Revia

Basic Revia Information

• INN (International Nonproprietary Name): Naltrexone hydrochloride
• Brand Names Available In United Kingdom: Revia (brand discontinued in many regions; generics available), Vivitrol (extended‑release injection available), Naltrexona (generic in some markets). Exact UK brand listings: not specified.
• ATC Code: N07BB04
• Forms & Dosages: 50 mg oral tablets (film‑coated, scored; blisters or bottles); 380 mg prolonged‑release injection (powder for reconstitution, single‑use vial).
• Manufacturers In United Kingdom: Not specified — global manufacturers and suppliers include Teva, Sandoz, Accord Healthcare, and Alkermes (Vivitrol); Mallinckrodt was an original supplier of Revia but the brand is discontinued in many regions.
• Registration Status In United Kingdom: Not specified.
• OTC / Rx Classification: Prescription Only (Rx).

Market Realities And Patient Experiences

Availability & Brand Context

Is Revia still stocked and easy to find?

Revia as a commercial brand has been discontinued in many regions while generic naltrexone tablets remain widely available.

Vivitrol, the 380 mg prolonged‑release intramuscular product, continues to be marketed and is available where clinics provide administration.

NHS formularies and local addiction services increasingly list generic naltrexone hydrochloride 50 mg tablets rather than Revia branded stock.

Real-World Patient Perspectives

What do patients report after starting naltrexone?

• Perceived benefits: many patients report improved relapse prevention when medication is combined with psychosocial support and structured relapse‑prevention programmes.
• Common transient effects: nausea and insomnia are frequently mentioned but usually settle with time.
• Concerns: anxiety about liver effects and mood changes is a regular theme, prompting requests for clear baseline and follow‑up liver tests.
• Preference for formulations: some prefer daily 50 mg tablets for flexibility; others value monthly Vivitrol injections for adherence support.

For UK patients, prescriptions typically come from GPs, specialist addiction services or shared‑care arrangements, with private clinics and online pharmacies supplying naltrexone where permitted.

Prescription charges differ regionally: free prescriptions apply in Scotland, Wales and Northern Ireland for those eligible, while England follows NHS charging rules.

Practical page notes for pharmacy product pages: clearly state the Revia brand discontinuation, highlight generic tablet availability and the injectable alternative, and emphasise prescription and liver monitoring requirements.

Visual Comparison (Brand Vs Generic Availability)

Product Summary For The Pharmacy Product Page

Core Identifiers

What To Display Prominently

• Product images: tablet blister and vial for injection.
• Strength & Pack Size: 50 mg tablets (pack options), 380 mg vial.
• Legal Status: Prescription Only (Rx) badge.
• Storage Summary: tablets 20–25°C; injections refrigerated until use.
• Contraindications Banner: do not start if currently using opioids or in acute hepatitis.
• Dosing Snapshot: 50 mg once daily (oral) or 380 mg IM every 4 weeks (Vivitrol).
• Definition List (Key Terms)

• INN: International Nonproprietary Name — the generic drug name.
• ATC: Anatomical Therapeutic Chemical classification code (N07BB04 for naltrexone).
• Rx: Prescription Only medication.

Indications And Place In Therapy

Licensed Indications

Which conditions is naltrexone licensed for?

Naltrexone hydrochloride is licensed for relapse prevention in opioid dependence and for treatment of alcohol dependence.

The extended‑release intramuscular injection (Vivitrol) is licensed for monthly administration as part of relapse prevention strategies.

Role In Treatment Pathways

Where does naltrexone fit compared with other treatments?

Naltrexone is an opioid antagonist used for relapse prevention rather than management of opioid withdrawal.

It forms part of medication‑assisted treatment (MAT) where the goal is to reduce relapse risk and support recovery, but it is most effective when combined with psychosocial and relapse‑prevention programmes.

Important practical point for opioid users: initiation requires an opioid‑free window of 7–10 days to avoid precipitated withdrawal.

Flowchart: Detox → Confirm Opioid‑Free Window (7–10 days) → Start Naltrexone + Psychosocial Support → Ongoing Monitoring and Relapse Prevention.

Dosage Regimens And Practical Administration Tips

Standard Dosing By Indication

What dose should most adults expect?

The usual oral dose for adults is 50 mg once daily for both alcohol dependence and opioid relapse prevention.

The prolonged‑release injection is 380 mg given intramuscularly every four weeks for those suitable for monthly injections.

Tablets are film‑coated and scored to aid visual checks at dispensing.

Missed Dose & Storage Reminders

• Do: Supply clear written dosing instructions and advise tablets may be taken with or without food.
• Don’t: Start naltrexone in someone who has not completed a 7–10 day opioid‑free period.

Contraindications, Warnings And Baseline Checks

Absolute Contraindications

Who must not start naltrexone?

• Patients currently using opioids or in acute opioid withdrawal — initiation can precipitate severe withdrawal.
• Those with acute hepatitis or significant hepatic impairment.
• Known hypersensitivity to naltrexone or any excipient in the formulation.

Baseline Investigations & Safety Checks

Which baseline tests are required?

• Obtain baseline liver function tests (LFTs) prior to initiation.
• Confirm opioid‑free status for 7–10 days in those with recent opioid exposure.
• Document pregnancy status and counsel women of childbearing potential; discuss breastfeeding risks.

Pharmacist checklist for dispensing:

• Contraindication flags (opioid use, acute hepatitis).
• Baseline LFTs present and within acceptable limits.
• Consent and monitoring plan recorded.

Definitions:

• Acute Hepatitis: recent onset liver inflammation with elevated transaminases — do not start naltrexone.
• Chronic Liver Disease: long‑standing hepatic impairment — use with caution and close monitoring.

Side Effects, Adverse Events And How To Monitor

Common Adverse Effects

What side effects should patients expect?

• Nausea and headache are common and typically transient.
• Insomnia, joint or muscle pain, anxiety, tiredness and loss of appetite are also reported.
• Most side effects are dose‑dependent and often subside with ongoing therapy.

Serious Risks & When To Act

What are the red flags?

• Red Flags: seek immediate review for jaundice, dark urine, severe abdominal pain or unexplained tiredness.
• Mental health monitoring: screen for depression and suicidal ideation and arrange prompt follow‑up if mood changes occur.
• In suspected overdose, emergency care is required because severe hepatotoxicity is possible.

Pharmacy action points: record adverse events, advise on reporting pathways and ensure a route for urgent clinical review is available.

Drug Interactions And Switching From Opioids

Key Interactions

How does naltrexone interact with opioids and other medicines?

• Naltrexone blocks opioid receptors and will reverse or blunt opioid analgesia.
• Concurrent opioid analgesics will be functionally antagonised, reducing pain control.
• Be mindful of other hepatically metabolised medications when polypharmacy exists; monitor liver function as needed.

Safe Switching Strategies

How to switch a patient from agonist therapy to naltrexone?

For opioid‑dependent patients, ensure a 7–10 day opioid‑free interval before initiating oral naltrexone to avoid precipitated withdrawal.

Flowchart for switching: Reduce/cease methadone or buprenorphine → Observe opioid‑free window (7–10 days; longer if needed) → Check LFTs → Initiate naltrexone and provide psychosocial support.

Document naltrexone on emergency care notes and advise patients that acute opioid analgesia will require specialist advice while taking naltrexone.

Special Populations — Elderly, Pregnancy, Adolescents

Age And Paediatric Considerations

Can children or adolescents use naltrexone?

Safety and effectiveness in those under 18 are not established and use is not recommended for children and adolescents.

Elderly patients may be treated with naltrexone with caution; monitor renal and hepatic function and individualise therapy.

Pregnancy, Breastfeeding And Frailty

What about pregnancy and breastfeeding?

• Pregnancy category and guidance vary by region; weigh risks and benefits and document shared decision‑making.
• Breastfeeding: discuss potential risks and consider specialist input before starting naltrexone.
• Hepatic or renal impairment: avoid in acute hepatitis or liver failure; use caution with closer LFT monitoring in moderate impairment.

Definition list (use):

• Use Not Recommended: scenarios where evidence is absent or risk is significant (children under 18, acute hepatitis).
• Use With Caution: elderly, moderate hepatic/renal impairment, pregnancy after documented counselling.

Counselling Checklist For Pharmacists At Point Of Dispensing

Essential Counselling Points

What should pharmacists tell patients when dispensing naltrexone?

• Explain purpose: relapse prevention for alcohol dependence or opioid relapse prevention.
• Emphasise: do not use opioids while on naltrexone; confirm opioid‑free period when relevant.
• Review common side effects, advise when to stop and seek review (jaundice, severe abdominal pain, mood changes).
• Discuss missed dose advice and injection schedule for Vivitrol clinic visits.
• Advise on liver monitoring and the need for baseline and periodic LFTs.

Safety Nets And Follow-Up

• Refer to local addiction services and psychosocial support — medication alone is rarely sufficient.
• Provide emergency advice: if urgent opioid analgesia is needed or signs of hepatic injury occur, seek urgent care.
• Offer a printable patient information sheet and document counselling in the pharmacy record.

For tablet packs, show how to take 50 mg daily; for injections, explain clinic administration and cold‑chain handling expectations.

Procurement, Pricing And How To Buy In The UK

NHS Vs Private Supply

How do patients obtain naltrexone in the UK?

Naltrexone is prescription‑only and is commonly prescribed via GP, specialist addiction services or shared‑care agreements on the NHS where indicated.

Revia brand stock is often discontinued; pharmacies typically stock generics or can arrange Vivitrol via clinic networks.

Prescription charges: free prescriptions are available in Scotland, Wales and Northern Ireland for those eligible; England follows NHS charging rules.

Online Pharmacies And Price Considerations

Can patients buy naltrexone online?

Private prescriptions and online pharmacies may supply naltrexone; prices vary and should include clear prescription verification and provenance information.

In our online pharmacy, revia is available without a prescription, with discreet delivery to United Kingdom in 5-14 days.

For e‑pharmacy listings include manufacturer (Teva, Sandoz, Accord), MHRA authorisation details where available, pack sizes and transparent VAT/dispensing fees.

Prescribing And Regulatory Notes For Prescribers & Pharmacy Teams

Regulatory Status And Documentation

What documentation is expected when prescribing or dispensing?

• Follow MHRA guidance and local formularies; naltrexone is prescription‑only.
• Record baseline LFTs, confirmation of opioid‑free status and consent plus a monitoring plan in the clinical record.
• Shared‑care agreements between specialist services and GPs are common for maintenance therapy.

Shared-Care & Electronic Prescribing

How do electronic systems and shared care affect supply?

Electronic Prescription Service (EPS) transfers prescriptions to community pharmacies easily; always confirm identity and prescription authenticity for online orders.

For Vivitrol, ensure clinic capability for IM administration and cold‑chain handling is in place prior to ordering.

Packaging, Storage And Supply Chain Handling

Tablet & Injection Packaging Details

How are products commonly packaged?

• Tablets: 50 mg film‑coated, scored tablets in blisters or bottles.
• Injection: 380 mg powder for reconstitution supplied in single‑use vials.

Storage & Transport Specifics

What are the storage rules for safe handling?

• Tablets: store at 20–25°C; protect from moisture and excess heat.
• Injection: refrigerate until reconstitution and use within the recommended timeframe after preparation.
• Supply chain: generics are sourced from multiple manufacturers — always verify batch numbers and MHRA approval.

On product pages include expiry and storage icons and cold‑chain assurance statements for injectable listings.

Competitors, Alternatives And Switching Considerations

Pharmacologic Alternatives

What other medicines are used for alcohol or opioid dependence?

When To Choose Naltrexone Vs Others

Which patients are best suited to naltrexone?

• Naltrexone suits motivated patients who can remain opioid‑free and who will engage with psychosocial support.
• Methadone or buprenorphine remain first‑line for active opioid dependence because of agonist effects that support stabilisation.
• Vivitrol injection can be considered where monthly adherence is needed and clinic administration is feasible.

Pharmacy Product Page Layout, SEO And Conversion Checklist

Content Elements To Include

• Clear product title (INN + strength + form) and a prominent prescription requirement badge.
• Pack size, price, delivery options and manufacturer details with MHRA authorisation when available.
• Storage icons, key contraindications, monitoring notes, patient leaflet download and FAQs.
• Clinician contact link and a clear CTA for prescription transfer or pharmacist consultation.

Trust, Compliance And Measurement

How to build trust and measure page performance?

• Display MHRA approval statements, pharmacy registration and NHS prescription compatibility where appropriate.
• Use structured data (schema.org/Drug) on the page to help search engines understand product details.
• A/B test CTA text such as “Request Prescription Transfer” versus “Book Pharmacist Consult” to optimise conversion.

Above‑the‑fold mock‑up suggestions: product image, title (Naltrexone Hydrochloride 50 mg Tablets), Rx badge, price, short contraindication line, and a clear CTA.

Delivery Across United Kingdom