Prescription onlyLower-cost generic availableClass: Pain

Vivitrol Alternatives

(naltrexone)

Prescription onlyLower-cost generic availableClass: Pain
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Compare Vivitrol (naltrexone) to alternatives

These medications are comparable to Vivitrol (naltrexone) or used for similar purposes.

Vivitrol
(naltrexone)

Methadose
(methadone)

Suboxone
(buprenorphine / naloxone)

Narcan
(naloxone)

Treats alcohol dependence and prevents relapse of addiction to opioids. Vivitrol (Naltrexone) is good for treating opioid and alcohol dependence. It needs to be used as directed and can't be used with alcohol or opioid pain medications.Treats severe pain and drug dependence. Methadose (Methadone) works well for moderate to severe pain especially nerve-related and complex pain and is effective for maintenance opioid addiction treatment. You need to be careful with dosing.Treats drug dependence. Suboxone (Buprenorphine / Naloxone) works well to reduce cravings and treat opioid dependence. It's most effective if you have an addiction to heroin or short-acting-opioids.Helps people breathe during an opioid overdose. Narcan (naloxone) is used in an emergency if you think someone has overdosed on opioids. It only works for a few minutes and you'll need to call for emergency help.
Reviews & ratings
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Have you used Vivitrol (naltrexone)?
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Have you used Methadose (methadone)?
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Reviews for Suboxone
80%
-30% worse vs. Naltrexone
66%
-16% worse vs. Naltrexone
0%
-33% worse vs. Naltrexone
Have you used Suboxone (buprenorphine / naloxone)?
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Have you used Narcan (naloxone)?
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Side effects
NaltrexoneMethadoneSuboxonenaloxone
  • Nausea 10%
  • Headache 7%
  • Dizziness 4%
  • Nervousness 4%
  • Fatigue 4%
  • Insomnia 3%
  • Vomiting 3%
  • Anxiety 2%
  • Somnolence 2%
More Naltrexone side effects »

The Methadone FDA package insert doesn’t have numbers about how common side effects are.

More about Methadone side effects »
  • Headache 14%
  • Pain 3%
  • Nausea 4%
  • Sweating 4%
  • Constipation 9%
  • Pain abdomen 4%
  • Vasodilation 2%
More Suboxone side effects »

The naloxone FDA package insert doesn’t have numbers about how common side effects are.

More about naloxone side effects »
How it works
NaltrexoneMethadoneSuboxonenaloxone
Vivitrol (Naltrexone) blocks all opioid receptors in your body and prevents you from feeling the effects of opioid medications and alcohol.Methadose (Methadone) is an opioid medicine (similar to morphine) that works in the brain to lower pain perception. Because withdrawal from Methadose (Methadone) is slower, takes longer, and is less severe than other opioids, it's used under the care of a doctor to treat opioid addiction.Suboxone (Buprenorphine / Naloxone) is a combination medicine with two parts that work together to treat opioid dependence. Buprenorphine is an opioid pain reliever (similar to morphine). Naloxone mildly counteracts the pain reliever, so it's added to prevent overuse or abuse of this medication.Narcan (naloxone) works by reversing the action of opioids. People who overdose on opioids can have problems breathing.
Type of medication
NaltrexoneMethadoneSuboxonenaloxone
Prescription onlyPrescription onlyPrescription onlyPrescription only
Available as
NaltrexoneMethadoneSuboxonenaloxone
  • Pill
  • Pill
  • Dispersable tablet
  • Liquid
  • Powder for solution
  • Pill
  • Sublingual film
  • Dissolving tablet
  • Injection
Used for
NaltrexoneMethadoneSuboxonenaloxone
  • Opioid Overdose
Risk factors for serious side effects
NaltrexoneMethadoneSuboxonenaloxone
  • Prior use of opioid medications
  • Use of Vivitrol (Naltrexone)
  • Current use of opioid medications
  • New use of Vivitrol (Naltrexone)
  • Women of childbearing age
Detailed Vivitrol (naltrexone) risks & warnings »
  • Start of treatment
  • Age 65 or greater
  • Dose changes and higher doses
  • People with not enough thyroid hormones
  • History of lung problems
Detailed Methadose (methadone) risks & warnings »
  • Cardiovascular disease
  • dehydration
  • taking drugs that lower blood pressure
  • Liver disease
  • Hepatitis B and C
Detailed Suboxone (buprenorphine / naloxone) risks & warnings »
  • Regular use of opioids
  • History of heart problems
  • Taking medications that affect the heart
  • History of seizures
  • Meperidine use
Detailed Narcan (naloxone) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Interactions
NaltrexoneMethadoneSuboxonenaloxone
No interactions related info.No interactions related info.
  • Fewer side effects and drug interactions compared to other similar medicines.
No interactions related info.
Alcohol
NaltrexoneMethadoneSuboxonenaloxone
  • If you're taking Vivitrol (Naltrexone) for alcohol dependence, it'll make you not want to drink alcohol, but it won't stop the effects of alcohol if you do drink.
  • Can be used with behavior modification therapy to treat opioid or alcohol use disorders.
  • Don't mix with alcohol or other sedating drugs.
  • Don't mix with alcohol or other sedating drugs.
No alcohol related info.
Food
NaltrexoneMethadoneSuboxonenaloxone
No food related info.
  • Some medicines can affect enzymes that break down Methadose (Methadone). Certain drugs to treat infections, HIV, and seizures can change the amount of Methadose (Methadone) in the body and cause either overdose or withdrawal. Tell your doctor about any prescription or over-the-counter medications you are taking.
  • Some medicines can affect enzymes that break down Suboxone (Buprenorphine / Naloxone). Certain drugs to treat infections, HIV, and seizures can change the amount of Suboxone (Buprenorphine / Naloxone) in the body. Tell your doctor about any medications you are taking and if you notice muscle aches, restlessness, anxiety, tearing eyes, runny nose, excessive sweating, yawning or inability to sleep. These may be symptoms of withdrawal.
No food related info.
Kidneys and liver
NaltrexoneMethadoneSuboxonenaloxone
  • Not a good choice if you have liver problems, depression, or are pregnant or breastfeeding.
No kidneys and liver related info.No kidneys and liver related info.No kidneys and liver related info.
Pain
NaltrexoneMethadoneSuboxonenaloxone
No pain related info.
  • Relieves pain and treats opioid addiction.
  • Need to use it “around-the-clock for pain control not “as needed”.
  • May cause you to become tolerant (more medicine is needed to treat the same pain) and physically dependent if you’ve used it for a while so don’t stop talking it suddenly or you may feel withdrawal symptoms.
  • The film can cause reduced sensation in your mouth, painful burning tongue, or burning mouth syndrome.
No pain related info.
Sleep
NaltrexoneMethadoneSuboxonenaloxone
No sleep related info.No sleep related info.
  • Can make you drowsy and dizzy.
No sleep related info.
Upsides and benefits
NaltrexoneMethadoneSuboxonenaloxone
  • Available in two different forms: a tablet you take every day and as a shot your doctor gives you once a month.
  • Good for people who have a mild opioid use disorder and who are highly motivated, or who can be supervised as they take their medication.
  • Can be used with behavior modification therapy to treat opioid or alcohol use disorders.
  • Higher success rates are seen in people who use this under supervision.
  • The tablet is available as a generic.
  • Relieves pain and treats opioid addiction.
  • Good option for people who don't get pain relief with more-common opioids, have side effects or allergies with other options, or have nerve pain (neuropathic pain).
  • Even low doses are more effective than placebo at treating shooting, burning pain.
  • Less constipating than other opioid medicines to treat pain.
  • Available as a generic medicine.
  • Effective at preventing abuse or misuse in people who are addicted to opioids. Works best for people addicted to short-acting opioids or heroin.
  • Your doctor can adjust the dose to a level that controls withdrawal symptoms until you're stable. Studies show the right dose depends on the person and how the drug works for them.
  • Fewer side effects and drug interactions compared to other similar medicines.
  • Can help save the life of someone who has overdosed on opioid drugs.
  • One brand of Narcan (naloxone) comes as a take-home auto-injection system with voice directions that talk you through giving Narcan (naloxone) in an emergency situation.
Downsides and risks
NaltrexoneMethadoneSuboxonenaloxone
  • People who try to take opioids after taking Vivitrol (Naltrexone) are at risk for opioid overdose and death since it takes a large amount of opioids to overcome the effects of Vivitrol (Naltrexone).
  • You won't be able to use any medications with opioids for pain relief since Vivitrol (Naltrexone) prevents them from working.
  • The shot is only available as brand name only, so it can be expensive.
  • Not a good choice if you have liver problems, depression, or are pregnant or breastfeeding.
  • Need to use it “around-the-clock for pain control not “as needed”.
  • Even one dose is too much for child or pet and is a medical emergency so store out of their reach.
  • Can cause slowed breathing, coma and death from overdose, especially if you mix with other nervous system depressants.
  • Has a higher risk of affecting heart rate control especially if you have cardiovascular disease (previous heart attack, stroke, fast/uncontrolled heart rate, or irregular heart beat).
  • Can reduce your ability to focus, think, and react so avoid activities that require you to be alert, such as driving a car or operating machinery, until you know how this medicine affects you.
  • Not safe to take if you're pregnant or breast-feeding and can increase the risk of neonatal withdrawal syndrome in women with a history of long-term opioid use.
  • May cause you to become tolerant (more medicine is needed to treat the same pain) and physically dependent if you’ve used it for a while so don’t stop talking it suddenly or you may feel withdrawal symptoms.
  • Can cause your blood pressure drop suddenly if you change positions quickly.
  • Certain prescription and over-the-counter medicines can change the amount of medicine in your body and cause either overdose or withdrawal.
  • Not as good for people who are dependent on long-acting opioids or Methadone because of the risk of a long withdrawal.
  • Like all opioids, it can cause slowed breathing, coma, and death from overdose, especially if you mix with other nervous system depressants like pain medicine or alcohol.
  • You have to be very careful with your dose. Changing the size or strength of a film can affect the amount of drug absorbed into your body, and could cause under- or over-dosing.
  • The film can cause reduced sensation in your mouth, painful burning tongue, or burning mouth syndrome.
  • Narcan (naloxone) is to be given right away and does not take the place of emergency medical care. Get emergency medical help right away after the first dose, even if the person wakes up.
  • Repeat dosing of Narcan (naloxone) may be required in some cases where the opioid hangs around in the body for a long time.
  • Narcan (naloxone) can cause acute withdrawal symptoms (body aches, anxiety, sweating, vomiting, fast breathing, shivering) if the person has been using opioids regularly.
Tips from our pharmacists for people taking the medication
NaltrexoneMethadoneSuboxonenaloxone
  • Before starting Vivitrol (Naltrexone), you should be off all opioid medications (including buprenorphine and methadone) for at least 7 to 10 days, otherwise you'll get withdrawal symptoms.
  • You'll need to use non-opioid pain medications (if necessary) while on Vivitrol (Naltrexone).
  • Wear a medical alert identification if you're taking Vivitrol (Naltrexone) since you would need to be given non-opioid medications in case of an emergency.
  • If you're taking Vivitrol (Naltrexone) for alcohol dependence, it'll make you not want to drink alcohol, but it won't stop the effects of alcohol if you do drink.
  • Vivitrol (Naltrexone) can make you feel dizzy the first few times you take it, so avoid doing anything requiring concentration until you know how your body reacts to it.
  • Long-acting opioid for moderate to severe pain.
  • May not be the best choice for people who have never taken opioids, or who've only taken shorter-acting opioids for pain.
  • May be part of a complete program to reduce opioid dependence.
  • For short-term treatment of opioid dependence, the target dose is 40mg for 2-3 days, then reduced every 2 days.
  • For long-term drug detoxification treatment the dose is increased until withdrawal symptoms stay away for 24 hours.
  • Dosing can vary widely, but for most people the general range is 80-120mg daily.
  • Take exactly as your doctor instructs and don’t take more than you're prescribed.
  • Can make you dizzy or drowsy.
  • Avoid activities that need you to be fully alert until you know how it affects you.
  • Don't mix with alcohol or other sedating drugs.
  • Constipation is common and may not go away while you're taking this medicine. Drinking lots of water and taking laxatives can help.
  • Talk to your doctor if it doesn't help enough for your pain.
  • If you need to stop taking this medicine, work with your doctor to slowly lower your dose. It'll help you avoid withdrawal symptoms.
  • Careful reduction from your maintenance dose is important. It shouldn't be more than 10% of the total daily dose, reduced every 10 to 14 days.
  • A doctor should supervise your use of this medication as part of a complete treatment program.
  • Can make you drowsy and dizzy.
  • Avoid activities that need you to be fully alert until you know how it affects you.
  • Suboxone film and Zubsolv tablets have different dosing. Be careful.
  • Don't mix with alcohol or other sedating drugs.
  • Drink water before putting the film under your tongue.
  • Don't cut, chew or swallow the film.
  • If you need to stop taking it, work with your doctor to slowly lower your dose. It'll help you avoid withdrawal symptoms.
  • Get emergency help right away after giving the first dose of Narcan (naloxone).
  • The signs and symptoms of an opioid emergency can return after Narcan (naloxone) is given. If this happens, give another dose after 2 to 3 minutes and watch the person closely until emergency help arrives.
  • Family and friends should know where Narcan (naloxone) is stored and know how to give it in case of an emergency.
  • It's important to check the expiration date of Narcan (naloxone) and to protect it from light if it is not stored in its box.
  • Family and friends should be able to recognize the signs and symptoms of an opioid overdose (unusual sleepiness, trouble breathing, small pupils, slow pulse).
Learn more
More about NaltrexoneSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Vivitrol (naltrexone)?
Worth itNot sureNot worth it
More about MethadoneSide effectsReviews & ratingsFDA package insert
Have you used Methadose (methadone)?
Worth itNot sureNot worth it
More about SuboxoneSide effectsReviews & ratingsFDA package insert
Have you used Suboxone (buprenorphine / naloxone)?
Worth itNot sureNot worth it
More about naloxoneSide effectsFDA package insert
Have you used Narcan (naloxone)?
Worth itNot sureNot worth it