Where to Get Naltrexone Online: Prescribers, Programs and Prices

The federal in-person exam rule doesn't cover naltrexone, but some states add one

Naltrexone tablets are labeled "Rx only," and federal law lets a pharmacy dispense a prescription-only drug only on a licensed practitioner's prescription.^1,2 That prescription can come from a clinician you never meet in person.

Federal law does require at least one in-person medical evaluation before a prescription is filled over the internet, but that rule (21 USC §829(e), from the Ryan Haight Act) covers controlled substances only.¹⁸ Naltrexone is named as an exception in Schedule II, so it is not a federally controlled substance.¹⁹ See is naltrexone a controlled substance?

State rules still apply. Boulder Care says some states require an in-person visit before virtual care starts, and Reframe Med+ says that "depending on your responses and state requirements," you may have a live video visit or be approved from your answers.^9,16 EnnHealth says it prescribes "where state regulations allow."⁷

A typical online visit runs like this:

1. Intake. You fill out a health questionnaire, usually 5 to 10 minutes.^9,20
2. Review. A clinician reads it. Some programs do this by message only (Oar, Sunflower); others require a video visit (Talkspace, Workit, Rezolv).^5,17,20-22
3. Prescription. It goes to a partner pharmacy that mails it, or to a pharmacy you choose.^7,21,22
4. Follow-up. Refills come with ongoing messages or visits. Cash plans bill monthly, every 3 months or yearly, depending on the program.^4,8,10,21

Four routes to a prescription and what each costs

1. Your own doctor. Any clinician licensed to prescribe can write a naltrexone prescription, and the tablets are approved for treating alcohol dependence.^1,2 You pay your usual visit cost, then fill the prescription at a pharmacy (where to fill it). If you have Medicaid, oral naltrexone was covered by 49 of 53 Medicaid fee-for-service programs in 2023.²³

2. An online program. Most charge a flat monthly or quarterly fee, and some include the pills; the comparison table lists each price. Workit says 95% of members start care within 2 days of signing up, and Eleanor says most people are seen within about two days.^20,24

3. A psychiatrist or addiction specialist. This route fits if you want one clinician for alcohol and for other mental health care. Talkspace Psychiatry, a general psychiatry service, charges $299 for the first video evaluation and $175 per follow-up, or $475 for three follow-ups, if you pay out of pocket, with medication extra.^22,25

4. A clinic that gives Vivitrol shots. The shot itself was listed from $1,758.09 on Drugs.com on October 17, 2026, before any clinic fee.²⁶ See Vivitrol.

13 online programs compared

Every cell comes from the program's own website, read on October 17, 2026, and "Not posted" means the public site shows no price. Programs are in alphabetical order; this table does not rank them. Each one has a profile with reader reviews in the provider directory. Spotted something out of date? Tell us.

Where pills are not included, the prescription goes to a pharmacy, which bills for the medicine separately.

What a first year costs where prices are posted

Monthly prices hide sign-up fees. This table adds up one year of each program's posted fees. Where pills are extra, the pharmacy's charge or your copay comes on top. The arithmetic is ours.

Boulder Care, Eleanor Health, FirePit Health, Reframe Med+ and Ria Health post no cash price, so they are not in this table. Insured costs depend on your plan; Talkspace's pricing page says both that "most insured members have a $0 copay" and that "the average copay for insured members is only $15."²⁵

Where to fill a prescription

Any licensed pharmacy can fill a naltrexone prescription from an online program or your own doctor. Each pharmacy sets its own cash price for the tablets, so ask before you fill. If you have insurance or Medicaid, ask what your copay will be. If you use an online pharmacy, check that it is licensed in your state first; see warning signs.

For Medicare, Medicaid and Vivitrol costs, see naltrexone cost. Vivitrol is not sold this way; see the shot.

Three programs ship compounded naltrexone, which is not FDA-approved

Generic naltrexone 50 mg tablets are FDA-approved: FDA's database lists seven generic tablet approvals as prescription products, while the original brand, ReVia, is listed as discontinued.⁴⁰

Reframe Med+, Sunflower Clinic and Sunnyside Med instead ship naltrexone made by a compounding pharmacy and combined with vitamin B6.^5,9,10 Sunflower lists its dose as 45 mg naltrexone with 5 mg B6, different from the 50 mg tablet.⁵ Sunnyside says the B6 "may improve absorption, reduce side effects" and cites no study for it.¹⁰

FDA states that "Compounded drugs are not FDA-approved," which means it does not check their safety, effectiveness or quality before they are sold.¹¹ FDA has also told telehealth companies not to describe a compounded drug as a generic version of an approved drug.⁴¹ Sunnyside and Reframe Med+ say on their own sites that compounded drugs are not FDA-approved or not FDA-reviewed.^9,10

If you want the FDA-approved tablet, ask the program which product it dispenses before you pay. Oar's daily pill is a tablet whose maker it doesn't name; its Clutch mint, meant for taking before drinking (an off-label way to dose naltrexone), is compounded.^21,30

A pharmacy that skips the prescription is a warning sign

You can buy naltrexone online, but only with a prescription. FDA's BeSafeRx guidance lists these warning signs of an unsafe online pharmacy⁴²:

• It does not require a prescription.
• It is not licensed in the US and by your state board of pharmacy.
• It has no licensed pharmacist to answer questions.
• Prices "seem too good to be true."
• The medicine looks different from what your local pharmacy gives you, or arrives damaged, foreign-labeled or expired.

You can check any pharmacy's license through your state board; FDA links each state's lookup.⁴³ For online programs, FDA's warnings to telehealth companies add two more red flags: calling a compounded drug "FDA-approved," and claiming it comes from an "FDA-approved" pharmacy, since FDA does not approve or license pharmacies.⁴¹

Vivitrol: 2 of 13 programs offer it, and the shot is given in person

Vivitrol "must be prepared and administered by a healthcare provider," as a monthly injection into the buttock muscle.³ That limits what an online program can do. Rezolv Health offers it in California, Washington and Nevada and says the monthly shot is given in person, coordinated by your provider.¹⁷ Boulder Care lists Vivitrol but doesn't explain how patients get the injection.¹⁶ Workit, Talkspace and Oar say they don't offer it.^20-22 For how the shot compares with pills, see naltrexone vs Vivitrol.

Before you start: 7 to 10 days without opioids

• Opioids. Be off all opioids, including tramadol and other opioid-containing medicines, for at least 7 to 10 days. If you are coming off buprenorphine or methadone, the risk of sudden withdrawal can last up to two weeks.¹ Tell the prescriber about any opioid use, even if you're being treated for alcohol.¹ Of the 13 programs in the table, EnnHealth is the one whose site says its prescriber screens for opioids at the consult; FirePit's FAQ says naltrexone "requires full detox before beginning treatment," and the other 11 programs' pages we read on October 17, 2026 describe no opioid check.^7,14

• Liver. The tablet label reports hepatitis and liver problems with naltrexone and says to stop it if signs of acute hepatitis appear.¹ Of the 13 programs, EnnHealth is the only one whose naltrexone service says it checks liver function before prescribing; Rezolv bills labs separately.^6,7

• Overdose risk. After stopping naltrexone, people who used opioids before may be more sensitive to lower doses and at risk of overdose; the label advises access to an overdose-reversal drug such as naloxone.¹

• Support. The label says the tablets haven't been shown to help except as part of an appropriate treatment plan.¹ Most programs above include coaching or follow-up visits.

How to choose: start with how you'll pay

Questions worth asking any program before you enter a card number:

1. What is the total first charge, including any intake fee?
2. Is the medication an FDA-approved generic tablet or a compounded product, and which pharmacy fills it?
3. How often does the plan renew, and how many days before renewal must you cancel?
4. Is anything refundable if a clinician doesn't prescribe?
5. Can the prescription be sent to your own pharmacy instead?

Programs we checked but didn't list

We profiled 23 services and kept 13. Confidant Health lists naltrexone for opioid use disorder, but its alcohol treatment page names gabapentin, acamprosate and disulfiram, not naltrexone.⁴⁴ Monument now offers per-visit therapy and doctor appointments, and its service pages no longer name an alcohol medication.⁴⁵ Nurx's naltrexone page is for weight management, not alcohol.⁴⁶ Seven more were left out because their own sites showed opioid treatment only, naltrexone only for weight loss, care outside the US, in-person care only, or no listed naltrexone: Ophelia, Bicycle Health, Hers/Hims, Contral, Better Life Recovery, Lionrock and Pelago. The reason for each is on our methodology page.

How we checked

• Programs. Each program's own pricing, FAQ, insurance and location pages were read and re-captured on October 17, 2026. We did not sign up, pay or contact any program.
• Prices. Program prices come only from each program's own pages, and the Vivitrol price from a dated Drugs.com capture.
• Rules. The same columns and rules apply to every program, including Sunflower Clinic, listed alphabetically.
• Law and labels. The tablet and Vivitrol labels, federal law and FDA pages. This page is not legal advice.