Vivitrol adverse reactions

[MChaplin]

unfortunately the vivitrol people have just come out with a new patient information guideline which informs patients of the risk of injection site reactions- it is available for review on their website and they sent me a beautiful color glossy on the importance of IM as opposed to subq injection.....the reactions do happen and can be very nasty and we wouldn't be doing our jobs if we didn't find a way of mentioning them...so now who is going to accept it??? sigh.

[deegee]

Hmm, agree that doesn't sound like a subcutaneous reaction. This is one of your patients? Do you have more info on the clinical course so that people can offer thoughts?

[MChaplin]

I was taught to Z track injections- a quick google search revealed these nice instructions- http://www.nursingcenter.com/upload/static/592775/take5_ztrack.pdf

[tstinson]

I don't think that injecting into the gluteus maximus, medius or minimus would protect against these complications. The most recent complication involved myositis of the buttock muscles (myoglobinuria and greatly increased CPK). This would be an unlikely sequel to a subcutaneous injection.

[entjwb]

I do a slide technique for the injection. When needle is about half way in, I slide the tissue by pulling downward and medially. That way the needle tract is not straight and should keep the injected suspension in the muscle.

[deegee]

This should not happen with IM injection. Local reactions usually are a result of a superficial injection, i.e. not deep enough, maybe in adipose. I use the 2" needle in all but the thinnest patients.

[kcairns]

had one case w abcess requiring I and d

[peterorrin]

My vivitrol patients have experienced worse than 'localized tissue reactions.' One patient developed a sterile abscess that had to be surgically excised. Ouch!

[DrBallester]

Make sure the injection is deep IM and that the powder is in complete suspension. I use a massager/vibrator (like in the chemistry lab) to mix the suspension.