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Suboxone vs. Sublocade: Which One Is Better for OUD Treatment?

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By Dr. Azrung Fayaz, MBBS, FCPS, MRCP
Sep 15, 2021

Medication for Addiction Treatment (MAT) is an approach to treating opioid use disorder (OUD) involving a combination of prescription medication and behavioral therapy. Numerous studies have shown that buprenorphine is highly effective for treating OUD. As a result, it is commonly used during MAT. Buprenorphine is a partial opioid agonist that occupies and activates opioid receptors in the brain, reducing cravings and preventing withdrawal.

Suboxone and Sublocade are brand-name medications that contain buprenorphine. Fundamental differences exist between the two, meaning one may be better for you over the other.

What is Suboxone?

Suboxone is licensed by the Food and Drug Administration (FDA) to treat OUD. The medication is used to reduce withdrawal, cravings, and prevents relapse. It is made up of two medications: buprenorphine and naloxone.

The combination of these two medications works well to combat OUD. Buprenorphine prevents withdrawal symptoms and cravings while naloxone discourages buprenorphine misuse. Were the patient to snort or inject the medication, he or she would not experience any euphoria or high. 

Suboxone comes in the form of a film or tablet and has four distinct strengths. It dissolves when applied beneath the tongue or between the cheek and gums. Each Suboxone formulation has a buprenorphine-to-naloxone ratio of 4:1.

Suboxone Side Effects

Suboxone, like many other medications, can cause side effects such as:

  • Headaches
  • Stomach Pain
  • Nausea and Vomiting
  • Constipation
  • Insomnia
  • Swollen arms and legs
  • Loss of sensation in the mouth

Suboxone can induce withdrawal if it is started while there are other opioids in the system. Therefore, it’s best to initiate it in collaboration with a healthcare professional.

What is Sublocade?

Sublocade is a newer FDA-approved medication for OUD containing only buprenorphine. This means it blocks opiate receptors and reduces cravings. Sublocade is available in two strengths as subcutaneous injections. Only a health professional can safely inject Sublocade under the skin.

Sublocade is an excellent alternative to other medications that contain buprenorphine like Suboxone. Since it is an injectable, long-acting medication, it is useful for people with OUD who have trouble remembering to take their daily dose of the medication. Sublocade is also prescribed to patients who struggle with problematic opioid use despite being prescribed Suboxone.

Sublocade Side Effects

Since Suboxone and Sublocade both contain buprenorphine, they have similar adverse effects.

  • Fatigue
  • Headaches
  • Sleeping problems
  • Nausea and vomiting
  • Constipation
  • Mouth or throat pain
  • Tingling sensations in the mouth

Like Suboxone, Sublocade can induce withdrawal if it is started while there are other opioids in the system. Therefore, it’s best to initiate it in collaboration with a healthcare professional.

Suboxone vs. Sublocade Comparison

Suboxone and Sublocade differ in several ways. It is essential to understand these differences when deciding which medication to use. 

Here’s a list of the five most common differences. 

1. Abuse Potential

While Suboxone is made up of buprenorphine and naloxone, Sublocade contains only buprenorphine.

Even though buprenorphine is safe, it still has some opioid agonist effects since it is occasionally abused by injection or snorting. Naloxone, when added to buprenorphine formulations, blocks any subjectively beneficial opioid agonist effects (euphoria or “high”) if someone misuses the medication through either of these mechanisms.

In theory, the addition of naloxone would give Suboxone a lower abuse potential compared to Sublocade. However, since Sublocade is administered only by a health professional, the person who is being treated does not have access to extra doses. If dispensed appropriately, it actually has a lower abuse potential than Suboxone. 

2. Dosage Differences

Suboxone is taken once a day in a single dose. It exists in four dosage forms, each with a buprenorphine-to-naloxone ratio of 4:1.

  • 2 mg buprenorphine / 0.5 mg naloxone
  • 4 mg buprenorphine / 1 mg naloxone
  • 8 mg buprenorphine / 2 mg naloxone
  • 12 mg buprenorphine / 3 mg naloxone

Sublocade is injected once a month and is available in two strengths. 

  • 100 mg / 0.5 mL
  • 300 mg /1.5 mL

3. Formulations and Administration

Suboxone comes in two sublingual forms -- film and tablet. Both dissolve when placed on the inside of the cheek or beneath the tongue. Since Suboxone is available in sublingual formulations, patients can take it at home.

Sublocade formulations exist as subcutaneous injections. Only healthcare professionals can administer them.

Healthcare providers often start people with OUD on Suboxone early on in a treatment program since it is available in lower dosages, and the dosing is flexible. After stabilization on Suboxone, patients can be easily transitioned to Sublocade usually after a week of Suboxone treatment. 

4. Generic Forms

There are currently no generic forms of Sublocade available. However, Sandoz and Alvogen are two companies that produce FDA-approved generic Suboxone.

5. Price Comparison

Brand-name medications are frequently more expensive than generic alternatives. This is why Suboxone is less expensive than Sublocade.

Treatment with Suboxone and Sublocade

MAT programs can be residential or outpatient. Most patients prefer buprenorphine-based medications because of the flexibility they provide, as well as the higher safety of buprenorphine compared to methadone. In outpatient MAT programs, people with OUD can maintain their independence and live their lives while also still receiving treatment. 

MAT is the most effective intervention for OUD. The combination of MAT and counseling provides a holistic approach to OUD treatment: The medication reduces the risk of relapse by blocking withdrawal and cravings. Simultaneously, counseling gives patients the coping skills they need to continue living a drug-free life.

Bicycle Health’s quality MAT programs provide people in recovery with many important services:

  • Individual or group counseling sessions
  • Confidential phone & video calls with your medical provider
  • Online support groups from the privacy of your own home
  • Planning for relapse prevention
  • Personalized case management
  • Experienced health professionals that genuinely care
  • Referral to community resources

With these services, you can achieve a strong and lasting recovery.

Learn More About Bicycle Health

To learn more about how Bicycle Health’s telemedicine Suboxone treatment compares to Sublocade, call us at (844) 943-2514 or schedule an appointment here.

Photo by Maksim Goncharenok from Pexels

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