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Acamprosate vs Naltrexone

Naltrexone is approved by the FDA for use in medication-assisted treatment for opioid and alcohol use disorders. It comes in two forms: as an oral pill under the brand names ReVia and Depade, and as a monthly injection under the brand name Vivitrol. Here is a closer look at the differences between these two options.

What's the difference between naltrexone and Vivitrol?

Because Vivitrol is a form of injectable naltrexone, there is no difference between naltrexone and Vivitrol. When most people ask this question, what they really mean is, “What’s the difference between Vivitrol and ReVia?” ReVia is the most commonly prescribed pill form of naltrexone.

Naltrexone is an opioid antagonist. It binds to and blocks opioid receptors, which can reduce cravings for opioids like heroin or pain pills. It reduces the euphoric effects of opioid medications like heroin, methadone, and oxycodone, and also helps to reduce the amount and frequency of drinking.

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Vivitrol (naltrexone injection) FAQs

In addiction treatment and substance use recovery, Vivitrol is primarily used to treat opioid use disorder. Because naltrexone blocks opioid receptors in the brain, it should not be used while a person still has opioids in their system. Doing so can send the person into withdrawal. For that reason, individuals should wait at least 7 days after they last used short-acting opioids and 10 to 14 days for long-acting opioids, before starting naltrexone. At Workit, we recommend that everyone start on oral naltrexone (ReVia) to be sure they tolerate the medication well.

  • Reduces opioid and alcohol cravings, making relapse less likely
  • Prevents you from getting high if you take an opioid
  • Reduces the euphoric effects of alcohol, making it easier to drink less
  • Extended-release injection is given on a monthly basis, so you don’t have to worry about taking a pill every day
  • Does not require abstinence from drinking
  • Must have gone through a full opioid detox 7-10 days before starting Vivitrol
  • Increased risk of overdose because naltrexone can reduce opioid tolerance 
  • Because Vivitrol’s extended-release naltrexone lasts for 28 days, you cannot take any opioid medications in that time, even if prescribed for pain

Yes, but because it is an injection, it isn’t as simple to receive Vivitrol via telehealth as it is to receive many other medications. If your healthcare provider recommends Vivitrol, they will usually start treatment with oral naltrexone from your local pharmacy. Then if you tolerate the medication well, they will continue care with a Vivitrol shot administered every four weeks at an approved pharmacy near you. At Workit Health, this is an option only for our members in California.

Naltrexone is usually tolerated well. Most doctors recommend starting with oral naltrexone (ReVia) to be sure it works well for you before switching to Vivitrol. Some of the reported side effects of taking naltrexone include sleep problems, dizziness, joint pain or muscle cramps, nausea and/or vomiting, and loss of appetite. It can also cause cold-like symptoms, like a stuffy nose, sore throat, and sneezing. As with most side effects, they vary per person and can dissipate after a period of time taking the medication. 

ReVia (naltrexone pills) FAQs

In addiction treatment and substance use recovery, ReVia is used to treat both opioid use disorder and alcohol use disorder. Because naltrexone blocks opioid receptors in the brain, it should not be used while a person still has opioids in their system. Doing so can send the person into withdrawal. For that reason, individuals should wait at least 7 days after they last used short-acting opioids and 10 to 14 days for long-acting opioids, before starting naltrexone. 

For opioid use disorder, ReVia is taken daily. For alcohol use disorder, it may be taken daily, or may be taken in a targeted manner one hour prior to drinking.

  • Reduces opioid and alcohol cravings, making relapse less likely
  • Prevents you from getting high in case of opioid use
  • Reduces the euphoric effects of alcohol, making it easier to drink less
  • For alcohol use disorder (sometimes called alcoholism or alcohol dependence), ReVia can be taken as needed, one hour prior to drinking
  • Does not require abstinence from drinking
  • Must have gone through a full opioid detox 7-10 days before starting Vivitrol
  • Increased risk of overdose because naltrexone can reduce opioid tolerance 

Yes! If your healthcare provider recommends ReVia, they will e-prescribe naltrexone for you to receive from your local pharmacy.

Naltrexone is usually tolerated well. Some of the reported side effects of taking naltrexone include sleep problems, dizziness, joint pain or muscle cramps, nausea and/or vomiting, and loss of appetite. It can also cause cold-like symptoms, like a stuffy nose, sore throat, and sneezing. As with most side effects, they vary per person and can dissipate after a period of time taking the medication.

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Other options for medication-assisted treatment

If naltrexone, in either injectable or pill form, isn’t right for you, there are other treatment options FDA approved to help.

The first part of Suboxone is buprenorphine, a partial opioid agonist that attaches to opioid receptors. It has strong binding ability, replacing and blocking other opioids so that they become ineffective. The second part is naloxone, a drug intended to reverse opioid overdoses, whcih is included to prevent misuse of this medication. Suboxone reduces opioid cravings and withdrawal symptoms to help you recover from opioid addiction.

Acamprosate (Campral) is a medication that is FDA-approved to treat alcohol use disorder. It can help you manage your cravings for alcohol, and may minimize the withdrawal effects and balance your brain chemistry once you’ve quit drinking. It cannot be taken while you are actively drinking.

Medication-assisted treatment available in many states

With multiple clinic locations around the country, we are working to bring the very best care to you.

Online therapy available nationwide.

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