause decreased libido (sex drive). But it isn’t known to cause other sexual side effects, such as erectile dysfunction (ED). Decreased libido was reported by people who took Vivitrol in studies, but it was extremely rare.

Opioid use disorder (which Vivitrol may be used to treat) can cause problems with sexual function, including ED.

If you have additional questions about sexual function, opioid use disorder, and your treatment plan, talk with your doctor or pharmacist.

It’s not likely, but weight gain is possible from using Vivitrol. Both weight gain and weight loss were reported by people who took Vivitrol in studies, but both were extremely rare.

Changes in body weight, such as weight gain, can also be a symptom of depression. Depression is a rare but serious side effect Vivitrol may cause.

If you have questions or concerns about your weight, talk with your doctor. They can suggest ways to maintain a weight that’s healthy for you. They can also review your treatment plan for anything that may be causing weight gain.

To learn more about Vivitrol and depression, see “Side effects explained” below.

Stopping Vivitrol treatment shouldn’t cause withdrawal symptoms.

But starting Vivitrol while you still have opioids in your system can cause severe opioid withdrawal. This can be serious and require treatment in the hospital. For this reason, doctors typically won’t prescribe Vivitrol unless you haven’t taken any opioids for at least 7 to 10 days.

If you have questions about withdrawal and Vivitrol, talk with your doctor or pharmacist.

Learn more about some of the side effects Vivitrol may cause.

Liver damage

While rare, liver damage has been reported in people receiving Vivitrol treatment.

Symptoms of liver damage can include:

Some people may be at higher risk of liver damage from Vivitrol, such as those who:

What might help

Call your doctor right away if you have symptoms of liver damage during your treatment with Vivitrol. They’ll likely want to examine you in person. They may also order blood tests, such as one to check your liver enzyme levels. (High levels of liver enzymes can be a sign of liver damage.)

If your doctor confirms you have liver damage, they’ll likely stop your Vivitrol treatment.

Depression and suicidal thoughts or behaviors

Treatment with Vivitrol can cause depression as well as suicidal thoughts and behaviors. While these side effects were very rare in Vivitrol’s studies, it’s still important to be aware of possible symptoms.

Symptoms of depression can include:

  • feeling angry or aggressive
  • feeling hopeless or sad
  • losing interest in activities or hobbies you usually enjoy
  • changes in body weight

Depression can lead to suicidal thoughts or behaviors. These can happen at any time during your Vivitrol treatment.

What might help

Due to the risk of depression, Vivitrol is typically prescribed as part of a comprehensive plan that also includes mental and social support.

Contact your doctor immediately if you notice symptoms of depression or have suicidal thoughts while you’re being treated with Vivitrol. Your doctor can discuss the best treatment options for you.

It can also help to tell family or friends that you’re being treated with Vivitrol if you’re comfortable doing so. That way, they can be on the lookout for any changes to your mood or behaviors while you’re receiving this medication.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Nausea

Nausea is a possible side effect that treatment with Vivitrol may cause. It was among the more common side effects reported by people receiving this medication in studies.

You’re more likely to have nausea following your first Vivitrol injection. This is usually mild and goes away on its own after a few hours or days. Your risk of nausea decreases with future injections of this medication.

What might help

Talk with your doctor if you have nausea that bothers you or won’t go away during your treatment with Vivitrol. They can suggest an appropriate medication to treat this side effect.

Headache

It’s possible you’ll have a headache as a side effect from Vivitrol. Headache was among the more common side effects reported by people receiving this treatment in studies.

It’s not uncommon to have a headache after your first Vivitrol injection. This should go away on its own after a few hours or days. The risk of this side effect goes down with future Vivitrol injections. If these headaches are persistent or bothersome, your doctor may recommend an over-the-counter medication, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

What might help

Talk with your doctor if you develop a headache that bothers you or won’t go away during your treatment with Vivitrol. They can suggest an appropriate medication to treat this side effect.

Allergic reaction

Like most drugs, Vivitrol can cause an allergic reaction in some people. But this wasn’t common in the drug’s studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you’ve had a mild allergic reaction to Vivitrol, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Vivitrol, they may have you switch to a different treatment.

Keeping track of side effects

During your Vivitrol treatment, consider keeping notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start using new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were receiving when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • any other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how Vivitrol affects you. They can then use this information to adjust your treatment plan if needed.

Vivitrol may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Vivitrol. Below are some factors to consider.

Bleeding problems: People with bleeding disorders, such as hemophilia, may have a higher risk of bleeding after Vivitrol injections. Your doctor can help determine whether treatment with Vivitrol is safe for you.

Current or recent opioid use: You must not use opioids for at least 7 to 10 days before starting treatment with Vivitrol. Receiving a Vivitrol injection while opioids are still in your body could cause severe opioid withdrawal. And taking opioids during your treatment with Vivitrol could cause opioid intoxication (overdose).

Kidney problems: It isn’t known if it’s safe for people with moderate to severe kidney problems to be treated with Vivitrol. Your doctor can assess the severity of your kidney problems and determine whether Vivitrol is safe for you.

Liver problems: Vivitrol can cause liver damage as a side effect. You may be at higher risk if you already have a liver problem, such as alcohol-related liver disease (ARLD) or hepatitis. Your doctor can determine whether Vivitrol is safe for you to use with your liver problem.

Allergic reaction: If you’ve had an allergic reaction to Vivitrol or any of its ingredients, your doctor will likely not prescribe it for you. Ask your doctor what other treatments might be better options.

Alcohol use and Vivitrol

Vivitrol is prescribed to treat alcohol use disorder. You shouldn’t drink alcohol if you’re prescribed Vivitrol for this use.

If you’re prescribed Vivitrol for opioid use disorder, it may be best to avoid drinking alcohol. Side effects of Vivitrol and alcohol are similar, such as nausea and headache. In addition, both alcohol and Vivitrol can cause liver damage. Consuming alcohol may increase your risk of these and other side effects that Vivitrol may cause.

If you consume alcohol and have questions about how to stop drinking before beginning treatment with Vivitrol, talk with your doctor.

Pregnancy and breastfeeding during Vivitrol treatment

It isn’t known whether it’s safe to use Vivitrol while pregnant or breastfeeding.

If you’re pregnant, breastfeeding, or planning on either, talk with your doctor about safe treatment options.

Vivitrol injections can cause mild to serious side effects. While serious side effects are rare, it’s not uncommon to have some mild side effects, especially injection site reactions from Vivitrol shots. But most mild side effects caused by this treatment go away on their own.

If you’re considering treatment with Vivitrol, talk with your doctor. Ask questions that help determine whether you’re comfortable using this medication. Some examples to help get you started include:

  • Does Vivitrol cause hair loss?
  • Will I have diarrhea or constipation from Vivitrol?
  • Can you tell me more about the negative side effects of Vivitrol?
  • Are there side effects if you drink alcohol while using Vivitrol?
  • When should I reach out for help if I feel like Vivitrol is affecting my mental health?

Q:

Are there pain medications that are safe to take if I’m being treated with Vivitrol injections?

Anonymous

A:

If you need pain medication while you’re taking Vivitrol, talk with your doctor. They may recommend pain medications that do not contain opioids. Some examples of non-opioid pain relievers include acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). Another option is topical lidocaine, which can help numb the painful area of your body.

You should not take opioids during Vivitrol treatment. (Some examples of opioids include heroin and pain reliever medications, such as oxycodone.) The combination can increase the risk of serious side effects, such as sudden opioid withdrawal or intoxication (overdose).

In some cases, it may be necessary to take opioids short term to manage pain, such as after emergency surgery. In this situation, your doctor may first give you a drug that reverses the effects of Vivitrol. They’ll also monitor you very closely.

If you have questions about managing pain during your treatment with Vivitrol, talk with your doctor.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline 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.