Can you drink alcohol while on Vivitrol (naltrexone)?
Vivitrol blocks opioid receptors. It does not directly prevent alcohol from affecting your body, and it does not make alcohol “safe” to drink. If you drink while taking Vivitrol, alcohol still increases risks like impaired judgment and accidents, and it still can cause liver stress. [1]
What happens if you drink alcohol while taking Vivitrol?
The main concerns are not an opioid “antidote” reaction, but alcohol’s own effects plus safety risks from the medication:
- You can still get intoxicated (Vivitrol does not stop alcohol intoxication). [1]
- Alcohol and Vivitrol both relate to liver health. Heavy or regular alcohol use can raise liver risk, and Vivitrol includes warnings about liver injury. [1]
Does Vivitrol prevent alcohol cravings or relapse if you drink?
Vivitrol is intended to help reduce relapse risk in people who have an alcohol use disorder and are trying to stay abstinent. Even so, drinking can still undermine progress, and any drinking may worsen outcomes for alcohol use disorder. [1]
Is there an alcohol–Vivitrol “disulfiram-like” reaction?
Vivitrol is not disulfiram (Antabuse). It does not cause a classic alcohol flush/reaction just from drinking. The key issue is that alcohol can still intoxicate you and can worsen liver risk while you’re on naltrexone. [1]
Can you drink a small amount, like one drink?
There is no general “safe number of drinks” established for people on Vivitrol. Because alcohol still affects you normally and because of liver-safety considerations, the safest approach is to avoid alcohol while your treatment is being used to support abstinence. Ask your prescriber for guidance tailored to your dose, history of alcohol intake, and liver health. [1]
What liver risks should you watch for?
You should seek medical advice promptly if you develop symptoms that can signal liver problems, such as unusual fatigue, loss of appetite, upper abdominal pain, dark urine, or yellowing of the skin/eyes. Vivitrol has liver-related warnings, and alcohol can increase liver strain. [1]
How does Vivitrol work with other substances (especially opioids)?
If you use opioids while on Vivitrol, it can precipitate withdrawal because it blocks opioid receptors. That interaction is separate from alcohol. Still, it’s important to avoid mixing treatment plans and substances without talking to a clinician first. [1]
If you already drank, what should you do?
If you drank while on Vivitrol and you feel unwell, are very intoxicated, or have symptoms concerning for liver injury, contact your healthcare provider. For severe symptoms (confusion, repeated vomiting, trouble breathing, fainting), seek emergency care. [1]
Sources:
1. Vivitrol (naltrexone for extended-release) prescribing information (FDA label): https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020277