Open Forum

 View Only
Expand all | Collapse all

Vivitrol (Naltrexone) administration question

  • 1.  Vivitrol (Naltrexone) administration question

    Posted 05-24-2022 12:58
    Hello,
    Interested to learn who (job title) administers Vivitrol at your facility. The company lists to be given by a "healthcare provider", but was looking for more specific information as to whether it is given usually by a RN or Physician/APP. 
    Also are you administering Vivitrol as a dorsogluteal injection or which IM site are you using to administer? 
    Thank you!

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health
    Detroit, MI
    (248)687-9230
    ------------------------------


  • 2.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 07:13
    Hi Christine,

    We recently did training with staff for Vivitrol injections with the Clinical Educator of the manufacturer of Vivitrol.  Currently, the medication is only given by nurses, RN's or LPN's.  It has to be a dorsogluteal injection due to the volume (it is 4 ml's) even though our facility does not recommend using that site.  It is too much volume for any of the other recommended IM injection sites.  You could try reaching out to the rep for Vivitrol in your area and find out who your Clinical Educator is for more information, but that is what we found out.  Hope this helps.

    Michelle Sorokoty, MSN, RN
    Nursing Professional Development
    Lee Physician Group
    Fort Myers, FL​

    ------------------------------
    Michelle Sorokoty MSN RN
    Lee Health
    Fort Myers FL
    239-343-6697
    ------------------------------



  • 3.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 09:40
    Thank you very helpful. Same at our facility, dorosgluteal is not a recommended site, but as you said necessary with this medication due to the volume.

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health System
    Troy MI
    (248)687-9230
    ------------------------------



  • 4.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-26-2022 11:21

    These are the guidelines we follow for volumes and injection sites per Lippincott.  We do not ever use Dorsal Gluteal.

     

    Ventrogluteal

    To identify the correct injection site for IM injection into the ventrogluteal muscle, have the patient sit, stand, lie laterally, or lie in a supine position. Locate the greater trochanter of the femur with the heel of your hand. Then spread your index and middle fingers from the anterior superior iliac spine to as far along the iliac crest as you can reach (as shown below). Insert the needle between your two fingers at a 90-degree angle to the muscle. (Remove your fingers before inserting the needle.) The maximum injection volume for this area is 5 mL.1

     

    Ventrogluteal injection site

     

    Vastus lateralis

    To identify the correct injection site for IM injection into the vastus lateralis muscle, have the patient sit or lie in a supine position. Ask the patient to flex the knee slightly and internally rotate the foot, if possible, to relax the muscle and reduce pain.4 Use the lateral muscle of the quadriceps group, from a handbreadth below the greater trochanter to a handbreadth above the knee (shown below). Insert the needle into the middle third of the muscle parallel to the surface the patient is lying on. The maximum injection volume for this area is 5 mL.1

     

    Vastus lateralis injection site






  • 5.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-26-2022 15:51
    I was going to post the same thing:) We also use the ventrogluteal site since Lippincott says it can accommodate up to 5 mL and we do not allow use of the dorsogluteal site.

    ------------------------------
    Angela Emery BSN,RN
    RN Program Manager
    Providence
    Missoula MT
    (406)327-3097
    ------------------------------



  • 6.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 07:58
    Hello. At my facility it is the RN who gives the shot.  It is given in the buttocks. We rotate site each time (right, left, right left). 





  • 7.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 09:41
    Thank you very much for your feedback!

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health System
    Troy MI
    (248)687-9230
    ------------------------------



  • 8.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-26-2022 09:14
    Thank you Lori!

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health System
    Troy MI
    (248)687-9230
    ------------------------------



  • 9.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 09:53
    We have RNs/LPNs/MAs administer it. And dorsogluteal I believe is the only place they recommend to administer it because of volume and I alternate buttocks each month.
    I work with a local Vivitrol rep and she is amazing!
    Try reaching out to yours through their website and they will give you SO much info! I do OBAT and give this frequently.
    Understanding the billing process was the hardest part for me, but they have great reps that will help you.

    ------------------------------
    Kelsey Ellis BSN RN
    Konza Prairie Community Health Center
    Junction City KS
    (913)602-6934
    ------------------------------



  • 10.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-26-2022 09:15
    Thank you Kelsey, will do!

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health System
    Troy MI
    (248)687-9230
    ------------------------------



  • 11.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-25-2022 12:23
    Good Day!
    Medical Assistants, nurses, and providers receive Vivitrol injection training and are approved to administer the Vivitrol injection at our organization in MN. The administrator(s) in each clinic depend on staffing and patient needs. For instance, the clinic where the provider administers has no MA nor nursing staff. 

    The manufacturer recommends the dorsogluteal site.

    Best, 

    Jenny Kelley, MSN, AMB-BC

    Professional Development Specialist-RN

    Hennepin Healthcare

    Ambulatory Care Community Clinics and at large

    612-873-9969  office

    612-715-8547 cell

    612-873-1507 fax


     


    Confidentiality Notice:

    Information contained in this e-mail is being sent to you after appropriate authorization or by legal exception. You are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without patient consent or as permitted by law is prohibited and may subject you to state and/or federal penalties. This information may also be legally privileged, the disclosure of which is governed by law. This information is intended for the use of the person or entity to which it is addressed. If you are not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any access, disclosure, copying or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or proof of destruction of the information contained in this message.






  • 12.  RE: Vivitrol (Naltrexone) administration question

    Posted 05-26-2022 09:14
    Thank you Jennifer for your feedback!

    ------------------------------
    Christine Nagy BSN RN
    Regional Nurse Manager
    Henry Ford Health System
    Troy MI
    (248)687-9230
    ------------------------------