Naltrexone interactions

Naltrexone (Vivitrol, Revia), an opioid antagonist has 77 documented interactions across the FDA labels and fact sheets we index: 40 major, 3 moderate, 31 minor, and 3 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (40)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Opioid Antagonist: Naloxegol ↑ naloxegol Avoid use with BIXLENVO; if unavoidable, decrease the dosage of naloxegol and monitor for adverse reactions. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)

  • BuprenorphineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Any individual who has failed the naloxone challenge test or has a positive urine screen for opioids [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • ButorphanolopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • CodeineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • DarunavirantiretroviralMajor

    John's wort ( Hypericum perforatum ) Hepatitis C direct acting antiviral: elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam Co-administration of PREZISTA/ritonavir… (Darunavir label, Contraindications)

  • Darunavir and cobicistatantiretroviralMajor

    John's wort ( Hypericum perforatum ) Hepatitis C direct acting antiviral: elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam PREZCOBIX or PREZCOBIX PED is… (Darunavir and cobicistat label, Contraindications)

  • EluxadolineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • FentanylopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • HydrocodoneopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • HydromorphoneopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • LenacapavirantiretroviralMajor

    Opioid Antagonist: naloxegol ↑ naloxegol Avoid use with SUNLENCA; if unavoidable, decrease the dosage of naloxegol and monitor for adverse reactions. (Lenacapavir label, Drug interactions)

  • LevorphanolopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • MeperidineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • MethadoneopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Methylnaltrexoneopioid antagonistMajor

    • Other Opioid Antagonists : Potential for additive effect and increased risk of opioid withdrawal; avoid concomitant use. (Methylnaltrexone label, Drug interactions)

  • MorphineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • NalbuphineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naldemedineopioid antagonistMajor

    Intervention Avoid use of SYMPROIC with another opioid antagonist. (Naldemedine label, Drug interactions)

  • Naloxegolopioid antagonistMajor

    Other opioid antagonists : Potential for additive effect and increased risk of opioid withdrawal; avoid concomitant use. (Naloxegol label, Drug interactions)

  • Naloxoneopioid antagonistMajor

    Any individual who has failed the naloxone challenge test or has a positive urine screen for opioids [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • …Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists: finerenone • Non-opioid analgesic (selective blocker of Na v 1.8 sodium channels): suzetrigine • Opioid antagonists: naloxegol • PDE5 inhibitor: sildenafil (Revatio ® ) when used for pulmonary arterial hypertension (PAH) • Sedative/hypnotics: triazolam, oral midazolam • Serotonin… (Nirmatrelvir and ritonavir label, Contraindications)

  • OliceridineopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • OxycodoneopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • OxymorphoneopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Any individual who has failed the naloxone challenge test or has a positive urine screen for opioids [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • RemifentanilopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • TapentadolopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • TramadolopioidMajor

    Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

  • Naltrexone for extended-release injectable suspension is contraindicated in: Patients receiving opioid analgesics [see Warnings and Precautions ( 5.3 ) ] . (Naltrexone label, Contraindications)

Moderate interactions (3)

  • EtravirineantiretroviralModerate

    Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (Etravirine label, Drug interactions)

  • Lofexidinealpha-adrenergic agonistModerate

    Oral Naltrexone : Concomitant use may reduce efficacy of oral naltrexone. (Lofexidine label, Drug interactions)

  • Nalmefeneopioid antagonistModerate

    Strongly consider recommending or prescribing an opioid reversal agent (e.g., naloxone, nalmefene) for the emergency treatment of opioid overdose (5.1) . (Naltrexone label, Warnings and precautions)

Minor mentions (31)

  • AlcoholAlcoholMinor

    Precipitation of Opioid Withdrawal : Opioid-dependent and opioid-using patients, including those being treated for alcohol dependence, should be opioid-free before starting naltrexone for extended-release injectable suspension treatment, and should notify healthcare providers of any recent opioid use. (Naltrexone label, Warnings and precautions)

  • Azelastine and fluticasoneantihistamineMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • BeclomethasonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • BetamethasonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • BudesonidecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Budesonide and formoterolcorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • CiclesonidecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • ClobetasolcorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • DeflazacortcorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Desfluranegeneral anestheticMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • DesonidecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • DexamethasonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Etomidategeneral anestheticMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • FludrocortisonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • FlunisolidecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • FluocinonidecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • FluticasonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Fluticasone and salmeterolcorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • HalobetasolcorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • HydrocortisonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Isofluranegeneral anestheticMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • KetamineCNS depressantMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • MethohexitalbarbiturateMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • MethylprednisolonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • MometasonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • Olopatadine and mometasoneantihistamineMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • PrednisolonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • PrednisonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

  • PropofolCNS depressantMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • Sevofluranegeneral anestheticMinor

    The opioid therapy must be provided by individuals specifically trained in the use of anesthetic drugs and the management of the respiratory effects of potent opioids, specifically the establishment and maintenance of a patent airway and assisted ventilation. (Naltrexone label, Warnings and precautions)

  • TriamcinolonecorticosteroidMinor

    Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)

No significant interaction reported (3)

  • AcamprosateNo interaction

    The pharmacokinetics of acamprosate are not affected by alcohol, diazepam, or disulfiram, and clinically important interactions between naltrexone and acamprosate were not observed [ see Clinical Pharmacology ( 12.3 ) ]. (Acamprosate label, Drug interactions)

  • Narcotic Analgesics: buprenorphine/ naloxone ↑ buprenorphine ↑ norbuprenorphine ↓ naloxone No dosage adjustment of buprenorphine/naloxone is required upon coadministration with GENVOYA. (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Drug interactions)

  • Emtricitabine and tenofovirantiretroviralNo interaction

    No clinically significant drug interactions have been either observed or are expected when DESCOVY is combined with the following drugs: buprenorphine, itraconazole, ketoconazole, lorazepam, methadone, midazolam, naloxone, norbuprenorphine, norgestimate/ethinyl estradiol, and sertraline. (Emtricitabine and tenofovir label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.