Intramuscular (IM) Naltrexone (Vivitrol®) is Formulary, with Restrictions:

• • Clinic: Formulary with Restrictions - Defer to payer clinical criteria.
  • Inpatient: Formulary with Restrictions - Add to formulary restricted to adult patients, where continuity of care has been established, for the patient 
    to receive monthly injections. Additionally, restricted to patients who have trialed alternative therapies for AUD/opioid dependence (ex. oral 
    naltrexone) or may have difficulty adhering to daily, oral treatment. Patients will need to have abstained from opioids for a minimum of 7 days 
    prior to initiation of therapy to avoid precipitation of withdrawal.

• Micromedex
• CareNotes
• UpToDate
• Facts & Comparisons
• MedLinePlus (Patient Information)