What happens if you drink alcohol while taking Vivitrol (naltrexone)?
Vivitrol is an extended-release form of naltrexone used to treat alcohol use disorder and opioid use disorder. Drinking alcohol while on Vivitrol can still make alcohol effects stronger or more unpredictable for you, but the medication is not meant to “cancel out” alcohol’s risks. Instead, alcohol can interfere with recovery and increase the chance of heavy drinking or relapse patterns.
If you take Vivitrol as prescribed for alcohol use disorder, it works mainly by reducing the rewarding effects of alcohol, but it does not make alcohol safe.
Does Vivitrol cause a dangerous reaction with alcohol?
Vivitrol is not the same kind of medication as disulfiram (Antabuse), which is well known for causing a strong reaction when alcohol is consumed. With Vivitrol, there is no widely recognized “instant, alcohol-causes-a-life-threatening-reaction” effect in the way disulfiram works.
That said, drinking alcohol can still lead to standard alcohol harms (accidents, impaired judgment, vomiting, injuries), and it can worsen liver risk in some people—an important issue because naltrexone products carry liver-related warnings.
Is alcohol more dangerous because Vivitrol can affect the liver?
Naltrexone has potential liver effects and comes with warnings about liver problems. Drinking alcohol adds stress to the liver. For someone who drinks heavily or already has liver disease, mixing alcohol with naltrexone treatment can raise the overall risk to the liver and increase the chance of medication-related intolerance.
What symptoms might people notice after drinking alcohol on Vivitrol?
People vary, but drinking while on Vivitrol can lead to:
- Usual alcohol intoxication symptoms (slower reaction time, drowsiness, poor coordination, vomiting)
- Worsening mood or relapse-driven behavior even if cravings are reduced
- Possible medication-related side effects becoming more noticeable (such as nausea)
If you feel unusually unwell after drinking, or you develop symptoms that could point to liver issues (like yellowing of the skin/eyes, dark urine, or severe right-sided upper belly pain), get medical help promptly.
What should you do if you already drank while on Vivitrol?
If you drank once or had a small amount, the key steps are:
- Do not try to “balance it out” with more alcohol.
- Contact your prescriber for advice, especially if you drank more than planned.
- Avoid taking any opioids while on Vivitrol (important for safety because Vivitrol can block opioid effects and can increase risk if opioids are used).
If you drank heavily or feel severe symptoms (blackouts, repeated vomiting, confusion, trouble breathing, or injury), seek urgent care or emergency help.
Can drinking reduce Vivitrol’s effectiveness?
Vivitrol can still work to reduce alcohol reinforcement, but continued alcohol use can undermine treatment goals and increase relapse risk. Drinking doesn’t usually “turn off” Vivitrol instantly, but it can make progress harder and can lead to more frequent heavy-drinking episodes.
Important safety note: Vivitrol and opioids are different from alcohol
Even though your question is about alcohol, Vivitrol has a critical safety issue with opioids: it can block opioid effects and can precipitate withdrawal in people dependent on opioids. If you are ever considering pain treatment, tell clinicians you’re on Vivitrol.
Sources
- [1] DrugPatentWatch.com – Vivitrol (naltrexone) information: https://www.drugpatentwatch.com/