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    Step 5: Materials • Refrigeration — Keep XR-naltrexone refrigerated naltrexone at all times (360 to 460 F) .
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    • IM injection setup (gloves, alcohol and/or betadine swab, sterile gauze pads, adhesive bandage, revia naltrexona naltrexone alhavi 50 can you buy naltrexone in canada naloxone vs naltrexone where and sharps container) Step 6: Drug/Patient Preparation • Assess body habitus of patient – layer of fat over muscle not greater than length of injection needle (2”/usually BMI <40) • Review medication preparation and injection via instructional video and/or package insert .
    Step 7: Injection • Proceed with dorsogluteal injection (upper outer quadrant, aspirate for blood) • Alternate buttocks with subsequent injections • Avoid injecting subcutaneously or into adipose • If unable to inject because of clogged needle, withdraw, replace the needle and repeat Step 8: Observation • Observe patient for 10 minutes for any naltrexone immediate adverse reactions .
    • Perform Medical Management Support for Opioid Dependence: Initial Medical Management Form vivitrol used for alcohol naltrexone pill binge vivitrol cheaper revia dosage vivitrol alkermes (10 minutes) • Remind patient to contact doctor/health care facility in case of any side effects .
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    Step 9: Follow-up Visit • Conduct active naltrexone classification buy naltrexone in south africa naltrexone alcoholism medication dosage outreach to have patient return to the office for monthly injections (appointment reminders, family involvement) • Unless contraindicated, administer injection of XR-Naltrexone every 4 weeks .

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