Vivitrol Injection Administration: What Patients Should Know
Vivitrol is prepared and given only by a healthcare provider as a deep gluteal injection. This guide explains the patient-facing safety essentials.
What this article does—and does not—cover
This is a patient-facing explanation of the labelled route, frequency, and safety issues. It is not training for injection preparation or administration. The full Directions for Use, supplied with the product, are for the trained healthcare professional preparing and giving the injection.
Vivitrol is different from oral naltrexone. It is a long-acting microsphere suspension that cannot be removed after it has been injected. A clinician must first confirm that it is suitable for the patient, including whether recent opioid use could trigger severe withdrawal. The current US prescribing information is the source for the full Directions for Use and the product-specific safety requirements.
The labelled administration essentials
The current US prescribing information says that Vivitrol:
- is given as a 380 mg deep intramuscular gluteal injection;
- is scheduled every four weeks or once a month;
- alternates buttocks at each subsequent injection;
- is prepared and administered only by a healthcare provider; and
- uses the components supplied in the product carton.
The label also says that the provider must assess body habitus before each injection so the supplied needle can reach the muscle. That is a clinical decision—not a reason to substitute a different needle, injection site, or route.
Quick answers to common Vivitrol questions
Who gives the injection? A healthcare provider prepares and administers it; it is not a self-injection.
Where is it given? The US label specifies a deep intramuscular injection in the gluteal muscle. It is not given into a vein, under the skin, or into the skin.
How often is it given? The labelled schedule is every four weeks or once a month, with the buttock alternated at subsequent appointments. A clinician should arrange the next dose if one is missed.
The patient’s role before an appointment
Before each injection, tell the treatment team about every recent opioid exposure. This includes prescribed opioid pain medicines, medicines for cough, diarrhoea, or cold symptoms that contain opioids, non-prescribed opioids, and treatment with buprenorphine or methadone. Do not rely on an online timeline or a home test to decide that it is safe to start.
The US label recommends an opioid-free interval of at least 7–10 days before starting Vivitrol. A longer clinician-managed transition may be needed after buprenorphine or methadone. See our guide to opioid-free initiation for why this safety check matters.
Also tell the clinician about a history of serious allergy, bleeding or clotting disorders, liver symptoms, pregnancy or breastfeeding, low mood, and any planned surgery or pain treatment. Naltrexone blocks opioid receptors, so emergency and surgical pain plans need advance clinical coordination.
Injection-site reactions: expected symptoms versus urgent review
Pain, tenderness, firmness, swelling, redness, bruising, or itching can occur after a Vivitrol injection. The label’s injection-site warning also reports rare but serious reactions, including cellulitis, abscess, tissue necrosis, and reactions requiring surgery.
Contact the treating clinic promptly if the injection area becomes increasingly painful, swollen, hard, red, open, blistered, darkened, or otherwise worse rather than better. Seek emergency help for symptoms of a severe allergic reaction, such as difficulty breathing or swelling of the face, lips, tongue, or throat.
Do not try to treat a severe reaction by injecting, draining, or applying a treatment that was not advised by a clinician.
Why administration details matter
Giving this product by the wrong route can cause serious injection-site injury. The labelled clinician-only process also provides an opportunity to check opioid-free status, discuss overdose prevention, review side effects, and coordinate follow-up.
For a broader review of Vivitrol and oral naltrexone availability in the United States, see Naltrexone in the USA. Product approvals, labelling, and administration requirements differ by country.
Primary source
- DailyMed: Vivitrol prescribing information and Directions for Use
US label, revised December 2025; dosing, route, supplied components, and injection-site warnings.