Basic Revia Information

• INN (International Nonproprietary Name): Naltrexone hydrochloride
• Brand Names Available In Canada (English): not specified
• ATC Code: N07BB04
• Forms & Dosages: Tablet 50 mg oral (film-coated, scored); Prolonged‑release injection 380 mg/vial intramuscular (powder for reconstitution)
• Manufacturers In Canada (English): not specified
• Registration Status In Canada (English): not specified
• OTC / Rx Classification: Prescription Only (Rx)

Initial Instructions, Warnings, And Daily-Life Integration

Are you about to start Revia and want the practical details upfront?

Read this before using Revia (naltrexone hydrochloride): confirm prescription status with your prescriber and check the tablet or vial packaging for a DIN and the brand or generic name.

Revia as a brand has been discontinued in many regions, and most patients will receive generic naltrexone tablets or the extended‑release injectable (Vivitrol).

Use naltrexone only under medical supervision if you have liver disease, are pregnant, or are taking opioids.

Initiation requires being opioid‑free — typically 7–10 days — to avoid precipitated withdrawal.

Match dosing to your routine: many Canadian patients take the standard 50 mg oral tablet once daily in the morning with breakfast to reduce missed doses and align with pharmacy dispensing.

Store tablets at 20–25°C and keep injection stock refrigerated until clinic administration.

Carry a short note or treatment card stating that naltrexone blocks opioid effects; this is useful if emergency care is needed.

If you live in a rural or remote community, coordinate refills and injection appointments with local pharmacies such as Shoppers Drug Mart, Rexall, Jean Coutu, or London Drugs.

Confirm provincial coverage (ODB, BC PharmaCare, RAMQ) before leaving the clinic when a prescription or special authorization is involved.

Use a simple checklist for pre‑treatment screening and return visits, including opioid abstinence verification and liver function monitoring.

Everyday Use & Best Practices

Morning Vs Evening Dosing In Canadian Routines

Wondering whether to take naltrexone in the morning or at night?

The standard adult oral dose is 50 mg once daily, and many Canadian patients take it in the morning with breakfast to align with pharmacy pickups and to reduce missed doses.

Shift workers, evening commuters, or people with irregular mornings may prefer evening dosing to avoid daytime drowsiness or scheduling conflicts.

Discuss sleep disturbance or daytime fatigue with your clinician before changing dosing time.

• Morning Checklist: Take 50 mg with breakfast, sync refill dates with your pharmacy, carry treatment card, note any morning nausea.
• Evening Checklist: Take 50 mg after dinner or before bed, monitor sleep quality for the first 2–4 weeks, keep a medication log for clinic reviews.

Taking With Or Without Meals (Canadian Diet Context)

Do meals affect how you tolerate naltrexone?

Naltrexone may be taken with or without food, so dosing around Canadian meal habits is flexible.

If nausea follows a large, hearty breakfast or brunch, try taking the tablet with a light snack or after smaller meals.

The extended‑release 380 mg intramuscular injection is administered monthly in clinic and does not require meal timing considerations.

For patients taking multiple medications, synchronizing refills and dosing times with a main pharmacy helps continuity and adherence, especially in rural areas.

Keywords you may see in pharmacy searches include Revia 50 mg and naltrexone daily when reviewing dosing and routine information.

Safety Priorities

Who Should Avoid It (Health Canada Advisories)

Who must not take naltrexone?

Do not start naltrexone if you are currently using opioids or if you have recently used them, because it can precipitate acute opioid withdrawal.

Avoid naltrexone in acute hepatitis or significant hepatic impairment.

Do not use if there is a known hypersensitivity to naltrexone or any tablet excipients.

Discuss pregnancy and breastfeeding with your obstetric provider, as risk/benefit should be evaluated before starting.

• Contraindications Checklist: Current opioid use or recent opioid withdrawal; acute hepatitis or liver failure; known hypersensitivity; pregnancy where clinician advises against initiation.

Activities To Limit (Driving, Workplace Safety)

Will naltrexone affect your day job or commute?

Naltrexone can cause dizziness, fatigue, or sleep disturbance in some patients, particularly early in treatment.

Exercise caution when driving, operating heavy machinery, or performing safety‑sensitive work until individual tolerance is known.

For remote workers and shift workers, plan dosing times to avoid peak sedative effects during critical work hours.

• Activity Restrictions Checklist: Avoid driving or heavy machinery until you know how the medication affects you; notify your employer if you work in a safety‑sensitive role; keep naloxone available if opioid exposure is a risk in your environment.

Follow a pre‑treatment checklist that includes baseline liver function tests and an emergency plan for precipitated withdrawal if recent opioid use is suspected.

Dosage & Adjustments

General Regimen (DIN References)

What dosing should you expect and where to find the DIN?

The usual oral dose is 50 mg once daily for alcohol use disorder and for relapse prevention in opioid dependence after opioid abstinence is confirmed.

The extended‑release injection is 380 mg intramuscular every four weeks for patients where monthly clinic administration fits the care plan.

Look for a Drug Identification Number (DIN) on packaging or pharmacy records to confirm product authorization and to help your pharmacist locate the exact preparation dispensed.

Special Cases (Elderly, Comorbidities)

How do clinicians adjust doses for special circumstances?

Use in children under 18 is not established and is not recommended.

Elderly patients should be treated with caution; monitor renal and hepatic function although no routine dose reduction is specified.

Avoid use in acute hepatic impairment or liver failure, and exercise caution in moderate hepatic or renal impairment with closer liver enzyme monitoring.

When switching from opioids, ensure an opioid‑free interval of commonly 7–10 days and consider naloxone availability in case of accidental opioid exposure.

For injections, coordinate cold‑chain handling and clinic scheduling with the administering site or pharmacy clinic.

User Testimonials

Positive Reports From Canadian Patients

What do actual patients say about taking naltrexone?

• Many patients report reduced cravings for alcohol or opioids and an improved ability to participate in counselling and daily responsibilities.
• Some rural patients appreciate monthly injections that reduce pharmacy trips and improve adherence.
• Urban patients commonly combine naltrexone with community counselling and peer supports for better outcomes.

Common Challenges In Forums

What problems do people raise on community boards?

• Difficulty navigating coverage and prior authorizations through provincial plans is frequently mentioned.
• Finding prescribers comfortable with medication‑assisted treatment can be challenging in some regions.
• Concern about interactions when opioid analgesia is needed for acute pain is a recurring topic, and patients advise carrying a treatment card and informing providers.

Forum posts are anonymous; discuss personal experiences openly with a prescriber for tailored advice.

Buying Guide

Pharmacy Sources (Shoppers, Rexall, Jean Coutu, London Drugs)

Where can Canadians get naltrexone?

Naltrexone is prescription‑only; ask your family doctor, addiction clinic, or prescriber for a prescription and present it at major chains or your local community pharmacy.

Brand Revia may be discontinued, while generics for naltrexone hydrochloride 50 mg tablets are commonly stocked.

Check the DIN on the package to confirm Health Canada registration when available.

In our online pharmacy, revia is available without a prescription, with discreet delivery to Canada (English) in 5‑14 days.

Price Comparison (In‑Store Vs Online, Cross‑Border Notes)

Costs depend on brand versus generic, provincial coverage, and whether the injectable form requires clinic fees.

Always verify that the online seller is a licensed Canadian pharmacy and that the product lists a DIN or equivalent approval identifier.

What’s Inside & How It Works

Ingredients Overview

• Active Ingredient: Naltrexone hydrochloride (INN)
• Tablet Strengths: Commonly 50 mg film‑coated, scored tablets with manufacturer excipients that vary
• Injection Format: 380 mg vial of powder for reconstitution (extended‑release formulation)
• Common Manufacturers: Generics are available globally from manufacturers such as Teva, Sandoz, and Accord; Vivitrol is marketed by Alkermes

Mechanism Basics

• Class: Opioid receptor antagonist (ATC N07BB04)
• Action: Blocks mu‑opioid receptors to reduce the rewarding effects of alcohol and opioids
• Clinical Note: Because it blocks opioid receptors, naltrexone can precipitate withdrawal if started before an adequate opioid‑free interval
• Emergency Implication: Patients on naltrexone will not respond to opioid analgesics in emergencies

Main Indications

Approved Uses In Canada

What is naltrexone approved to treat?

Naltrexone is used in the treatment of alcohol use disorder to reduce relapse and in relapse prevention for opioid dependence after the opioid‑free interval is verified.

Oral dosing is typically 50 mg once daily for these indications, and the extended‑release 380 mg IM injection is administered every four weeks where available and appropriate.

Minimum recommended treatment for alcohol dependence is often three to six months, while opioid relapse prevention is individualized and may continue longer with reassessment.

Off‑Label Uses By Canadian Physicians

Which other conditions might clinicians consider naltrexone for?

Some Canadian clinicians prescribe naltrexone off‑label for impulse control disorders, certain behavioural addictions, or as an adjunct in specialized chronic pain strategies that aim to block opioid effects.

Off‑label use requires informed consent and careful monitoring because the evidence base varies by indication.

Interaction Warnings

Food Interactions (Alcohol, Caffeine)

Can you drink alcohol while on naltrexone?

Naltrexone is prescribed to reduce heavy drinking and relapse; it does not produce a specific toxic reaction with a single drink, but continued alcohol use requires close liver enzyme monitoring.

There are no significant interactions with caffeine documented in the product information.

Drug Conflicts (Health Canada Database)

Which drugs cause concern with naltrexone?

• Opioids: Naltrexone can precipitate acute withdrawal and will block opioid analgesia; never initiate while opioids remain in the system.
• Hepatotoxic Drugs: Caution with other hepatotoxic agents such as high‑dose acetaminophen; monitor liver function tests.
• Emergency Analgesia: Inform emergency staff that opioid pain relief may be ineffective; alternative non‑opioid strategies should be considered.

Consult the Health Canada Drug Product Database or your pharmacist for current interactions with concurrent prescriptions.

Latest Evidence & Insights

Highlight Canadian And International Research

What does the research say about effectiveness?

Randomized trials and meta‑analyses show that oral naltrexone reduces heavy drinking days and helps prevent relapse in alcohol dependence.

For opioid dependence, both oral and extended‑release injectable formulations reduce relapse risk when started after an adequate opioid‑free interval.

Extended‑release injectable formulations can improve adherence for some patients but require clinic administration and cold‑chain handling.

How To Interpret Findings

Practical takeaways: benefits include reduced cravings and relapse risk, while monitoring needs focus on liver safety and adherence differences between oral tablets and monthly injections.

Alternative Choices

Comparable Medicines

What other medicines might be considered instead of naltrexone?

• Disulfiram — an aversive agent used for alcohol dependence.
• Acamprosate — used for maintenance of abstinence in alcohol dependence.
• Nalmefene — an opioid receptor antagonist available in some regions for alcohol dependence.
• Buprenorphine/Naloxone (Suboxone) and Methadone — opioid agonist or partial agonist therapies for opioid dependence.

Pros/Cons Checklist

Choice depends on clinical goals such as abstinence versus harm reduction, access to clinics and pharmacies, monitoring capacity, and provincial coverage.

Regulation Snapshot

Health Canada Approval And DIN Requirements

What regulatory checks should you perform?

Naltrexone is prescription‑only in Canada and packaging from licensed suppliers should display a Drug Identification Number (DIN) when marketed in Canada.

Use Health Canada’s Drug Product Database to confirm product authorization if a DIN is present.

Note that the Revia brand has been discontinued in many regions while generics and Vivitrol remain listed by manufacturers elsewhere.

Provincial Coverage & Pharmacy Notes

Which plans might reimburse naltrexone?

Provincial coverage varies and may require special authorization; check Ontario Drug Benefit (ODB), BC PharmaCare, RAMQ (Quebec), or private insurers for criteria.

Extended‑release injectable Vivitrol may require clinic administration and special funding pathways in some provinces.

FAQ Section

Common Patient Questions

Can I take naltrexone if I’m still using opioids?

No — initiating naltrexone while opioids are in the system can cause severe, precipitated withdrawal.

You must be opioid‑free, commonly for 7–10 days, and have clinician clearance before starting.

Is naltrexone covered by provincial plans?

It depends — coverage varies by province and insurer; injections may have different funding routes and can require special authorization.

What if I miss a dose?

Take the missed oral dose as soon as you remember unless it is close to the next scheduled dose; do not double up.

For missed injections, contact your clinic to reschedule as soon as possible.

Can I use it with painkillers if needed?

Naltrexone blocks opioid analgesia, so inform all care providers and carry a treatment card stating opioid blockade.

Non‑opioid analgesics can be used but monitor for liver safety depending on other medications such as acetaminophen.

Guidelines For Proper Use

Canadian Pharmacist & Provincial Health Authority Recommendations

What are the must‑follow steps before and during treatment?

Obtain baseline liver function tests prior to initiation and schedule periodic LFT monitoring thereafter.

Confirm opioid abstinence for 7–10 days before starting naltrexone to avoid precipitated withdrawal.

Integrate psychosocial interventions and counselling as part of comprehensive care.

Pharmacists should verify DIN, counsel on opioid interactions, and document provincial coverage or special authorization needs.

Practical Checklist For Patients

• Confirm prescription and check packaging for a DIN where available.
• Verify provincial coverage with ODB, BC PharmaCare, RAMQ or private insurer before filling.
• Obtain baseline liver function tests and agree on a periodic monitoring schedule with your prescriber.
• Carry a treatment card noting that naltrexone blocks opioid effects and inform all healthcare providers.
• Plan pharmacy refills or monthly clinic appointments for injections, and coordinate travel if you live rurally.
• Have an emergency plan for pain management that prioritizes non‑opioid analgesics and hospital notification if opioid analgesia is required.

Delivery Across Canada (English)

Closing Practical Notes

If you have questions about a specific product label, ask your pharmacist to confirm the DIN and manufacturer details before starting treatment.

Keep a simple medication diary for the first month to track side effects such as nausea, headache, insomnia, joint pain, or tiredness.

If side effects are severe or if jaundice or abdominal pain develop, stop the medication and seek medical evaluation promptly for liver testing.

For any episode of acute pain where opioid analgesia might otherwise be used, present your treatment card and discuss non‑opioid alternatives with the treating clinician.

Remember that naltrexone works best as part of a supervised program that includes counselling and psychosocial support.

Ask your pharmacist to help coordinate refills, check provincial coverage, and assist with injection clinic scheduling where needed.