How Much Does Naltrexone Cost?

To compare online programs and what each one includes, see where to get naltrexone online.

Prices at a glance

Every figure below carries the date it applies to. Prices move, so check the current price with the pharmacy or clinic before you pay.

Naltrexone pills without insurance

For alcohol dependence, the tablet label recommends "a dose of 50 mg once daily" for most patients, so a month's supply is 30 pills.¹³ The tablets are filled at a pharmacy, and each pharmacy sets its own cash price. Ask for the price before you fill the prescription, and if you have insurance, ask what your copay will be.

There is no manufacturer coupon for the tablets. Drugs.com found "no manufacturer promotions" and "no Patient Assistance Programs" for generic naltrexone.¹⁴

If you get naltrexone through an online program, check what the fee covers. Choose Your Horizon's fee includes the medicine, while Rezolv's does not, so a pharmacy bills for the pills on top.^1,3 Each program's price and what it includes are in where to get naltrexone online.

Vivitrol: the drug plus a visit to give it

Vivitrol is naltrexone too, in an extended-release form. The label dose is 380 mg "every 4 weeks or once a month," injected into the buttock muscle, and it "must be prepared and administered by a healthcare provider."⁵ So the cost has two parts: the drug, and the visit to give it. For how the shot and the pills compare apart from price, see naltrexone vs Vivitrol; for the shot's side effects, see Vivitrol side effects.

On the drug alone, the three reference prices we found sit within about $42 of each other:

• Cash: Drugs.com listed "380 mg, 1 powder for injection from $1,758.09."⁴
• Pharmacy benchmark: NADAC, a CMS benchmark of what chain and independent pharmacies pay to buy a drug, was $1,716.11 per kit (effective September 23, 2026). It was $1,622.14 in the first 2026 file (effective December 17, 2025) and has stayed near $1,716 to $1,719 since January. It is not a patient price.^6,15
• Medicare: the Part B payment limit for October through December 2026 is $4.537 per milligram under billing code J2315, which comes to $1,724.06 for a 380 mg dose.^7,12

At the cash price, 12 monthly shots add up to about $21,097 a year. Every-4-weeks dosing means 13 shots, or about $22,855 (our arithmetic).^4,5

We found no national figure for the administration fee, so we don't estimate it. Before the first appointment, ask the clinic for the drug charge and the injection or visit charge as separate lines; whether it buys the drug and bills you or has a specialty pharmacy ship the kit; who files any prior authorization and how long that takes; and what you owe if the appointment is canceled after the kit arrives.

The Vivitrol co-pay savings program

Alkermes, which makes Vivitrol, runs a co-pay program: "Maximum savings per prescription is $500 up to 12 prescriptions per calendar year, with maximum savings up to $6,000 per calendar year." It is open to people with commercial insurance or no insurance.⁹ The full terms, read October 17, 2026, add these conditions¹⁰:

• Who qualifies: people 18 or older with a Vivitrol prescription who live in the US or Puerto Rico.¹⁰
• Who doesn't: anyone in a government program that pays for any part of medication costs, including Medicare (Part D and Medicare Advantage too), Medicaid (managed care too), Medigap, VA, DOD and TRICARE.^9,10
• What it pays for: the drug only. It does not help with the office visit or the injection, "even if such costs are associated with VIVITROL administration."¹⁰
• Limits: 12 prescriptions a year, so the 13th shot in an every-4-weeks year gets no savings (our reading of the terms). One card per person, and it can't be combined with another coupon, discount card or savings offer.¹⁰
• Timing: claims with a date of service up to 90 days before you enroll can count. The card expires after 5 years and can be renewed if you still qualify.¹⁰

Because of the no-combining rule, the $500 can't come off the Drugs.com discount-card price. A cash payer uses the card against the pharmacy's own cash price, which we have not captured. If that price matched the Drugs.com figure, a shot would cost about $1,258.09 and 12 shots about $15,097, but treat that as a rough stand-in, not a quote (our arithmetic).^4,10

Alkermes also reports that "88% of eligible patients had no out-of-pocket expenses for VIVITROL," based on its 2025 claims data for commercially insured people enrolled in the program.⁹ That is the manufacturer's own statistic, and it covers only insured enrollees.

The unbranded version of Vivitrol

DailyMed now lists "naltrexone for extended-release injectable suspension," made by Alkermes and distributed by Amneal, under the same FDA application as Vivitrol (NDA 021897).¹⁶ The FDA's product directory gives it a marketing start date of May 1, 2026.¹⁷ It is the same medicine sold without the brand name.

We could not find a price. It had no NADAC row and did not appear in Medicare's October 2026 billing crosswalk, which maps only Vivitrol to J2315.^6,12 In a July 2026 SEC filing, Alkermes said its supply agreement with Amneal had ended and that Amneal "did not wish to order any Batches under the Agreement."¹⁸ Whether pharmacies can actually stock it is unclear.

With private insurance

What you pay depends on your plan's drug list and cost-sharing, and the data sources we used can't tell you that. For the pills, your copay is the number to ask about.

For Vivitrol, the co-pay card works against your plan's cost share. If your plan charges $750 per shot, the card covers $500 and you pay $250, for up to 12 prescriptions a year. If your share is $500 or less, the card can bring it to $0 (our arithmetic from the program terms).⁹

With Medicare

The shot (Part B). Medicare.gov says Part B "covers methadone, buprenorphine, and naltrexone when you get them in a doctor's office or through an Opioid Treatment Program."¹⁹ For Vivitrol, the October 2026 CMS file sets the payment limit at $4.537 per mg and the patient coinsurance at 19.283%, labeled "inflation-adjusted coinsurance."⁷ The 2026 Part B deductible is $283.⁸ Put together (our arithmetic):

• About $332.45 per shot once the deductible is met.
• Up to about $560.88 for the first shot of the year if the deductible isn't met yet.

Those figures cover the drug only. For the provider's services, Part B coinsurance is "usually 20% of the Medicare-approved amount," and "there's no yearly limit on what you pay out-of-pocket" in Part B unless you have supplemental coverage such as Medigap or a Medicare Advantage plan.²⁰ The CMS file itself warns that listing a payment limit "does not indicate whether Medicare covers a drug."⁷ These figures apply from October 1 through December 31, 2026. CMS publishes a new payment file each quarter.

Two exceptions on Medicare's opioid use disorder page: at a Medicare-enrolled Opioid Treatment Program that meets other requirements, "you won't have to pay any copayments" (the Part B deductible still applies), and if you have both Medicare and Medicaid, "you pay nothing for the services that you get through your state Medicaid program."¹⁹

The pills (Part D). Tablets come from a pharmacy, so they fall under Medicare drug coverage, which Medicare says "may cover buprenorphine and naltrexone."¹⁹ In 2026, no Part D plan can have a deductible above $615. After the deductible you pay 25% until your out-of-pocket spending reaches $2,100, and then $0 for covered drugs for the rest of the year.²¹ Until you meet the deductible, you pay the plan's full price for the pills, so check your plan's drug list for what that is.

One caveat: the Medicare.gov pages we read spell out naltrexone coverage for opioid use disorder. They don't say the same for alcohol use disorder. Part D does cover "many outpatient prescription drugs you may need to treat a mental health condition," but check your plan's drug list.²²

With Medicaid

Medicaid coverage of naltrexone is broad. A SAMHSA review of 2023 fee-for-service programs (50 states, DC, Puerto Rico and the US Virgin Islands) found oral naltrexone covered in 49 of 53 programs and the extended-release shot in 46.¹¹ SAMHSA concluded that "both forms of naltrexone are widely covered and unlikely to require PA or be subject to quantity limits."¹¹

Medicaid managed care plans looked a little different. In a study of 241 Medicaid managed care plans in 2021, 84.2% covered oral naltrexone and 72.6% covered the injection. Prior authorization and quantity limits were rare, "except for injectable naltrexone, for which 75 plans (42.8%) imposed at least 1 of these utilization management requirements."²³ If you're on a Medicaid plan and want the shot, ask about prior authorization early.

States set Medicaid copays within federal limits. The regulation's base maximum for a preferred drug is $4, with that cap raised each year for inflation.²⁴

Naltrexone vs acamprosate: pill count and coverage

Acamprosate, the other daily pill approved for alcohol dependence, means far more tablets. The label dose is "two 333 mg tablets (each dose should total 666 mg) taken three times daily," or six tablets a day, against one naltrexone tablet.^13,25 Coverage favors naltrexone: in 2023, 36 of 53 Medicaid fee-for-service programs covered acamprosate, against 49 for oral naltrexone.¹¹ How the two drugs compare on results is covered in Naltrexone vs acamprosate.

What about low-dose naltrexone?

Low-dose naltrexone (LDN) is an off-label use: the doses are far below the 50 mg tablet in the FDA label, and the uses are ones the FDA has not approved.¹³ LDN prices are not on this page. Advertised prices from online LDN sellers, dated and not checked at checkout, are in the LDN cost section.

How we checked these prices