Injection Site Reactions With Naltrexone

By | 2022-02-08T14:41:18-05:00 October 15th, 2008|0 Comments

The FDA has alerted healthcare professionals of the risk of adverse injection site reactions in patients receiving naltrexone (Vivitrol), an intramuscular injection indicated for the treatment of alcohol dependence. The new alert was prompted by 196 reports of injection site reactions, including cellulitis, induration, hematoma, abscess, sterile abscess, and necrosis. Sixteen patients required surgical intervention, including incision and drainage for abscesses and extensive surgical debridement among patients who developed tissue necrosis.

Proper injection technique is crucial to minimizing adverse reactions. Remember that naltrexone is only indicated for intramuscular injection into the gluteal area. Naltrexone should never be administered intravenously, subcutaneously, or inadvertently into fatty tissue. Do not substitute any other needle for the pre-packaged 1½-inch needle that accompanies the medication. It is specifically designed for this drug.

Patient teaching: Instruct patients to monitor the injection site and notify their prescribing healthcare provider if they develop pain, swelling, tenderness, induration, bruising, pruritis, or redness at the injection site that does not improve or worsens within two weeks. Injection sites that demonstrate worsening reactions should prompt immediate referral to a surgeon.

Caution: Review current drug information before administering and monitoring medications.

Drug News is compiled by Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, CRRN, who maintains a private practice in Plantation, Fla., and is professor and area chair for nursing at the University of Phoenix, Fort Lauderdale.


Information for healthcare professionals: naltrexone injection site reactions [naltrexone for extended-release injectable suspension (marketed as Vivitrol)]. FDA Web site. Accessed September 17, 2008.


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