naltrexone (injection)

Pronunciation:	nal TREX own
Brand:	Vivitrol

What is the most important information I should know about naltrexone injection?

Do not use narcotic drugs or alcohol while you are being treated with naltrexone injection. Never try to overcome the effects of the medication by using large doses of narcotic drugs or alcohol. Doing so could result in dangerous effects, including coma and death. Ask your doctor before using any prescription or over-the-counter medicine to treat a cold, cough, diarrhea, or pain during your treatment with naltrexone injection. These medicines may contain narcotics or alcohol.

Naltrexone injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Carry an ID card or wear a medical alert bracelet stating that you are being treated with naltrexone, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are receiving this medication.

Additional forms of counseling and/or monitoring may be recommended during treatment with naltrexone injection.

What is naltrexone injection?

Naltrexone injection is a special narcotic drug that blocks the effects of other narcotic medicines and alcohol.

Naltrexone injection is used to treat narcotic drug or alcohol addiction..

Naltrexone injection may also be used for purposes other than those listed in this medication guide.

What should I discuss with my health care provider before receiving naltrexone injection?

Do not receive this injection if you are allergic to naltrexone, or if you have:

an addiction to narcotics;
a history of alcohol or narcotic drug use within the past 7-10 days; or
drug or alcohol withdrawal symptoms.

Before receiving naltrexone, tell your doctor if you are allergic to any drugs, or if you have:

kidney disease;
liver disease; or
a bleeding disorder such as hemophilia.

If you have any of these conditions, you may not be able to receive naltrexone injection or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether naltrexone injection passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is naltrexone injection used?

Naltrexone injection (Vivitrol) is given as a shot into a muscle. This injection is usually given once a month (every 4 weeks) and can be given only by a doctor or nurse in a clinic.

It is important to receive your naltrexone injections regularly to get the most benefit.

Additional forms of counseling and/or monitoring may be recommended during treatment with naltrexone injection.

What happens if I miss a dose?

If you miss an appointment to have your naltrexone injection, make another appointment as soon as possible.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a naltrexone injection overdose may include nausea, stomach pain, dizziness, or seizure (convulsions).

What should I avoid while using naltrexone injection?

Naltrexone injection can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Do not use narcotic drugs or alcohol while receiving naltrexone injection. Never try to overcome the effects of the medication by using large doses of narcotic drugs or alcohol. Doing so could result in dangerous effects, including coma and death. Ask your doctor before using any prescription or over-the-counter medicine to treat a cold, cough, diarrhea, or pain while you are being treated with naltrexone injection. These medicines may contain narcotics or alcohol.

What are the possible side effects of naltrexone injection?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

blurred vision or eye problems;
fast heartbeat;
mood changes, hallucinations (seeing or hearing things), confusion, thoughts of hurting yourself;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
ear pain, ringing in your ears;
feeling light-headed, fainting;
skin rash or itching; or
wheezing, difficulty breathing.

Other less serious side effects are more likely to occur, such as:

feeling anxious, nervous, restless, or irritable;
increased thirst;
muscle or joint aches;
weakness or tiredness;
sleep problems (insomnia);
decreased sex drive, impotence, or difficulty having an orgasm; or
pain, tenderness, itching, or a hard lump where the shot was given.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect naltrexone injection?

The pain-relieving effects of any narcotic pain medications you use will be blocked if you use them during your treatment with naltrexone injection. Harmful side effects could also occur.

Before receiving naltrexone injection, tell your doctor if you use any of the following drugs:

buprenorphine (Buprenex, Subutex);
butorphanol (Stadol);
codeine (Tylenol with codeine);
hydrocodone (Lortab, Vicodin);
dezocine (Dalgan);
hydromorphone (Dilaudid);
levorphanol (Levo-Dromoran);
meperidine (Demerol);
methadone (Dolophine, Methadose);
morphine (Kadian, MS Contin, Roxanol);
nalbuphine (Nubain);
nalmefene (Revex);
naloxone (Narcan);
oxycodone (OxyContin, Roxicodone, Percocet);
oxymorphone (Numorphan); or
propoxyphene (Darvon, Darvocet).

There may be other drugs not listed that can affect naltrexone injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your doctor has additional information about naltrexone injection written for health professionals that you may read.

What does my medication look like?

Naltrexone injection is available with a prescription under the brand name Vivitrol. Other brand or generic formulations may also be available. Ask your doctor or pharmacist any questions you have about this medication, especially if it is new to you.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 1.03. Revision date: 8/23/06.

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