Is It Okay to Take Vivitrol While Pregnant?
Vivitrol is a prescription, brand-name drug that’s injected once a month to help people avoid recurrence of misuse of opioids. Along with helping people avoid opioids, Vivitrol can be administered to help with alcoholism as well. Vivitrol has to be given by a trained, medical professional. It can help prevent recurrence of use in opioid-dependent people, but they have to first detox from opioids. For alcohol dependence, it’s important to stop drinking before Vivitrol is administered as well. For Vivitrol to be most effective, it’s intended to be used along with an alcohol or drug recovery program. Anyone who is currently using opioids or who hasn’t yet gone through detox shouldn’t be given Vivitrol. People with opioid withdrawal symptoms are also not candidates for Vivitrol.
The active ingredient in Vivitrol is called naltrexone. Side effects of naltrexone can include sleep disturbances, nausea, headaches and anxiety. There have been rare cases of liver damage or hepatitis resulting from the use of Vivitrol. If Vivitrol is given to someone still on opioids, they may go through sudden withdrawal. Naltrexone is an opioid antagonist. Opioid antagonists like naltrexone work by blocking the effects of opioids. The objective of naltrexone is to reduce opioid cravings and reduce the risk of an overdose. Naltrexone can also decrease how often and how much someone drinks by blocking the positive reinforcement effects of alcohol. Typically, a doctor won’t administer Vivitrol or naltrexone products until a patient hasn’t used opioids for seven to ten days to prevent acute opioid withdrawal.
So, is it okay to take Vivitrol while pregnant? Vivitrol is classified by the U.S. FDA as a category C pregnancy drug. There are several different pregnancy categories created by the FDA, which indicate how safe or unsafe a drug potentially is if a pregnant woman uses it. The categorization is based on animal studies looking at effects on animal fetuses and, if available, human studies. A category A drug is one that’s considered safe during pregnancy. Typically, a category A drug will have animal studies and human, well-controlled studies backing up its safety. Category B drugs are considered fairly safe as well, although the human research may be more limited. A category C drug is a much more common classification. Category C drugs may have shown some adverse effects in animal studies. There are typically few, if any, well-controlled human studies for category C drugs. There are also category D drugs, which have shown harmful effects to a fetus. Category D drugs should only be used if the benefits of the medication significantly outweigh the risks. Category X drugs are not advised for use during pregnancy.
In the limited amount of research currently available, Vivitrol has been linked to both positive and negative effects if used during pregnancy. For example, one research study recently found babies born to women dependent on opioids who were treated with a version of naltrexone had lower rates of neonatal abstinence syndrome compared to women treated with methadone or buprenorphine. These babies also had shorter hospital stays. Both naltrexone and buprenorphine were linked to lower rates of neonatal death and birth defects compared to methadone. However, there were limitations to the study including that it wasn’t controlled.
At the same time, there was a recent review looking at rats exposed prenatally to naltrexone. There were some development and behavioral effects seen later on, but there were some positive effects such as higher birth weights. Another review looking at opioids found some effects on brain development in animal studies with naltrexone exposure. These scenarios exposed animals to very high doses of naltrexone, so it’s difficult to derive real links. Further evidence indicates naltrexone can cross the placenta in humans, and there may be overall effects on growth and behavior. Even while there is still a lot of research that needs to be done on Vivitrol, it may have more benefits than risks for some pregnant women.
The decision of whether or not Vivitrol is a viable option during pregnancy is between a woman and her healthcare provider. If the risks of the woman not using Vivitrol outweigh the risks of using it, a doctor may advise that she receive the monthly injection. For example, while there isn’t a lot known for sure about Vivitrol during pregnancy, the risks of opioids and alcohol are clear. A doctor may decide that the benefits of not using opioids or alcohol during pregnancy are the right option for a pregnant patient. A pregnant woman might also benefit from an addiction treatment program, either in conjunction with Vivitrol or on its own.
Vivitrol in Your System
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