Naltrexone Pill vs. Naltrexone Injection: A Comparison

If you want to cut down on drinking alcohol or quit completely, medication may be appropriate to help you do so. 

Naltrexone is a medication approved by the Food and Drug Administration (FDA) for the treatment of alcohol use disorder (AUD). Naltrexone curbs your desire to drink. It is available as a daily pill or monthly injection. Several factors will determine which form of naltrexone is best for you.

Naltrexone Oral: Tablet/Pill Form

The pill form of naltrexone is a prescription medication that blocks the “buzz” and intoxicated feelings associated with drinking alcohol. 

Naltrexone hydrochloride is the full name of the drug, but it is widely known as just naltrexone. 

When taken daily as a 50-milligram (mg) pill to treat AUD, naltrexone helps reduce heavy drinking, frequency of drinking, alcohol cravings, and alcohol relapse.

Qualify For Treatment

What is Oar?

Oar is a service that provides people who are ready to change their relationship with alcohol access to medical support and science-based solutions so they can cut down on drinking or quit entirely.

How does it work?

The first step is taking an online alcohol use assessment on the Oar website, which is reviewed by a qualified healthcare provider. Based on their review, the provider determines a treatment plan, which may include a prescription for naltrexone.

What is Revia?

Revia is a brand name of naltrexone. It was manufactured by Teva Pharmaceuticals but has been discontinued for sale in the United States. However, people may still call generic naltrexone Revia since it was the brand name for many years.

How does it work?

Revia is the same drug as generic naltrexone. It has the same effects and is completely interchangeable with the generic version. The only difference is the name.

Naltrexone Injection

The naltrexone injection is an extended-release injectable form of naltrexone that’s given once a month. Like the pill form of naltrexone, it helps people cut down on drinking and remain alcohol-free. 

What is Vivitrol?

Vivitrol is the brand name of injectable naltrexone. It is manufactured by the pharmaceutical company Alkermes.

How does it work?

Vivitrol is given once a month as a 380-mg intramuscular injection in the buttocks. Like the pill form of naltrexone, it helps reduce alcohol cravings and heavy drinking, and assists people in staying off alcohol completely.

Key Differences Between the Naltrexone Pill and the Naltrexone Injection

Uses

Both the pill form and the injectable form of naltrexone have the same use: the treatment of AUD.

How long is each effective?

The pill form of naltrexone begins to work in the body about an hour after it’s taken. It becomes slowly less effective over the next 24 to 36 hours. 

Injectable naltrexone takes slightly longer to begin to work—about 2 hours—and slowly loses effectiveness over the next 30 days.

Side effects

Side effects of oral naltrexone are rare and usually mild. Nausea is the most frequent complaint. Other common side effects are: 

- Headache

- Dizziness

- Drowsiness

- Feeling anxious or nervous

- Insomnia

- Achy muscles or joints

Common Vivitrol side effects are largely similar to oral naltrexone. People may also experience reactions at the injection site such as redness, swelling, or pain.

Dosage

Oral naltrexone is typically taken every day in the form of a 50-mg tablet. Injectable naltrexone, or Vivitrol, is administered by a doctor monthly in the form of a 380-mg injection.

Interactions with alcohol: Can you drink on them?

You can continue to drink if you’re taking oral naltrexone. There are no harmful interactions between naltrexone and alcohol. 

Naltrexone will blunt the “buzz” and euphoria from drinking, which will help you drink less. Many people take a naltrexone pill about an hour before drinking specifically to help them control how much alcohol they consume. 

People who take injectable naltrexone should discuss with their doctor whether it’s OK to continue drinking. Both Vivitrol’s manufacturer and the FDA recommend that you are alcohol-free for 7 to 14 days when starting Vivitrol and that you do not drink while on it. 

Are they prescription drugs?

Yes, both oral and injectable naltrexone are only available via prescription.

Price differences

The cost of naltrexone pills and injectable Vivitrol varies greatly depending on insurance coverage. In general, Vivitrol is significantly more expensive per dose than oral naltrexone. 

Can You Combine Oral and Injectable Naltrexone?

Combining oral naltrexone and Vivitrol will provide a higher than recommended dose of medicine for the treatment of AUD. For this reason, you’ll be prescribed either the pill form of naltrexone or the injection, but not both.

Choosing Between Oral Naltrexone and Vivitrol to Stop Drinking Alcohol

Both forms of naltrexone—oral and injectable—have advantages and disadvantages. 

Vivitrol is given once a month, so people worried about remembering to take a pill may find the injection is more effective and more convenient. 

On the other hand, many people prefer the pill’s flexibility. Instead of always having naltrexone in their system from the injection, some people (particularly those following the Sinclair Method) only take a pill when they are going to be drinking. 

Oral naltrexone is generally cheaper than the injectable version, so if cost is a concern, the pill may be a better option. 

In the end, deciding whether to choose oral or injectable naltrexone is a decision you need to make with your doctor. 

FAQ

What is naltrexone 50 mg used for?

Naltrexone 50 mg is the pill form of naltrexone. It is used to treat AUD. It helps with alcohol cravings, reduces heavy drinking and frequency of drinking, and helps you stay off alcohol once you’ve quit.

Is naltrexone a prescription drug?

Yes. Oral naltrexone pills and injectable Vivitrol are available only by prescription from a healthcare provider.

Is Vivitrol safe?

Vivitrol is generally safe for most people. Common side effects include nausea, drowsiness, headache, and dizziness.

Is Revia safe?

Revia, which is an old brand name of generic naltrexone, is generally safe for most people. Nausea is the most frequent side effect. Other common side effects are: 

- Headache

- Dizziness

- Drowsiness

- Feeling anxious or nervous

- Insomnia

- Achy muscles or joints

How long after taking naltrexone can I drink?

If you are taking naltrexone pills, the best time to take naltrexone is an hour before you start drinking. This way, the pill has time to work into your system and help you control how much alcohol you consume.

Is Vivitrol the same as naltrexone?

Yes, Vivitrol is naltrexone. It is the injectable version of naltrexone, which is also available in pill form.