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Treatment in patients who have been able to abstain from alcohol in outpatient settings before treatment initiation.

In some individuals the use of opioid antagonists has been associated with a change in baseline levels of some hypothalamicpituitaryadrenalor gonadal hormonesThe clinical significance of such changes is not fully understood.

The safety and efficacy of concomitant use of REVIA and disulfiram is unknownand the concomitant use of two potentially hepatotoxic medications is not ordinarily recommended unless the probable benefits outweigh the known risks.

There are no systematically collected data that specifically address the switch from buprenorphine or methadone to REVIAhoweverreview of postmarketing case reports have indicated that some patients may experience severe manifestations of precipitated withdrawal when being switched from opioid agonist therapy to opioid antagonist therapysee WARNINGSPatients transitioning from buprenorphine or methadone may be vulnerable to precipitation of withdrawal symptoms for as long as 2 weeksHealthcare providers should be prepared to manage withdrawal symptomatically with non-opioid medications.

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