Vivitrol Question

Buprenorphine Post
fishdoc
Posts: 111

Postby fishdoc » Wed Apr 27, 2016 1:01 pm

The longer Vivitrol stays in the syringe, the thicker it becomes. It becomes like paste and might not pass through the needle.

We have patients bring a 50 mg tablet cut into quarters by the pharmacy on the day of induction. The patient takes one quarter and gets Vivitrol if there is no withdrawal. If there is withdrawal, they come back one or 2 days later and the procedure is repeated.

DrBranton
Posts: 14

Postby DrBranton » Wed Apr 27, 2016 1:01 pm

My understanding is that Vivitrol must be injected within one hour of being reconstituted. I agree with and appreciate the oral Naltrexone advice however, I would likely administer a 12.5 or 25mg dose.

DrB

NoDrugs4u
Posts: 198

Postby NoDrugs4u » Wed Apr 27, 2016 1:01 pm

I would bill the patient for the $1500. Consider it a Stupidity Fee.

tdbailey
Posts: 9

Postby tdbailey » Wed Apr 27, 2016 1:01 pm

I'm not sure how long the Vivitrol 'stays good' once reconstituted but would have tried to get a 50mg PO Naltrexone to try with the patient first. If he did fine with this I would have been fine with the injection. If he did have withdrawal with the tablet at least it would have 'worn off' relatively soon.

(We usually do this when we first start pts on Vivitrol anyway to ensure enough time has elapsed since last use. I write for one tablet and the pt fills it at the pharmacy the same time they fill the shot)

DrBallester
Posts: 84

Postby DrBallester » Wed Apr 27, 2016 1:01 pm

Consider sending the question to Dr. A. Bisaga

If you cannot do an oral naltrexone challenge, let the patient decide to take the risk of potential precipitated withdrawal.


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