Basic Revia Information

• INN (International Nonproprietary Name): Naltrexone hydrochloride.
• Brand Names Available In Canada (English): Revia (brand discontinued in many regions), Depade (discontinued), Vivitrol (available), Naltrexona (generic in some regions).
• ATC Code: N07BB04.
• Forms & Dosages: Tablet 50 mg oral film-coated, scored, in blisters or bottles; Prolonged-release injection 380 mg vial for intramuscular administration.
• Manufacturers In Canada (English): Mallinckrodt was the original supplier of Revia (now discontinued); other global manufacturers include Teva, Sandoz and Accord Healthcare; Vivitrol by Alkermes. (Local Canadian manufacturer details: not specified.)
• Registration Status In Canada (English): not specified.
• OTC / Rx Classification: Prescription Only (Rx).

Major National Pharmacy Chains (Shoppers Drug Mart, Rexall, London Drugs)

Access to naltrexone at major Canadian chains requires a valid prescription and pharmacist dispensing procedures.

Shoppers Drug Mart, Rexall, London Drugs and Jean Coutu will dispense naltrexone only with a prescription and will provide counselling at the point of sale.

Stocking of branded Revia is inconsistent because the original brand is discontinued in many regions and generics are more common.

Many stores list the product as naltrexone 50 mg tablets or as Vivitrol 380 mg IM when the injectable is available.

Rural and smaller urban stores are more likely to display "stock varies" or order on request than large urban branches.

Online Pharmacy Trends In Canada (Including Provincial Restrictions)

Canadian online pharmacies require a valid prescription before dispensing naltrexone.

Many have integrated e-prescribing links with provincial systems to speed verification and delivery.

Cross-border shipping from U.S. online pharmacies is common among patients seeking lower cost generic naltrexone, but such shipments may face customs checks and lack a Canadian DIN.

Provincial drug plans can affect out-of-pocket cost, so patients often compare in-store prices versus online Canadian pharmacy prices.

Pharmacies must confirm prescriptions and, where Vivitrol is involved, ensure cold-chain logistics for an injectable product.

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

Price Ranges By Package Size (With Provincial Differences)

Out-of-pocket price for a one-month supply of naltrexone 50 mg tablets varies depending on the manufacturer and pharmacy markup.

Provincial formularies such as Ontario Drug Benefit, BC PharmaCare and RAMQ may offer coverage under specific criteria, which reduces patient cost.

Because brand Revia is often discontinued, generics (Teva, Sandoz, others) typically determine retail pricing.

Keywords And Search Terms To Know

Searches such as revia, naltrexone 50 mg, naltrexone tablets and Vivitrol injection are common when patients look for information or prices.

Forum And Review Platforms (Reddit Canada, HealthBoards, AskDocs)

People often ask how to access naltrexone at local clinics and whether it requires specialist referral.

Threads compare Vivitrol versus oral naltrexone for adherence and clinic logistics.

Rural posters frequently describe access barriers and inconsistent pharmacy supply of Revia.

Users report receiving pharmacy-level counselling at chains such as Shoppers and Jean Coutu.

Some posts describe cross-border ordering for generics as a cost-saving strategy.

• How to start naltrexone and which clinic to approach.
• Vivitrol injection logistics versus daily tablets.
• Experience with side effects and liver monitoring.
• Coverage questions about provincial drug plans.
• Ordering generics online and customs experiences.

Reported Benefits And Challenges From Canadian Patients

Many patients report reduced alcohol cravings and fewer relapse events while on naltrexone.

Some describe that oral naltrexone is simpler than opioid agonist therapy for those not seeking substitution therapy.

Common challenges include the required opioid-free interval of seven to ten days before starting and the need for liver monitoring.

Side effects reported in forums frequently include nausea, insomnia and headaches.

Cost and provincial coverage variability are commonly cited barriers to starting or continuing treatment.

Personal stories stress that medication works best when combined with psychosocial supports and counselling.

INN And Brand Names Used In Canada

The International Nonproprietary Name is naltrexone hydrochloride and Canadian listings commonly use the INN on labels.

Branded extended-release injection appears as Vivitrol, while oral presentations are usually listed as naltrexone 50 mg tablets from various generic manufacturers.

Legal Classification Under Health Canada

Naltrexone is a prescription-only medication and requires a prescription for dispensing in Canada.

Pharmacists should verify the Drug Identification Number on packaging to confirm Health Canada registration when available.

Generic packaging and manufacturer names can vary, so checking the DIN, lot and expiry is standard practice before sale.

Approved Uses (Health Canada DIN Context)

Registered products containing naltrexone are used for alcohol dependence and for relapse prevention following opioid detoxification.

Typical adult oral dosing is 50 mg once daily and Vivitrol is 380 mg IM every four weeks where available.

Treatment is normally part of a program that includes psychosocial interventions and regular monitoring.

Off-Label Patterns In Canadian Healthcare

Some prescribers consider naltrexone for behavioural addictions or psychiatric augmentation, though evidence is variable.

Off-label use requires clear documentation of rationale and informed consent in the medical record.

Community addiction clinics may have local protocols for initiation, monitoring and eligibility for coverage.

• Approved: Alcohol dependence; opioid relapse prevention after confirmed detox.
• Off-Label: Trial for behavioural addictions or as adjunctive psychiatric therapy in select cases.

Layman’s Explanation

Naltrexone blocks opioid receptors in the brain so that alcohol and opioids no longer produce the same rewarding effects.

For patients, this often translates into fewer cravings and a lower chance of relapse for alcohol or opioid use disorders.

The medicine does not cause opioid effects and is not a replacement therapy like methadone or buprenorphine.

Starting naltrexone requires that a person be opioid-free for seven to ten days to avoid precipitated withdrawal.

Clinical Detail From Health Canada Resources

Naltrexone acts as a competitive antagonist at μ-opioid receptors and modulates reward pathways implicated in dependence.

Product monographs emphasise the risk of hepatotoxicity at high doses and recommend baseline and periodic liver function monitoring.

Vivitrol delivers sustained plasma levels via monthly 380 mg intramuscular injections for maintenance therapy.

Standard Regimens Per Canadian Guidelines

The usual adult oral dose is 50 mg once daily for alcohol dependence or opioid relapse prevention after detoxification.

Vivitrol is administered as a 380 mg intramuscular injection every four weeks when used.

Before initiation, assess liver enzymes and document recent opioid use to confirm eligibility and safety for treatment.

Adjustments By Patient Type (With Canadian Clinical Notes)

Use is not recommended for patients under 18 years of age due to limited safety data.

Elderly patients should be started with caution and monitored for hepatic and renal function.

Do not use in cases of acute hepatitis or liver failure; moderate impairment requires careful monitoring and possible dose adjustment.

• Missed Dose: Take when remembered unless near the next dose; do not double up.
• Overdose: Seek emergency care promptly; monitor for hepatic injury.

Common Side Effects (Health Canada-Approved List)

Common adverse effects include nausea, headache and trouble sleeping.

Other frequently reported symptoms are joint or muscle pain, anxiety, fatigue and decreased appetite.

Most side effects are dose-dependent and often lessen with continued treatment.

Rare But Serious (With Canadian Pharmacovigilance Data)

Serious hepatic injury and hepatotoxicity have been reported; baseline and periodic liver enzyme monitoring is recommended.

Initiating naltrexone in patients who still have opioids in their system can precipitate severe withdrawal.

Injectable forms may cause injection-site reactions and systemic adverse events that should be reported to Canada Vigilance.

Alternatives Table (With DIN References)

Pros And Cons List

Pros: Naltrexone is a non-opioid antagonist that reduces cravings and can be taken orally or as a monthly injection.

Cons: It requires a seven to ten day opioid-free window before initiation, demands liver monitoring and may not be suitable for everyone.

Compared with methadone or buprenorphine, naltrexone does not provide opioid agonist effects and is not a substitution therapy.

Major Canadian Or International Studies 2022–2025

Recent research continues to compare oral naltrexone and extended-release injectable formulations for real-world effectiveness and retention.

Canadian studies emphasize implementation in primary care, rural access and integration with psychosocial supports.

Emerging work focuses on predictors of response and strategies to monitor liver safety in routine practice.

Practice And Policy Trends In Canada

There is growing interest in injectable formulations to improve adherence in targeted programs.

Policy discussions focus on formulary listings across provinces and expanding pharmacist roles in monitoring and renewals.

Post-marketing surveillance through Health Canada and Canada Vigilance continues to inform safety updates.

Can I Get Naltrexone Through Provincial Drug Plans?

Coverage varies by province and often requires enrolment in addiction programs or specific clinician documentation.

Ontario Drug Benefit, BC PharmaCare and RAMQ may list naltrexone or Vivitrol under certain criteria.

Patients should check provincial formularies and speak with their pharmacist about special authorisations.

Safety And Lifestyle Questions Patients Ask

Patients commonly ask how long before they can use opioids again; while on naltrexone, opioids will not work and opioids should not be used.

Questions about feeling sick are common; nausea, headache and insomnia are possible but often transient.

Liver tests are required at baseline and periodically during treatment to detect hepatotoxicity early.

• Can I take opioids while on naltrexone? No — opioids are blocked and taking them risks precipitated withdrawal if started too soon.
• Will I need blood tests? Yes — baseline and periodic liver enzyme checks are recommended.
• What about emergency pain relief? Inform emergency providers that naltrexone is in use because opioid analgesia may be ineffective.

Health Canada Approval Process

Health Canada reviews quality, safety and efficacy before assigning a Drug Identification Number to approved products.

Generic naltrexone products can receive DINs; Vivitrol follows its own regulatory track as an injectable product.

Pharmacies should check the DIN on packaging to verify registration and access official monograph details.

DIN Number Relevance

The DIN confirms a product is approved for sale in Canada and helps pharmacists and patients verify product information.

For cross-border purchases, lack of a Canadian DIN means the product is not a Health Canada-registered item and may not be acceptable for dispensing in Canada.

Adverse events should be reported to Canada Vigilance to support regulatory surveillance.

• Check DIN, manufacturer and expiry before dispensing.
• Confirm packaging and lot numbers for authenticity.
• Report any serious adverse events to Canada Vigilance.

Infographic Ideas For Canadian Context

Create a patient-facing infographic titled "How Naltrexone Works" that shows receptor blockade versus agonists in plain visuals.

Include an "Initiation Checklist" showing opioid-free interval, baseline LFTs and informed consent steps.

Design a "Choosing Oral Vs Injectable" panel comparing adherence, clinic visits and cost, with provincial icons for Ontario, BC and Quebec to indicate formulary differences.

Product Imagery & Label Guidance

Use clear mock-ups of tablet packaging annotated with DIN, manufacturer, dose (50 mg) and storage instructions (20–25°C).

For injectable Vivitrol, include a fridge symbol and single-use vial label with administration site notes and cold-chain reminders.

Provide a small table that compares blister pack versus bottle packaging for tablets and defines DIN, Rx and extended-release.

In-Store Vs. Online Canadian Purchase Tips

All legal Canadian dispensaries require a prescription for naltrexone.

In-store pickup provides immediate pharmacist counselling and on-the-spot verification of DIN and lot number.

Online Canadian pharmacies accept e-prescriptions or require upload of a prescription and will note delivery times and cold-chain requirements for injectables.

Cross-border purchases carry risks such as customs seizure, absence of DIN and uncertain authenticity.

Proper Storage With Canadian Climate Considerations

Tablets should be stored at 20–25°C and protected from moisture and excess heat, which is important in humid coastal provinces or heated indoor winter environments.

Injectable vials require refrigeration and pharmacies must maintain cold-chain integrity during transport and delivery.

Advise patients not to store tablets in bathrooms or vehicles and to return unused medication to a pharmacy for safe disposal.

• Store tablets at 20–25°C away from moisture.
• Keep injectables refrigerated and confirm cold transport for home delivery.
• Use provincial medication return programs for disposal.

Canadian Doctor/Pharmacist Advice Style

Clinicians and pharmacists should confirm the indication, review opioid history and obtain baseline liver tests before starting naltrexone.

Explain common side effects, missed-dose rules and the importance of psychosocial supports during therapy.

Document informed consent and check provincial formulary coverage before prescribing or dispensing.

Practical Monitoring Checklist

Recommend baseline liver function tests and follow-up reviews at four to twelve weeks initially.

Provide referral information for counselling and community addiction supports as part of a bundled care plan.

For injectables, ensure clinic procedures for administration and refrigeration are in place and that the patient receives a written handout with DIN and pharmacy contact details.

Delivery Across Canada (English)

Infographic And Label Visual Notes

Use simple icons for "Opioid-Free 7–10 Days", "Baseline LFTs", and "Monthly Injection" to make initiation steps clear to patients.

Annotate a sample tablet pack with DIN, dose and storage range 20–25°C for patient handouts.

For injectables, show a fridge icon and the single-use vial with reconstitution timing and administration location.

Buying And Storage Advice

Confirm prescription validity and DIN when buying in-store or online within Canada.

Online orders should specify delivery timing, packaging and cold-chain methods for injectables.

Cross-border purchases lack a Canadian DIN and may be subject to customs inspection or rejection, so verify rules before ordering.

• Store tablets at 20–25°C, away from moisture.
• Refrigerate injectable vials and confirm cold transport for home delivery.
• Return unused medication to the pharmacy for safe disposal.

Guidelines For Proper Use

Provide shared decision-making information that explains the opioid-free requirement and need for LFT monitoring before starting.

Document informed consent and discuss emergency analgesia planning since opioids will be ineffective during treatment.

Pharmacists in some provinces can assist with monitoring and collaborate with prescribers on renewals and adherence checks.

Practical Monitoring Checklist

Baseline liver enzymes, follow-up visits at four to twelve weeks, counselling referrals and documentation of adherence are core monitoring steps.

For injectables, confirm administration dates and ensure clinic cold-chain procedures are recorded.

Provide patients with a handout listing the DIN, pharmacy contact and provincial coverage notes to carry to appointments.

Final Notes And Next Steps

Naltrexone is a valuable option for relapse prevention in alcohol and opioid dependence when used with psychosocial support and appropriate monitoring.

Pharmacists can help patients navigate provincial coverage, check product DINs and answer practical storage and safety questions.

If considering treatment, arrange baseline testing, confirm opioid abstinence and discuss injection versus oral options with a clinician.