Adult Dosing
Alcohol/opioid dependence
- 380 mg IM q4 wks
- Note: Patient must be opioid free for 7-10 days; consider naloxone challenge test if risk of withdrawal suspected
Pediatric Dosing
- Safety and efficacy in pediatric patients not established
[Outline]
- Overdosage may cause hepatotoxicity. It is contraindicated in acute hepatitis or hepatic failure. Discontinue if acute hepatitis symptoms occur [US Black Box Warning]
- Severe injection site reactions have been reported which may require surgical intervention
- Carefully monitor for the symptoms of pneumonia as therapy may cause eosinophilic pneumonia
- Risk of hypersensitivity reactions, including anaphylaxis
- For IM administration, do not give IV or SC
- Do not start treatment unless patient has been opioid free for at least 7-10 days
- In case of question of occult opioid dependence, perform a naloxone challenge test. Do not attempt treatment if signs of opioid withdrawal are still observed following challenge test
- Patients should be monitored for the development of depression or suicidal thinking
- Do not perform naloxone challenge in patients showing clinical signs or symptoms of opioid withdrawal or in patients whose urine contains opioids
- Administer with caution in patients with thrombocytopenia or any coagulation disorder
- Severe opioid withdrawal syndrome precipitated by accidental ingestion of naltrexone may occur in opioid-dependent individuals
- Regional analgesia or non-opioid analgesics should be used for pain management in an emergency situation in patients receiving therapy
- Therapy does not eliminate nor diminish alcohol withdrawal symptoms
- Monitor LFTs at baseline and periodically during therapy
Cautions: Use cautiously in
- Moderate to severe renal impairment
- Severe hepatic impairment
- Hx of depression
- Suicidal ideation
- Thrombocytopenia
Pregnancy Category:C
Breastfeeding: Limited data indicate that naltrexone is minimally excreted into breastmilk. If naltrexone is required by the mother, it is not a reason to discontinue breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 February 2011). Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Vivitrol 380 MG SUSR [Vial] (ALKERMES)
1 mg = $1101.94
3 mg = $3263.83
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.