Vivitrol - Instructions For Use Of The Drug, Reviews, Price, Analogues

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Vivitrol

Vivitrol: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Vivitrol

ATX code: N07BB04

Active ingredient: naltrexone (Naltrexone)

Manufacturer: Alkermes, Inc. (Alkermes, Inc.) (USA), Baxter Pharmaceutical Solutions, LLC (USA)

Description and photo updated: 2018-26-11

Prices in pharmacies: from 19100 rubles.

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Vivitrol is a non-agonist opiate receptor blocker in the brain, used to relieve alcohol and opioid dependence.

Release form and composition

Vivitrol is produced in the form of a powder for preparing a suspension of prolonged action for intramuscular (i / m) administration: a powdery mass from white (almost white) to light yellow-brown in color, does not contain visible foreign inclusions. The attached solvent is a colorless transparent liquid in which the powder is easily suspended, without agglomerates, into a white or slightly yellowish-brownish suspension passing through a needle (included) without resistance or with little resistance; the needle should not leave the solvent without suspension (430 mg each in glass vials, with a capacity of 5 ml, complete with a solvent - 4 ml, a 5 ml syringe, one short needle for preparing a suspension and two needles for injection; in a cardboard box 1 set).

1 bottle of powder contains (with an excess of 12.9%) active ingredient: naltrexone [encapsulated in polymer: 75:25 DL JN1 (copolymer of glycolic and lactic acids)] - 430 mg.

One bottle is designed for the preparation of 1 dose (4 ml) of the finished suspension, containing 380 mg of naltrexone.

1 bottle with a solvent contains sodium chloride, polysorbate 20, sodium carmellose (sodium carboxymethyl cellulose), water for injection.

Pharmacological properties

Pharmacodynamics

The active component of Vivitrol, naltrexone, is an opioid receptor antagonist with the highest affinity for OR-μ (opioid mu receptors). Naltrexone does not show any other pharmacological activity other than blockade of opioid receptors, but for unknown reasons it can cause pupil constriction. Does not contribute to the development of tolerance or mental / physiological dependence. Administration of Vivitrol to physically dependent opioid patients causes withdrawal symptoms.

In patients with alcohol dependence, when taking naltrexone, the neurobiological mechanisms responsible for reducing alcohol consumption are activated, their effect is not fully understood, but it is assumed that it is associated with the function of the endogenous opioid system.

Naltrexone, by competitively binding to OP-μ, blocks the action of opiates. The blockade of the action of naltrexone can be eliminated by the administration of high doses of opioids, which can result in an increase in the release of histamine, accompanied by a characteristic clinical picture. Binding to opioid receptors is able to block the action of endogenous opioid peptides.

Since naltrexone does not belong to aversive therapy, Vivitrol does not cause a disulfiram-like reaction when using opiates or alcohol.

Pharmacokinetics

• absorption: for intramuscular administration of naltrexone, two peaks of its concentration in blood plasma are characteristic - the initial one, which reaches its maximum value after administration in about 2 hours, and the second - after 2-3 days. The concentration of the substance in the plasma begins to decrease in about 2 weeks, the process occurs gradually, for more than 1 month its indicators remain measurable. For naltrexone and its main metabolite (6-beta-naltrexol), the maximum concentration (Cmax) and the total concentration during the entire observation period (AUC) in blood plasma are proportional to the dose of Vivitrol administered intramuscularly. With a single administration of 380 mg of Vivitrol, the total exposure of naltrexone is 3-4 times higher than when taken orally at 50 mg / day for 4 weeks. Equilibrium concentration (Css) after the first injection is reached by the end of the interdose interval,the accumulation of naltrexone and its main metabolite after repeated administration is minimal (<15%);
• distribution: according to the results of in vitro studies, it was determined that naltrexone binds weakly to blood plasma proteins (up to 21%);
• metabolism: naltrexone is actively metabolized, its main metabolite, 6-beta-naltrexol, is formed with the participation of the cytosolic enzyme dihydrodiol dehydrogenase. Isoenzymes of the cytochrome P450 system do not participate in the metabolism of the drug. Naltrexone, its main metabolite and other metabolites (2-hydroxy-3-methoxy-6-beta-naltrexol, 2-hydroxy-3-methoxy-naltrexone) are conjugated with glucuronic acid. Due to the reduced presystemic elimination of i / m, the introduction of Vivitrol significantly reduces the formation of 6-beta-naltrexol in comparison with the ingestion of the substance;
• excretion: naltrexone and its metabolites are excreted mainly by the kidneys, the amount of the drug excreted unchanged is minimal. The half-life (T _1/2) of naltrexone and its main metabolite is 5 to 10 days. In naltrexone, it depends on the degree of polymer degradation.

Pharmacokinetic parameters of naltrexone in special clinical cases:

• liver dysfunction: mild or moderate (class A and B on the Child-Pugh scale) - pharmacokinetics does not change, dose adjustment is not required for patients; severe liver dysfunction - pharmacokinetics have not been studied;
• impaired renal function: mild with creatinine clearance (CC) from 50 to 80 ml / min - practically does not affect the effectiveness, dose adjustment is not required for patients; moderate and severe renal dysfunction - pharmacokinetics have not been studied;
• gender: according to the results of studies conducted with the participation of healthy patients of both sexes (18 women and men each), it was revealed that the sex of patients does not affect the pharmacokinetics of naltrexone;
• elderly patients, children and representatives of different races: pharmacokinetics have not been studied.

Indications for use

According to the instructions, Vivitrol is recommended for the treatment of alcohol dependence only in patients who are able to abstain from drinking alcohol before starting the course (they also need to restrain themselves from actively drinking alcohol at the beginning of treatment).

The drug is prescribed to prevent relapse of opioid dependence after opioid detoxification. Opiate-dependent patients (including those receiving treatment for alcoholism) should not take opioids at the beginning of therapy.

Taking Vivitrol should be part of a comprehensive addiction elimination program, one of which must be psychosocial support.

Contraindications

• simultaneous use of narcotic analgesics;
• concomitant use of opioids;
• opioid withdrawal syndrome (sudden withdrawal of opioids);
• no results of a provocative test with naloxone, a positive test result for the presence of opioids in urine;
• severe hepatic insufficiency (including hepatitis);
• period of pregnancy;
• lactation (breastfeeding);
• children and adolescents under 18 years of age;
• individual hypersensitivity to any components included in the drug and solvent.

Instructions for the use of Vivitrol: method and dosage

The injection should only be administered by qualified healthcare professionals. It is required to use only the components in the package for the preparation of the solution and the procedure; they are not allowed to be replaced.

Vivitrol is a long-acting drug, it is recommended to administer it IM once every 28 days or once a month at a dose of 380 mg. The drug is injected into the muscle of the right and left buttocks alternately.

You can not enter the solution prepared from the suspension intravenously and subcutaneously.

If the next injection is missed, the next dose should be administered as soon as possible.

Oral administration of naltrexone is not required before starting i / m administration.

There is no data on the resumption of therapy after a break.

There is no systematic data on the results of transferring patients from oral naltrexone to Vivitrol.

To prepare the suspension, use only the supplied solvent. It is required to inject the drug with the included needle. For injection, all components of the package are required - vials with powder and solvent, a needle for preparing a suspension and an injection needle with a protective cap. The kit also includes a spare injection needle with a protective cap. It is strictly forbidden to replace the supplied components.

To ensure accurate dosing, you must strictly follow the directions for the preparation and administration of the drug.

During the preparation and administration of the suspension, aseptic rules should be strictly observed.

Recommendations for the procedure:

1. 45 minutes before the injection, the package with the drug should be removed from the refrigerator and allowed to warm to room temperature.
2. To loosen the powder before reconstitution, to facilitate mixing, tap the bottom of the bottle against a hard surface.
3. Remove the aluminum safety caps from both vials (the drug cannot be used if the vial caps are missing or damaged).
4. The necks of the vials should be wiped with an alcohol wipe.
5. To prepare the suspension, put a short needle on the syringe, draw 3.4 ml of the solvent from the vial with the solvent, while some of the solvent will remain in the vial. Into the vial with the powder add 3.4 ml of the solvent and vigorously shake the vial for about 1 min to mix the solvent and powder. Make sure that the suspension is homogeneous, it should be milky white, not contain lumps, flow freely along the walls of the bottle.
6. After visual assessment of the prepared suspension, using the same short needle, 4.2 ml should be drawn into the syringe.
7. Replace the suspension needle on the syringe with an injection needle. Before injection, knock on the syringe to release air bubbles, and then gently push the plunger, leaving 4 ml of suspension in it. Everything is ready for immediate injection.
8. Insert the syringe needle deep into the gluteus muscle, with a suction movement of the piston, check if the needle has entered the vessel, there should be no blood in the syringe. A spare needle in the kit is necessary when blood appears, when it is necessary to repeat the procedure, having previously replaced the first needle with it. The suspension should be injected with a smooth movement deep into the gluteus muscle. The injections are carried out alternately in different buttocks.
9. After the procedure, the needle should be closed with a protective cap, holding it away from you and pressing it with one hand against a hard surface. The safety cap prevents splashing of liquid, which residues may be on and in the needle after injection. Used / unused packaging components must be discarded.

Side effects

The results of clinical trials lasting up to six months in patients taking Vivitrol therapy:

• alcohol dependence: 9% of patients discontinued therapy due to side effects. In the placebo group, 7% of the subjects discontinued treatment under the same conditions. Most often, the refusal from the drug was due to: reactions at the injection site - 3%; nausea - 2%; pregnancy - 1%; headache - 1%; suicidal behavior - 0.3%. Moreover, in the placebo group, due to the occurrence of reactions at the injection site, treatment was stopped only in 1% of cases;
• opioid dependence: 2% of both opioid-dependent patients and placebo-administered subjects discontinued the course due to side effects.

Frequent adverse reactions from systems and organs (more than 5% of cases) in patients with alcoholism, encountered in clinical trials, with mild to moderate severity:

• digestive system: nausea / vomiting, diarrhea, dry mouth, gastrointestinal upset, frequent urge to defecate, abdominal pain, frequent loose stools, stomach discomfort, loss / impairment of appetite, anorexia;
• respiratory system: infection of the upper respiratory tract (sinusitis, laryngitis, nasopharyngitis, pharyngitis, including streptococcal);
• musculoskeletal system: joint pain, arthritis, joint stiffness, limb pain, back pain, muscle spasm / twitching, muscle stiffness;
• skin and subcutaneous tissues: rash, papules, prickly heat;
• nervous system: headache, dizziness, migraine, fainting, anxiety, drowsiness, sedation;
• general reactions: asthenia, lethargy, hemorrhage, lethargy;
• local reactions: induration, pain, soreness, swelling, itching.

In patients with opioid dependence, side effects were generally the same as in the treatment of alcohol dependence.

Frequent side reactions from systems and organs (more than 2% of cases) in patients with opioid dependence, occurring in clinical trials, with mild to moderate severity:

• respiratory system: flu, nasopharyngitis;
• nervous system: insomnia, headache;
• cardiovascular system: increased blood pressure (BP);
• general disorders, reactions at the injection site: pain;
• digestive system: toothache;
• laboratory parameters: an increase in the activity of hepatic transaminases alanine aminotransferase (ALT), aspartate aminotransferase (AST) and the enzyme gamma-glutamyl transpeptidase (GGT).

Side effects identified during pre-registration clinical trials of the drug:

• digestive system: dysgeusia, increased appetite, constipation, flatulence, gastrointestinal bleeding, colitis, tooth abscess, hemorrhoids, paralytic ileus, perrectal abscess, gastroenteritis, abdominal discomfort, cholelithiasis, acute pancreatitis, increased AST and ALT activity, acute cholecystitis reflux esophagitis;
• mental disorders: sleep disturbance, irritability, alcohol withdrawal syndrome, euphoria, agitation, delirium;
• nervous system: migraine, impaired attention, decreased mental performance, convulsions, cerebral artery aneurysms, ischemic stroke, paresthesia;
• sense organs: conjunctivitis, blurry vision;
• musculoskeletal system: muscle spasm, pain in the limbs, joint stiffness, myalgia;
• skin and subcutaneous tissues: hyperhidrosis, including at night, itching;
• respiratory system: shortness of breath, sore throat, nasal congestion, bronchitis, obstructive bronchitis, pneumonia, sinusitis, laryngitis, upper respiratory tract infections;
• metabolism: dehydration, heat stroke, hypercholesterolemia;
• cardiovascular system: pulmonary thrombosis, deep vein thrombosis, hot flashes, atrial fibrillation, heart palpitations, myocardial infarction, angina pectoris (including unstable), atherosclerosis of the coronary arteries, chronic heart failure;
• hematopoietic system: lymphadenopathy (including inflammation of the cervical lymph nodes), increased leukocyte count in the blood;
• allergic reactions: seasonal allergies, angioedema, urticaria;
• immune system: in HIV-infected patients, progression of HIV infection;
• urinary system: decreased libido, spontaneous abortion, urinary tract infections;
• general reactions: trembling, chills, chest pain / tightness, fever, weight gain / decrease, facial edema, lethargy.

Overdose

Data on overdose with naltrexone are very limited. When 5 healthy subjects were administered a single dose of 784 mg, no serious side effects were noted.

Symptoms of a naltrexone overdose may include the most common side effects: reactions at the injection site, abdominal pain, nausea, drowsiness, and dizziness. A significant increase in the activity of liver enzymes was not observed.

If such reactions develop, supportive treatment is recommended.

special instructions

Opioid-dependent patients need to stop taking opioids at least 7-10 days before starting therapy with Vivitrol in order to avoid the development of an acute withdrawal syndrome and / or to prevent an exacerbation of an already existing withdrawal syndrome.

The absence of opioids in the urine is often an insufficient indicator to confirm their absence in the body, in case of a risk of withdrawal syndrome, a provocative test with naloxone must be done before starting the course of Vivitrol therapy.

With the development of hypersensitivity reactions, such as urticaria, anaphylaxis, angioedema, you should immediately stop further use of the drug and consult a doctor.

Vivitrol therapy not only does not exclude, but does not even reduce the symptoms associated with stopping alcohol intake.

It is not known what effect the drug has on the birth process.

Depression and suicidal behavior

Family members and people caring for patients receiving treatment with Vivitrol should be warned about the need to carefully monitor for signs of depression or suicidal behavior, and immediately report them to their doctor.

Data from controlled clinical trials of suicidal behavior when taking Vivitrol (suicidal intent, attempted suicide, committed suicide):

• alcohol-dependent patients: suicidal behavior was uncommon, but it was more common in patients receiving Vivitrol than in the placebo group (1% versus 0). In some episodes, this behavior was recorded after the completion of the study, but was a consequence of depression that appeared during drug therapy. Two committed suicides were recorded in which patients were treated with Vivitrol. Depression-related termination of the course in the group of patients taking Vivitrol occurred more often (1%) than in the placebo group (0). A placebo-controlled study of 24 weeks duration showed that adverse events associated with depression were observed: in the group receiving treatment with Vivitrol at a dose of 380 mg - in 10%; in the placebo group - 5%;
• opioid-dependent patients: suicidal side effects were observed in 5% of patients receiving Vivitrol injections and in 10% of patients receiving oral naltrexone. A 24-week, placebo-controlled study showed no depression-related adverse events in both the Vivitrol 380 mg group and the placebo group.

Injection site reactions

Vivitrol injections can be accompanied by swelling, soreness, pain, induration, itching, erythema. But in some cases, very strong reactions are possible at the injection site of the suspension. In the course of clinical studies, a case of the formation of a seal that continued to increase four weeks after injection was reported, with the development of necrosis, which required surgical removal.

Post-registration monitoring also noted such reactions at the injection site as compaction, inflammation of the subcutaneous tissue, hematomas, abscesses, sterile abscesses, necrosis. Some of them had to be removed promptly, in some cases, mainly in women, scars formed at the injection site.

Vivitrol should only be injected into the gluteus maximus; accidental subcutaneous administration increases the likelihood of serious adverse reactions at the injection site. The included injection needle is specially designed for the administration of Vivitrol suspension, and it absolutely must not be replaced with any other. When the length of the needle is insufficient due to the peculiarities of the physique, a different treatment should be prescribed. Before giving an injection, it is the physician's responsibility to ensure that the needle is suitable for the patient.

Patients should be warned about the obligation to inform the attending physician about the occurrence of any reactions at the site of suspension administration. At the first signs of an abscess, significant swelling, inflammation of the subcutaneous tissue or necrosis, the doctor must decide whether surgery is necessary.

Retinal artery occlusion

During clinical and post-registration observations, there were no cases of retinal artery obstruction. After the injection of other drugs containing a copolymer of lactic and glycolic acid, occlusion of the retinal artery in post-registration studies was observed extremely rarely and only with the concomitant presence of an abnormal arteriovenous anastomosis. In order to avoid getting the drug into a blood vessel, the suspension should be injected strictly into the gluteus muscle.

Hepatotoxicity

Exceeding the recommended dosage of naltrexone can cause hepatocellular disorders.

The use of Vivitrol is contraindicated in patients with acute hepatitis and acute liver failure. In acute liver disease, the appointment of naltrexone should be carefully weighed and justified taking into account the risk of severe liver dysfunction. The ratio of a safe dose of naltrexone to a dose that causes liver damage is less than 5.

Vivitrol, when used in recommended doses, is not hepatotoxic.

It is necessary to inform patients at the beginning of therapy about the likelihood of liver disorders and recommend that if symptoms of hepatitis occur, seek medical attention. Drug therapy in this situation should be interrupted.

Eosinophilic pneumonia

In clinical studies, one case of eosinophilic pneumonia was diagnosed, one case of suspected it. Both times, patients required hospitalization and therapy with antibiotics and glucocorticosteroids (GCS).

The possibility of eosinophilic pneumonia during Vivitrol therapy cannot be ruled out, and therefore patients are advised to consult a doctor immediately in the event of symptoms such as hypoxia and progressive shortness of breath.

The specialist should take into account that the development of eosinophilic pneumonia is possible in patients with antibiotic resistance.

Elimination of blockade of opioid receptors with Vivitrol

For patients receiving treatment with Vivitrol, in emergency situations, the proposed method of relieving pain is regional anesthesia or the use of non-narcotic analgesics.

If it is necessary to use narcotic analgesics for the purpose of anesthesia or analgesia, patients need to provide long-term medical supervision.

Therapy with narcotic analgesics should be carried out by specially trained personnel (in order to avoid breathing problems), capable of carrying out artificial ventilation (IVL) in case of complications.

Regardless of the drugs used to eliminate the effect of naltrexone, the patient must be kept in a specially equipped intensive care unit under the constant supervision of qualified medical workers.

Opioid overdose while trying to overcome opioid receptor blockade

Patients usually have decreased opioid tolerance after opioid detoxification. Vivitrol blocks the action of exogenous opioids for 28 days, but there are cases of patients receiving a lethal dose of opioids who took them before the introduction of a new dose of Vivitrol or when skipping the next injection of the drug.

After treatment with Vivitrol, an increase in sensitivity to opioids is possible, which can be the cause of potentially life-threatening opioid intoxication (including respiratory failure or respiratory arrest and collapse). Patients should be warned that upon completion of treatment with Vivitrol, they may be more sensitive even to low doses of opioids. We must not forget about the decrease in tolerance to opiates at the end of the dosing interval (one month after the previous injection and when the next injection is skipped). Patients and their families should be informed about opioid hypersensitivity during these periods and the risk of overdose.

The blockade caused by Vivitrol can be overcome, despite its strong antagonistic effect on opioid receptors and long-term pharmacological effect. Patients who try to overcome this blockade by administering high doses of exogenous opioids run the risk of fatal doses. At a plasma concentration of opioids, immediately after their administration, sufficient to overcome the competitive blockade of opioid receptors, opioid intoxication can instantly develop, life-threatening, manifested by respiratory depression and collapse. Patients should be educated about the severity of the consequences of trying to overcome opioid receptor blockade.

The effect of the drug on laboratory blood parameters

At the beginning of treatment with Vivitrol, an increase in the concentration of eosinophils in the blood was noted, but after several months of therapy, this indicator returned to normal.

With therapy with high doses of the drug, an average of 17.8 × 10 ³ μl decrease in the number of platelets was recorded. Opioid-dependent patients who received therapy for 24 weeks showed a decrease in platelet count to an average of 62.8 x 10 ³ μl. In the placebo group, this indicator was 39.9 × 10 ³ μl. But when conducting randomized controlled trials in all patients, no evidence of the effect of Vivitrol on increased bleeding was obtained.

The increase in AST activity with Vivitrol was the same as with oral naltrexone and was 1.5% compared to 0.9% in the placebo group.

Clinical studies of patients with opioid dependence lasting up to six months have shown that hepatitis C was diagnosed in 89% of cases, and HIV infection in 41% of cases. In the course of studies, an increase in the activity of liver enzymes and GGT was often observed. Such side effects were more likely to be observed in the group of patients receiving Vivitrol therapy at a dose of 380 mg than in the placebo group. At the same time, the study did not include patients in whom the activity of ALT or AST exceeded the upper limit of normal (UHN) more than 3 times. Such an increase in enzyme activity was observed in 20% of cases with Vivitrol treatment and in 13% of cases in the placebo group.

In the treatment of opioid dependence with Vivitrol, the ALT / AST activity increased on average by 61/40 IU / L, in the placebo group - on average by 48/31 IU / L.

Increased activity of CPK (creatine phosphokinase): in the course of clinical studies of patients receiving Vivitrol injections, the indicator, as a rule, exceeded the UGN by 1–2 times. Similar results were observed with oral forms of naltrexone. But there are known cases of a 4-fold excess of VGN with oral administration of naltrexone and even a 35-fold increase in CPK activity with Vivitrol injections.

In the treatment of opioid dependence with Vivitrol, the CPK activity above normal increased on average in 39% of patients, in the placebo group - in 32%.

There are known cases of an increase in CPK activity in comparison with VGN: in the placebo group - by 41.8 times; in the group of patients treated with Vivitrol - 22.1 times.

In laboratory studies of urine by enzyme immunoassay, false positive results are possible for a number of drugs, in particular for opioids. Such studies are required in accordance with the information provided in the instructions for conducting specific analyzes.

Influence on the ability to drive vehicles and complex mechanisms

Patients who develop dizziness during therapy should refrain from driving vehicles and mechanisms, as well as from other potentially hazardous activities that require concentration of attention and speed of psychomotor reactions.

Application during pregnancy and lactation

The effect of Vivitrol during pregnancy has not been studied. The drug is used only in case of a significant excess of the potential benefit to the mother over the possible risk to the fetus.

Oral administration of Vivitrol resulted in the excretion of naltrexone and its primary metabolite, 6-beta naltrexol, in breast milk. Due to the fact that they are potentially carcinogenic and can cause serious side effects in infants, during lactation, depending on the degree of significance of therapy for the mother, treatment with the drug should be discontinued or breastfeeding should be interrupted.

Pediatric use

There are no data on the safety and effectiveness of Vivitrol in pediatrics.

With impaired renal function

Patients with mild renal insufficiency, with CC from 50 to 80 ml / min, do not need to adjust the dose of naltrexone. Patients with moderate to severe renal impairment are advised to prescribe Vivitrol with caution, since naltrexone and its primary metabolite are excreted mainly in the urine.

For violations of liver function

Patients with mild or moderate hepatic impairment (classes A and B on the Child-Pugh scale) do not require dose adjustment. In severely impaired liver function, the pharmacokinetics of Vivitrol have not been studied. As with other intramuscular injections, Vivitrol should be administered to such patients with caution, given the risks associated with intramuscular injection of the emulsion (for example, in the presence of thrombocytopenia and coagulation disorders).

Use in the elderly

In clinical trials of Vivitrol, a small number of elderly patients over 65 years old took part, insufficient to compare the effect of treatment in different age groups.

Drug interactions

The interaction of Vivitrol with other substances / drugs has not been studied.

Naltrexone is an antagonist of opiate-containing drugs (eg, opioid analgesics, cold, cough, diarrhea).

In theory, inducers or inhibitors of enzymes of the cytochrome system should not affect the clearance of Vivitrol, since naltrexone is not a substrate for these enzymes.

Due to the fact that studies to assess the clinical significance of the effect of other drugs on the metabolism of Vivitrol have not been carried out, caution should be exercised when assessing the possible risks and potential benefits when Vivitrol is prescribed concurrently with other drugs.

The safety indicators for the use of Vivitrol with / without antidepressants are the same.

Analogs

Vivitrol analogs are Antaxon, Biotredin, Naltrexon, Naltrexon FV, Esperal, Teturam, Selinkro, Colme, etc.

Terms and conditions of storage

Store at 2 to 8 ° C (do not freeze). Storage at temperatures up to 25 ° C is allowed, but not more than 7 days. Exposure to temperatures over 25 ° C should be avoided.

Keep out of the reach of children.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Vivitrol

In most reviews of Vivitrol, patients describe the side effects they have suffered, mainly weakness, poor condition, headache, insomnia, joint pain, depression, unmotivated aggression. At the same time, many believe that the result is worth the suffering experienced, since the craving for alcohol disappears completely. Even the rather high cost of the drug raises no objections.

The price of Vivitrol in pharmacies

The approximate price of Vivitrol for 1 set, including a bottle (bottle) with powder for preparation of a suspension for intramuscular administration of prolonged action of 380 mg, a bottle (bottle) with a solvent, a syringe and 3 needles is 18630-19553 rubles.

Vivitrol: prices in online pharmacies

Drug name Price Pharmacy

Vivitrol 380 mg powder for suspension for intramuscular administration of prolonged action 1 pc. RUB 19,100 Buy

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!