Vivitrol consent form 2025

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Medical alert bracelets are most commonly recommended for the following chronic medical conditions: Asthma. Diabetes. Down Syndrome. Epilepsy. Heart conditions. Seizure disorders.
VIVITROL is an off-white to light tan powder for injectable suspension in a 5 mL single-dose vial. VIVITROL contains 380 mg of naltrexone in a microsphere formulation per vial (337 mg of naltrexone per gram of microspheres).
The naltrexone readiness form is used to verify the patients medical history, drug use history, lab information, physical exam findings, and other pertinent information to check patient readiness.
You should carry alert information so others know you are on naltrexone in a medical emergency: medical alert necklace, bracelet, and/or emergency card.
Patients should be provided with a medication alert card, indicating that they are taking naltrexone, to carry with them. It should be ceased a few days prior to major surgery because once the acute effects of the naltrexone have subsided, it leaves the patient with a transient increased sensitivity to opioids.

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You will need to stop using opioids for at least 7 to 10 days before you can start taking naltrexone. Your healthcare provider may need to do the naloxone challenge test or a test for opioids to make sure you are opioid-free.

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