What is this medication?
Antidote, Opioid Antagonist
Naltrexone, Vivitrol/Revia is indicated for treatment of alcohol use disorder, opioid use disorder.
How does this medication work?
Naltrexone, Vivitrol/Revia exists as a mixture of isomers which account for its ability to bind to immune cells and opioid receptors. Naltrexone, Vivitrol/Revia taken in low doses of 0.5mg to 10mg has been shown to reduce inflammation and modulate the immune system by antagonizing a toll-like receptor which suppresses cytokine production. Naltrexone, Vivitrol/Revia has also been shown to increase the release of endorphins in the brain. Naltrexone, Vivitrol/Revia taken in larger doses of 50mg to 300mg seem to negate the immunomodulatory effect and acts as a competitive antagonist at opioid receptor sites, showing the highest affinity at the mu receptor. Endogenous opioids are involved in modulating the expression of alcohol’s reinforcing effects and modifying the hypothalamic-pituitary-adrenal axis to suppress alcohol consumption.
How should I take this medication?
Usual (Oral): taken once daily. The dose taken is dependent on the indicated use.
Note: Do not initiate therapy until patient is opioid-free (including tramadol) for at least 7 to 10 days after last opioid use; up to 14 days may be necessary for patients on long-acting opioids. Consider a naloxone challenge test to confirm patient is opioid-free. If need for opioid pain management is anticipated during treatment, discontinue oral naltrexone ≥3 days prior to surgery or IM naltrexone ≥30 days prior to surgery.
How to Use: May be taken with or without food. Taking naltrexone with food or after a meal may reduce gastrointestinal effects.
What should I watch for while using this medication?
Before starting Naltrexone, Vivitrol/Revia make sure your physician is aware of any allergies or medications you currently take, and activities you perform. Naltrexone, Vivitrol/Revia may precipitate symptoms of acute withdrawal in patients with an opioid use disorder and should be monitored carefully. Naltrexone, Vivitrol/Revia has been associated with eosinophilic pneumonia, hepatic injury, injection-site injury when administered by injection including cellulitis, induration, hematoma, abscess and necrosis. Monitor patients closely for suicidal thoughts and depression. Use naltrexone with caution in patients with thrombocytopenia or any bleeding disorder, hepatic and/or renal impairment.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Syncope, headache, insomnia, sleep disorder, dizziness, anxiety, nausea, vomiting, anorexia, change in appetite, decreased appetite, diarrhea, abdominal pain, increased serum transaminases, increased serum aspartate aminotransferase, increased creatine phosphokinase in blood specimen, asthenia, arthralgia, arthritis, joint stiffness, pharyngitis, depression, drowsiness, sedated state, skin rash, xerostomia, muscle cramps, back pain, back stiffness, injection site reaction
Note: this is not a complete list of side effects, only the most common.
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