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Sublocade vs. Vivitrol: Which Is Better for Me?

July 1, 2022

Table of Contents

Both Sublocade and Vivitrol can be used to treat opioid addiction.

Sublocade and Vivitrol are both injected by trained professionals once per month to help manage abstinence from opioid use disorder (OUD). However, these two medications contain different active ingredients and work differently in the brain.

Sublocade contains buprenorphine, while Vivitrol contains naltrexone. Buprenorphine is a partial opioid agonist that eases withdrawal symptoms to help maintain abstinence. Naltrexone, in contrast, is an opioid antagonist, meaning it blocks the effects of opioids, including buprenorphine, and should only be taken after you have fully tapered off all opioid drugs.

Either Sublocade or Vivitrol can benefit your treatment, but you cannot take them at the same time.

Long-Lasting Medications for Addiction Treatment

People with diagnosed opioid use disorder (OUD) or opioid dependence benefit from a combination of counseling or behavioral therapy and medication. This combination is called Medication for Addiction Treatment (MAT). Maintenance medications provide physiologic support to manage cravings so the individual can focus on behavioral treatment to ultimately overcome addiction.

Both Sublocade and Vivitrol are long-lasting maintenance medicines used in addiction treatment, but they have several important differences.

What Is Sublocade?

Sublocade is a prescription subdermal injection administered once a month.[1] The injection releases buprenorphine, a partial opioid agonist, into the bloodstream steadily over 28 days.

The advantage to a long acting injectable as opposed to a daily medication is that the steady release of medication with the injectable helps to prevent breakthrough cravings that might occur if a patient misses a dose of their daily suboxone. Therefore, patients who are stable on Suboxone might prefer to switch from a daily Suboxone tablet to a monthly injection.

Sublocade was approved by the US Food and Drug Administration (FDA) in 2017.[2] Although other forms of buprenorphine, like Suboxone, can be administered in an outpatient setting like a physician’s office, Sublocade is an injection. It requires special training to administer it in a specific clinic. Not all providers who give Suboxone also give Sublocade, but may know providers that do.

Talk to your doctor if you are taking Suboxone and are interested in switching to Sublocade.

What Is Vivitrol?

Vivitrol, generic name Naltrexone, is also a prescription injectable medication used to treat OUD.[4] It can also treat alcohol addiction.

The active ingredient in Vivitrol is naltrexone, not buprenorphine. While buprenorphine is an opioid agonist (it turns on opioid receptors to prevent cravings), naltrexone is a opioid antagonist (prevents patients from getting “high” on opioids if they do take them). Thus, these two long lasting injectables work differently in the way they treat OUD.

Unlike buprenorphine/Sublocade, Naltrexone has NO addictive potential because it does not contain an opioid. It does not cause any euphoria when it binds to receptors in the brain. It also does not cause any withdrawal symptoms if you stop taking it.[5]

It is important not to take naltrexone for at least seven days after the last dose of a short-acting opioid like heroin, or between 10 and 14 days after the last dose of a long-acting opioid, like methadone or buprenorphine. Before you begin naltrexone treatment, you will need to completely taper off buprenorphine treatment, including Suboxone or Sublocade.

Differences Between Sublocade & Vivitrol

These are similarities between Sublocade and Vivitrol:

  • They are both brand-name medications.
  • They are both injection medications that are given by trained professionals.
  • They are both given once per month
  • They are both used in the treatment of opioid use disorder after the individual has physically stabilized from the acute withdrawal phase.
  • They both help maintain abstinence from opioids.

The differences between Sublocade and Vivitrol include:

  • Sublocade forms a gel patch just beneath the skin, while Vivitrol is injected into the muscles.
  • Sublocade contains buprenorphine, a partial opioid agonist.
  • Vivitrol contains naltrexone, which blocks all opioids, including buprenorphine.

Is Sublocade or Vivitrol a Better Treatment Option?

Sublocade and Vivitrol can both work for you if you do not want to take a daily maintenance medication. However, you cannot take these medications together because they work in opposition in the body.

There are many benefits with either prescription medication. Your doctor can best advise you on what works for your individual needs. Talk to your doctor about these medications and if either of them may be right for you.

Bicycle Health provides Suboxone therapy for opioid use disorder. Bicycle offers educational resources on Belbuca, Subutex and Sublocade, but does not currently offer those therapies.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Homepage. Sublocade.com. https://www.sublocade.com/. Accessed January 2022.
  2. FDA Approves First One-Monthly Buprenorphine Injection, a Medication-Assisted Treatment Option for Opioid Use Disorder. US Food and Drug Administration (FDA). https://www.fda.gov/news-events/press-announcements/fda-approves-first-once-monthly-buprenorphine-injection-medication-assisted-treatment-option-opioid. November 2017. Accessed January 2022.
  3. Buprenorphine. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. January 2022. Accessed January 2022.
  4. Homepage. Vivitrol.com. https://www.vivitrol.com/. Accessed January 2022.
  5. Naltrexone. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone. November 2021. Accessed January 2022.

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