In Collaboration With

THERAPEUTICS

Brands

• Revia (oral)
• Vivitrol (injection)
• see index for additional brand names

Generic?

• Yes (not injection or solution)

Class

• Alcohol dependence treatment; muopioid receptor antagonist

Commonly Prescribed For

• (bold for FDA approved)
• Alcohol dependence
• Blockade of effects of exogenously administered opioids (oral)

How The Drug Works

• Blocks mu opioid receptors, preventing alcohol or exogenous opioids from binding there and thus preventing the pleasurable effects of alcohol or opioid consumption

How Long Until It Works

• Can begin working within a few days but maximum effects may not be seen for a few weeks

If It Works

• Diminishes rewarding effects of alcohol or opioid consumption
• Reduces cravings, decreases alcohol or opioid consumption

If It Doesn’t Work

• Evaluate for and address contributing factors
• Consider switching to another agent
• Consider augmenting with acamprosate

Best Augmenting Combos for Partial Response or Treatment-Resistance

• Acamprosate
• Augmentation therapy may be more effective than monotherapy
• Augmentation with behavioral, education, and/or supportive therapy in groups or as an individual is probably key to successful treatment

Tests

• Urine screen for opioids and/or naloxone challenge test prior to initiating treatment for opioid use
• None for use in treating alcohol dependence, although baseline liver function testing, usually obtained anyway for managing alcohol dependence, may be useful