What happens if you drink alcohol while on Vivitrol (naltrexone)?
Vivitrol (extended-release naltrexone) blocks opioid receptors. If you drink alcohol while on it, you generally should not get the “opioid reversal” effect, because alcohol is not an opioid. But alcohol can still cause harm on its own, and it increases the risk of side effects and dangerous choices that Vivitrol is meant to reduce.
Key risks people ask about include:
- Increased intoxication and impaired judgment. Alcohol still affects your brain and coordination normally, even while you’re taking Vivitrol.
- Higher risk of relapse to alcohol and/or other substance use. Vivitrol helps reduce opioid-driven cravings, but it does not stop you from drinking or replace substance-use treatment.
- Potential liver concerns. Naltrexone is processed through the liver, and both alcohol and naltrexone can stress liver function. Heavy drinking increases the risk of liver injury. People with active hepatitis or significant liver disease may be advised not to take naltrexone.
Because your specific situation matters (dose, how much you drink, your liver history, and what other substances you may use), the safest general guidance is: avoid alcohol while on Vivitrol and contact your clinician if you have already been drinking.
Does alcohol cause a dangerous reaction with Vivitrol the way opioids do?
The most dangerous reactions associated with Vivitrol relate to opioids, not alcohol. Vivitrol can precipitate withdrawal if you use opioids while it’s in your system, because it blocks opioid effects.
Alcohol does not block the same pathway, so there is no standard “Vivitrol + alcohol” signature reaction like the opioid-precipitated withdrawal risk. The danger is still real, though, because alcohol can worsen sedation, impairment, and decision-making, and it can add strain to the liver.
What if you drink and also use opioids while on Vivitrol?
This is the high-risk combination to avoid.
If you drink and then use opioids while Vivitrol is active:
- The opioid may not work the way you expect, because Vivitrol blocks opioid receptors.
- You could still experience withdrawal symptoms or severe side effects as your body reacts to the loss of opioid effect.
- Attempting to overcome the block by taking more opioids can be dangerous and unpredictable, and it can lead to overdose risk when the medication level changes (for example, as the shot wears off).
How much is too much, and is “just one drink” safe?
There isn’t a universally safe amount for everyone. The practical guidance clinicians give most often is to avoid alcohol during treatment, especially if you’re taking Vivitrol for alcohol use disorder or if you have liver concerns.
If you’re considering drinking, it’s worth checking directly with the prescriber who knows why you’re on Vivitrol, your medical history, and your liver tests.
What side effects might show up after drinking on Vivitrol?
People report different effects, but drinking can make these more likely:
- Nausea, stomach upset, dizziness, or headache
- Increased sedation or impaired coordination
- Mood changes or worsening sleep
- Liver-related problems if drinking is heavy or regular
Seek urgent care if you have severe symptoms like confusion, fainting, yellowing of the skin/eyes, dark urine, or severe abdominal pain.
What should you do if you already drank on Vivitrol?
If you already drank:
- Don’t use opioids (even “to counteract” cravings or effects).
- Avoid further alcohol until you speak with your clinician.
- Call your prescriber or pharmacist for personalized advice, especially if you drink heavily or have liver disease.
- Get emergency help if you develop severe symptoms or feel at risk of using other substances.
When does Vivitrol wear off (so alcohol risk changes)?
Vivitrol is an extended-release injection, so it stays in your system for weeks. The opioid-blocking effect changes gradually as levels fall, but you should assume you’re still affected for the duration recommended by your prescriber and the dosing schedule. Do not use the idea of “it’s been long enough” to justify drinking or opioid use.
If you tell me why you’re taking Vivitrol (opioid use disorder vs alcohol use disorder) and when your last injection was, I can tailor the risk discussion more precisely.
Sources
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/022529s000lbl.pdf
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/022529s000lbl.pdf