Naltrexone Interactions: Wellbutrin, Opiates, Weed, Etc.

Last Updated: June 24, 2020

Authored by Olivier George, Ph.D.

Reviewed by Michael Espelin APRN

While the drug is well-tolerated and safe on its own, naltrexone interactions with other substances might lead to severe side effects. At the same time, certain Vivitrol drug interactions might actually enhance the effectiveness of the medication. Still, the patients need to be aware of the potential adverse interactions with the medication.

Naltrexone Major Drug Interactions

Naltrexone drug interactions can be divided into several categories by their severity. Major interactions pose a significant threat to a person’s health. Medications and substances from this list should be avoided during Vivitrol treatment.

Naltrexone And Morphine

Morphine and naltrexone interaction can be particularly dangerous because morphine is an opiate. Naltrexone is used for opiate addiction, and it should not be started if opioid medications are present in a patient’s system. In combination with morphine, Vivitrol may induce acute opioid withdrawal symptoms. Furthermore, the patient will not be able to feel any therapeutic effects of morphine. If the use of opioids is crucial for emergency pain relief, rapid Vivitrol detox can be done in a medical setting. Still, naltrexone and morphine can also have some beneficial interactions. The combination of the drugs is available as a pain reliever under the trade name Embeda which is used for pain management.

Naltrexone And Suboxone

It is not recommended to combine Vivitrol and Suboxone. The simultaneous use of naltrexone and buprenorphine is likely to cause withdrawal symptoms in patients who have been using Suboxone for more than a week. In addition, patients should be careful when transitioning from one medication to the other since buprenorphine can linger in the system for up to two weeks and interact with Vivitrol even if a person doesn’t take it anymore.

Does Vivitrol block Suboxone?

The medication can block the therapeutic effects of Suboxone. In addition to buprenorphine, Suboxone contains naloxone, which is an opioid antagonist itself. The use of Vivitrol together with Suboxone is, therefore, dangerous and not beneficial.

does vivitrol block suboxone

Naltrexone And Methadone

Being an opioid, methadone has a major interaction with naltrexone hydrochloride. Vivitrol and methadone should not be used together. The combination of the drugs can lead to withdrawal symptoms and accidental overdose in patients who are dependent on opioids. In addition, Vivitrol blocks the analgesic effects of methadone. It can be an unexpected and significant problem for patients who use methadone for chronic pain management.

Naltrexone And Hydrocodone

Vivitrol interaction with hydrocodone can result in adverse health consequences. Vivitrol counters the effects of hydrocodone, rendering it useless for pain management. The combination can also cause acute opioid withdrawal symptoms in patients who take hydrocodone regularly.

Naltrexone Moderate Drug Interactions

It is generally recommended to avoid medications and substances that can have a moderate reaction with Vivitrol.

Naltrexone And Wellbutrin

Naltrexone and bupropion should not be used together as separate medications unless the benefits greatly outweigh the risks. Both medicines are known to induce hepatotoxicity. Vivitrol interaction with Wellbutrin can, therefore, cause liver damage, fever, joint pain, unusual bleeding, and abdominal pain. If these symptoms occur, a person should contact a doctor immediately.

In specific cases, however, the interaction can be beneficial. In 2014, the FDA approved the combination of bupropion and naltrexone for weight loss. Sold under the trade name Contrave, this prescription medication can help obese individuals lose weight and keep it off.

Naltrexone And Marijuana

Vivitrol was found to enhance the pleasurable qualities of marijuana used for recreational purposes. However, naltrexone interaction with marijuana is not associated with significantly increased imminent risks to a person’s health. Patients who use medical cannabis should not discontinue the treatment without talking to a doctor. In some cases, certain side effects of low-dose naltrexone such as insomnia and headaches might be amplified by marijuana.

Naltrexone And Antabuse

Vivitrol interactions with Antabuse haven’t been sufficiently studied. The concurrent use of this drug and disulfiram might result in amplified hepatotoxicity. When it is necessary to use the medications simultaneously, biweekly liver function tests are recommended.

naltrexone and antabuse interaction

Naltrexone And Tramadol

Tramadol is a weak opioid agonist. Vivitrol interaction with Tramadol can reduce the effectiveness of the painkiller and induce withdrawal symptoms.

Naltrexone And Topiramate

In certain cases, Vivitrol can significantly decrease the anticonvulsant effects of topiramate. A patient should monitor their condition closely and contact a doctor if they experience seizures or other adverse symptoms.

Naltrexone And Acamprosate

Vivitrol interaction with acamprosate can increase the levels of acamprosate in the system. This may lead to an emergence of side effects related to acamprosate.

Naltrexone And Kratom

Two compounds in Kratom are known to interact with opioid receptors in the brain. The concurrent use of naltrexone, therefore, can cause precipitated withdrawal from Kratom.

Naltrexone And Cymbalta

Vivitrol drug interactions with medications that exhibit hepatotoxicity are potentially dangerous. Regular liver function tests are recommended when the drug has to be used with Cymbalta.

Naltrexone And Ibuprofen

Vivitrol interaction with ibuprofen might cause liver injury. There is also a possibility of ibuprofen affecting the levels of naltrexone in a person’s system by affecting liver function. Low-dose naltrexone drug interactions with painkillers like ibuprofen might also occur. Patients should consult their doctors to determine whether ibuprofen is suitable for them during Vivitrol treatment.

Risks Of Taking Opiates While On Vivitrol

Using opiates on Vivitrol is hazardous in several ways. The medication blocks the effects of opioids and induces rapid withdrawal in patients who are not completely opiate-free when the treatment begins. This property can be life-saving if a person overdoses on opioids, but Vivitrol cannot be used for emergencies. In comparison to opioid antagonists that are intended for emergencies, naltrexone vs naloxone, the first has a significantly longer half-life, meaning that it doesn’t act immediately but continues to exert influence for a significantly longer period of time.

what happens if you take opiates while on vivitrol

The prolonged action of the medication can lead to long-term damage to a person’s health when Vivitrol interaction with opioids occurs. For instance, using Vivitrol when heroin detox is in progress can cause breathing and heart rate problems, hallucinations, and depression.

Taking naltrexone while on opiates also significantly increases the risk of overdose. Patients might try to counter Vivitrol blockade by ingesting large doses of opioids. Treatment with opioid antagonists also leads a person to gradually lose the developed tolerance for opioids. This way, the individual might also overdose unintentionally by consuming a dose that used to be regular for them. Drinking on Vivitrol might also be dangerous for this reason.

Avoid Dangerous Interactions

Naltrexone drug interactions are most severe when the medication is combined with morphine, Suboxone, and methadone. Also, Vivitrol interactions with other opioid agonists and opiates may cause the development of withdrawal symptoms. In certain cases, it can lead to overdose and death. Still, the analgesic effects of opioid pain medications may be significantly reduced due to Vivitrol interactions. The patients should never try to abuse any substances while on Vivitrol treatment. Drug addiction facilities can facilitate the process of recovery. To ensure the safety and effectiveness of substance treatment, it is crucial to follow the recommendations of the medical staff.

Page Sources


Published on: June 7th, 2019

Updated on: June 24th, 2020

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


Leave a comment