Revia (Naltrexone)

I've never actually taken "Vivitrol" the injectable form. I've taken Revia the pill form a few times though.

Used For: Blocking the high from heroin (oral form only), blocking the craving for alcohol (both forms).

I take Revia to block craving for alcohol. Can't say I've ever needed it for its heroin blocking purposes. I thought I heard a guy in the movie Super Size Me say something about how Naltrexone can also block craving to eat chocolatey and sugary foods. Then once I read somewhere else that naltrexone combined with the antidepressant Wellbutrin are being studied as tandem for eating disorders treatment. I think at the moment Revia is only approved for heroin and alcohol treatment though.

Do Not Use If: You are not serious about stopping use of heroin or alcohol or you have liver disease. Alcoholics who receive naltrexone, especially the extended-release form, must not be taking opiates like heroin, OxyContin, Vicodin, or morphine. In some cases of patients with liver disease, the physician will still prescribe naltrexone.

The only reason I ever stopped using Revia is 'cause I've always found the drug to be very sedating, like big-time fatigue causing most especially at the beginning of treatment. This side effect is pretty rare for Revia though. And actually some people even get the opposite side effect of this such as agitation and insomnia, though this side effect is also unlikely to occur with Revia treatment.

Tests to Take First: Blood tests for liver problems are recommended. Patients using oral naltrexone to treat heroin addiction should not start naltrexone until at least a week has passed since they used heroin; a blood or urine test is required to confirm the absence of heroin in the body.

I never took any tests before starting Revia. I've read though that tests for your liver are recommended in other books before too. I find it kind of funny that in order to stop drinking (and perhaps save your liver) a drug that may or may not cause liver problems is sometimes your only hope.

Tests to Take While You Are on It: Blood tests to confirm that naltrexone is not hurting your liver should be done periodically.

Yes, perhaps I should have one of these liver tests done sometime soon as I have been on Revia for approximately a month now. And seeing how Revia may not be good for your liver (though I'd imagine taking this drug regularly is way better for your liver than drinking every night or else it would never be prescribed), it seems like if you can't control your drinking habit even while still taking Revia (meaning you're taking the drug yet still pounding booze every night 'cause you're some sort of alcoholic-freak-monster who needs to be on the A & E show "Intervention"...j/k) then that would be a double whammy on your poor liver. But based on my experiences with Revia, I'd find it hard to believe anyone could be just as severe of a alocholic once they start taking this drug regularly. It really does work at blocking the urge to get buzzed. In fact, Revia is the closest thing I've experienced to one of those "miracle drugs" you hear about, which doesn't much as far as my ability to control my own drinking!!

Usual Dose: For patients using oral naltrexone to treat heroin addiction, treatment is not begun until the patient has been off heroin for at least one week. This fact is often confirmed by obtaining a blood or urine test. For both heroin addicts and alcoholics, 50mg can be given every day to block the high. Because naltrexone has a very long length of action, many patients being treated for alcohol addiction eventually take it only three times a week. One schedule, 100 mg on Monday and Wednesday and 150 mg on Friday, seems to offer sufficient blockage. Patients trying to stop alcohol use usually take 50 mg daily. For patients with alcoholism using the injectable form (Vivitrol), an injection of 380 mg is given in the muscle of the arm or buttocks once every four weeks.

Of the times I've been on Revia, I've always taken 50mg per day because I've been told and I've read that this is the standard daily dose for treating alcohol abuse. I wondered about trying to get down to 25mg a day though to perhaps counter the sedating effects Revia has on me, but my psychiatrist says 50mg is more effective than 25mg at treating alcohol abuse, so I've continued to stay on 50mg. That second Revia dosing schedule above where you take it three times a week sounds interesting. I like the idea of taking the big 150mg dose on a Friday 'cause I know that as an alcohol abuser (and being someone who makes lame excuses to drink such as "C'mon, just it's the weekend! I got nothin' goin' on tomorrow!") I am far more tempted to drink on the Friday and Saturday, although also a dose of 150mg in one day would likely be very sedating for me the following morning after I took it. Also, for the injectable form of Revia (a.k.a. Vivitrol), getting a shot in the ass to treat alcoholism just sounds funny. I mean, imagine that one "Rehab" scene from the movie Half-Baked redone...

"Oh yea. I used to get shots of Vivitrol in the ass to treat my alcoholism." - Bob Saget
"I seen it!" - that guy who got kicked off the Real World
"Now that's an addiction..." - Bob Saget

Oh brother...

How Long Until It Works: For heroin detoxification, the effect is immediate. If, after taking naltrexone, a patient shoots up with heroin, he or she will not get high. This quickly discourages the patient from shooting up. For discontinuation of alcohol, the effect is more subtle. The patient should experience decreased craving for alcohol in conjunction with a comprehensive alcohol cessation program.

For me, Revia works fairly fast at reducing craving to drink booze. Like, within a day or two of taking the first pill. And if you are unfamiliar with Revia, this drug honestly does reduce craving to drink significantly. And it has hardly has any side effects. This is a very interesting drug...Oh yea, I've heard stories about this drug working so fast that it's a true life-saver in hospitals for people who come in with heroin overdoses.

Common Side Effects: Nervousness, insomnia, low energy, headache, joint and muscle pain, nausea and vomiting, difficulty ejaculating, impotence, dizziness, diarrhea, constipation, rash, increased thirst, decreased appetite, and chills. Injectable naltrexone (Vivitrol) can cause redness or rash at the site of injection.

I never experienced any of those side effects from Revia except for the low energy one, and also the nausea one rarely. Thank god this drug didn't make me impotent at all, even if only temporarily. 'Cause I swear I'm a sex addict yet also a virgin. Well, I mean I want to be a sex addict, but it's hard to be one when you're virgin. Am I making any sense right now?...

Less Common Side Effects: If a person is mistakenly prescribed naltrexone while still addicted to heroin, he or she will experience an acute withdrawal syndrome. In other words, naltrexone will suddenly block of all of heroin's effect and the patient will be in the same boat as if he or she had suddenly stopped heroin. The withdrawal syndrome includes tremors, sweating, shaking, runny nose, tearing, and rapid pulse. Injectable naltrexone (Vivitrol) carries a very small risk of causing liver disease, although this seems most likely at higher doses than given to patients. Vivitrol was also associated in research studies with a very slightly elevated risk of depression and even suicidal thoughts compared to placebo. There is also a small risk of pneumonia and serious rash at the injection site from Vivitrol.

Okay, I'd have to imagine that any depression or suicidal thoughts caused by Revia or Vivitrol had to have been more withdrawal related than drug-related. 'Cause we all know that alcohol (I have no heroin experience here) causes depression in the long run, so if you take this drug to treat alcoholism and the drug does its job by stopping you from drinking, how could that make you depressed? Blah. I don't know. I swear, the placebo is always made out to be the hero. It's like, "Everyone who took this new antidepressant suffered from suicidal thoughts in this study, whereas everyone who took the placebo experienced better orgasms and wound up dating a supermodel." Grrr. Moving on...

What to Do About Side Effects: The abrupt withdrawal syndrome induced by mistakenly prescribing naltrexone to someone still addicted to heroin can be treated with methadone or, in some cases, with clonidine. It is best to wait a week before trying naltrexone again. The common side effects are not dangerous and may subside on their own. In actual practice, few former heroin addicts or alcoholics are very bothered by the side effects of naltrexone. The nausea that often occurs with the first injection of Vivitrol usually passes quickly and does not occur with subsequent injections. For mild skin reactions at the injection site, applying heat can be helpful and it may be best to choose a different place for the next injection. However, if swelling and redness last more than four weeks or are severe, the doctor should be warned immediately. Similarly, if cough, shortness of breath, extreme fatigue, depression, or suicidal thoughts occur, tell your doctor right away.

The side effects I experienced from Revia (fatigue and rarely nausea) seem to become milder as time goes on. Always a good thing...

If It Doesn't Work: Patients who cannot stop injecting heroin even though they are taking naltrexone to block the high should probably be placed on methadone. For patients with alcohol abuse, some doctors add acamprosate (Campral). Naltrexone will probably not work for alcoholism unless you are also in a treatment program like AA.

I know for a fact that I am not a full-blown alcoholic, but I will admit I am somewhere in the spectrum of people who drank way more booze than they should. I mean, 'cause who honestly drinks one glass of wine a month like a true moderate drinker? Everyone either drinks more than that, or probably doesn't drink at all. "Let's get intoxicated tonight my love. I purchased a two-ounce box of fine wine. This box will last us one month." Yea right. Anyway, if you're like me Revia WILL WORK at blocking the urge to drink alcohol. It doesn't block the urge 100% (meaning AA er something else may be needed if you want to completely give up drinking) but Revia will help you drink less in quantity and less often.

If It Does Work: Treatment can continue indefinitely, although liver problems can rarely occur that warrant stopping naltrexone. It is hoped that psychological treatments will work so that the patient can ultimately stop naltrexone without returning to heroin or alcohol abuse.

It seems like if you're an alocholic and Revia helps you quit drinking, and also you aren't experiencing any side effects on it, then you might as well stay on the drug and not risk quitting it only to turn back into your old self -- Boozy Joe.

Cost: For users of oral naltrexone, the generic drug is just as safe and effective as brand-name ReVia and less expensive. There is no generic form of Vivitrol, making it an expensive treatment.

Good ole cheap drugs in their generic form : )

Special Comments: Naltrexone treatment requires a motivated alcoholic or heroin addict who really wants to quit. It is easy to stop taking naltrexone at any time and start injecting heroin or drinking again. After about a week off naltrexone, the effects wear off and the addict is able to get high again. The effect of Vivitrol, however, last for four weeks after the injection. Naltrexone treatment works for patients with alcoholism but unfortunately is underused.

The only special comments I have about Revia are this...for all of you suffering from alcohol addiction and who want to get a good buzz, try Revia. You'll get the best buzz of all from this drug my friend -- the feeling of being sober : )

This Revia page was typed on February 19, 2008.
Back to the "my meds" page.