Last Updated on August 9, 2026

Oral naltrexone and Vivitrol contain the same active medication. Oral naltrexone is a daily pill, while Vivitrol is a monthly injection. Research suggests they’re similarly effective, so the best choice depends on your preferences and which option you’ll stick with. Sunnyside Med offers online clinician evaluations, compounded oral naltrexone, and ongoing coaching to help support long-term success.

You’ve been researching naltrexone to help you drink less. Then you come across something called Vivitrol, which seems really similar. You wonder: Is this a different medication? Am I mixing two medications up?

Short answer: Oral naltrexone and Vivitrol contain the same active medication. The difference between them is how they’re administered. Oral naltrexone is a daily pill. Vivitrol is a long-acting injection administered monthly by a healthcare provider.

Neither is inherently more effective than the other. In the 2025 ADOPT trial, people taking oral naltrexone and those receiving monthly Vivitrol had similar reductions in heavy drinking. The biggest differences were practical ones: how the medication is delivered, how long it lasts, cost, and which format people preferred.

For many people who want to cut back on alcohol, the real question isn’t which option is better. It’s which option fits their life well enough that they’ll stick with it.

Oral Naltrexone and Vivitrol Are the Same Drug

Both oral naltrexone and Vivitrol contain the same active medication: naltrexone, an opioid receptor antagonist that’s been FDA-approved to treat alcohol use disorder since 1994.

The difference is how the medication is delivered.

• Oral naltrexone is taken as a daily pill. Sunnyside Med prescribes a compounded version with vitamin B6 that ships discreetly to your door.
• Vivitrol is an extended-release intramuscular injection given by a healthcare provider about once every four weeks.

Both work by reducing alcohol’s rewarding effects in the brain, making drinking feel less gratifying over time. Many people find that cravings become quieter and easier to manage, although individual responses vary.

Oral Naltrexone vs. Vivitrol: The Day-by-Day Experience

Here, we’ll outline how the daily experiences of taking these medications differ, including cost, side effects, and ease of use.

Oral naltrexone

Oral naltrexone is taken once a day. With Sunnyside Med, it’s typically taken about 60 to 90 minutes before your usual drinking window to help reduce alcohol’s rewarding effects.

Some people notice a difference the first time they drink while taking it. For most, meaningful changes in drinking habits develop over several weeks of consistent use. Because it’s a pill, your clinician can adjust the dose or stop treatment if needed.

Vivitrol

Vivitrol is a long-acting injection given by a healthcare provider about once every four weeks. Once it’s administered, the medication remains active for about a month, so there’s no daily pill to remember.

Like oral naltrexone, you must be opioid-free before starting treatment to avoid precipitated opioid withdrawal. Side effects are generally similar, including nausea, headache, dizziness, and fatigue, though Vivitrol can also cause injection-site reactions.

The biggest practical difference is cost. Generic oral naltrexone is relatively inexpensive, while Vivitrol has a much higher list price, although insurance may reduce out-of-pocket costs.

What the Research Says

People often assume the monthly injection must work better because it doesn’t rely on remembering a daily pill. The evidence doesn’t support that.

As mentioned above, the strongest head-to-head study is the 2025 ADOPT trial, which randomized 248 hospitalized adults with alcohol use disorder to receive either daily oral naltrexone or monthly injectable naltrexone. After three months, both groups had substantial reductions in heavy drinking, with no statistically significant difference between the two formulations. The researchers concluded that factors like cost, convenience, and patient preference should guide the decision.

Earlier research established that Vivitrol is effective. In the pivotal placebo-controlled trial that led to its FDA approval, monthly extended-release injectable naltrexone significantly reduced heavy drinking days compared with placebo in adults with alcohol dependence. 

Overall, the evidence suggests that both oral naltrexone and Vivitrol are effective treatment options. The biggest difference is whether the treatment fits your life well enough to stick with it.

Oral Naltrexone vs. Vivitrol: Which Is Right for You?

The choice comes down to your preferences, budget, and treatment goals rather than one medication being objectively better.

Oral naltrexone may be a better fit if you:

• Want the flexibility of a daily medication
• Prefer a private, at-home treatment option
• Are looking for the lower-cost option
• Want the support of a behavior-change program like Sunnyside Med

Vivitrol may be something to consider if you:

• Prefer a once-monthly treatment
• Have access to a healthcare provider who administers the injection
• Have insurance coverage that makes the cost manageable

Whichever option you choose, naltrexone works best when it’s taken as prescribed and paired with behavioral support that helps you build lasting changes in your drinking habits.

The Adherence Question: Why the Shot Exists and What Actually Fixes It

One reason Vivitrol exists is to solve a common problem: people forget to take daily medication. And research has found that more than half of people who fill an initial oral naltrexone prescription never refill it. A monthly injection removes that barrier. 

But that doesn’t mean opting for Vivitrol is your only option. Moving forward with the daily pill is totally possible alongside a behavior-change program like Sunnyside, which makes it easier to stay consistent with daily medication.

Internal data backs this up. Among Sunnyside Med members who actively engage with the program, prescription refill rates are about three times higher than among less-engaged members. Members with at least 50% app engagement are also much more likely to remain on medication through month four. (Individual results vary, and these are observational member data rather than results from a randomized trial.)

Dr. Hrishikesh Belani, M.D., Sunnyside Medical Advisor, endorses this approach: “I prescribe naltrexone regularly as a safe, effective way to curb heavy drinking,” he said. “I highly recommend pairing it with a behavioral health program like Sunnyside.”

Why Many Clinicians Recommend Starting With the Pill

For people who are new to naltrexone, clinicians often recommend trying the oral medication before moving to the monthly injection.

The biggest reason is flexibility. If side effects such as nausea, headache, or fatigue occur, the medication can be adjusted or stopped. It also gives you and your clinician a chance to see how well it works before committing to about a month of injectable treatment.

At Sunnyside Med, every application is reviewed by a licensed clinician. If prescribed, compounded oral naltrexone is shipped discreetly to your door, along with coaching, drink tracking, and ongoing support designed to help you stay on treatment.

Get Started with Sunnyside Med

If you’re interested in trying oral naltrexone, Sunnyside Med makes it easy to get started from home.

After a short online assessment, a licensed clinician reviews your information to determine whether naltrexone is appropriate for you. If prescribed, compounded oral naltrexone ships discreetly to your door, and you’ll get access to the tools that help people stay on treatment, including drink tracking, personalized plans, one-on-one coaching, and a private member community.

Sunnyside Med is available in all 50 states, costs $99/month, is HSA/FSA eligible, and doesn’t require insurance.

One member described the experience this way: “For the first time in years I have control over my drinking and my cravings. I know I can have a drink, but I just don’t really want one.”

If you’re comparing oral naltrexone vs. Vivitrol, remember that they contain the same medication. For many people who want to drink less, the best choice is the one that fits their lifestyle well enough to stay consistent.

Frequently Asked Questions (FAQ): Oral Naltrexone vs. Vivitrol

Is Vivitrol the same as naltrexone?

Yes. Vivitrol is the brand name for an extended-release injectable form of naltrexone. Oral naltrexone and Vivitrol contain the same active medication but are delivered differently.

Which is more effective: oral naltrexone or Vivitrol?

Current evidence suggests they’re similarly effective at reducing heavy drinking. The choice usually comes down to cost, convenience, and which format you’re most likely to stick with.

Can you drink while taking Vivitrol?

Yes. Like oral naltrexone, Vivitrol reduces alcohol’s rewarding effects rather than making you sick if you drink. The difference is that the injection provides continuous medication for about a month, while the pill is taken daily. Like oral naltrexone, Vivitrol should not be used by people who are currently taking opioids, have acute opioid withdrawal, or have acute hepatitis or liver failure. A clinician will review your medical history to determine whether it’s appropriate for you.

Why do doctors often start with the pill?

Many clinicians begin with oral naltrexone because it’s easy to adjust or stop if side effects occur, and it lets you see how well the medication works before committing to a month-long injection.

How much does oral naltrexone cost compared with Vivitrol?

Generic oral naltrexone is generally much less expensive than Vivitrol, although insurance may lower the cost of the injection. Sunnyside Med costs $99/month and includes the medication, clinician oversight, and behavior-change support.

Sunnyside Med Makes It Easy to Get Started with Oral Naltrexone

If you’re leaning toward oral naltrexone after comparing it with Vivitrol, the next step is finding a program that gives you more than just a prescription.

Sunnyside is the #1 mindful drinking app. Since 2020, we’ve helped more than 400,000 people cut over 22 million drinks from their baseline habits. In a third-party study, our approach reduced weekly drinking by 33% after 12 weeks, and 96.7% of members report success drinking less.

When you sign up, you’ll start with a quick 3-minute assessment. If a licensed clinician determines that naltrexone is appropriate for you, you’ll receive compounded oral naltrexone along with ongoing support that goes beyond the prescription, including drink tracking, personalized weekly plans, one-on-one coaching, educational resources, and a private member community.

Whether your goal is to drink less, build more alcohol-free days, or eventually stop drinking altogether, Sunnyside Med is designed to help you make lasting changes, not just for a few weeks, but for the long term.

Each new member receives a 15-day free trial, so you can explore the program and decide whether it’s the right fit for your goals.

Naltrexone is a prescription medication. This content is for educational purposes only and isn’t a substitute for medical advice. A licensed clinician reviews every Sunnyside Med application. Individual results vary.