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

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Sep 18, 2023 • 7 cited sources

Suboxone and Zubsolv are brand-name medications that contain buprenorphine and naloxone. They have the exact same ingredients – Buprenorphine and Naloxone. Suboxone is available in both a tablet and a strip, while  Zubsolv is a brand name for the tablet form only. They work equally well to treat OUD. 

What Is Suboxone?

Suboxone is a medication approved by the Food and Drug Administration (FDA) and used to treat OUD.[1] It has two main components: buprenorphine and naloxone.

Buprenorphine is a partial opioid agonist that occupies and activates opioid receptors in the brain, reducing cravings and preventing withdrawal symptoms.[2] Buprenorphine also has a ceiling effect, meaning it loses its ability to activate opioid receptors at higher doses. In other words, it does not carry the high risk of overdose that full agonists like methadone do.

Naloxone is an opioid antagonist that blocks the opioid receptor and the effects of other opioids.[3] Adding naloxone to Suboxone discourages people from misusing Suboxone through injection or snorting.

Suboxone is available as a sublingual film or a tablet in four different strengths, each having a buprenorphine-to-naloxone ratio of 4:1. It generally takes less than 5 minutes to dissolve when placed under the tongue or between the cheek and gums.

Although both Suboxone formulations are equally effective, you should be aware of three key differences.

  • Suboxone tablets are less expensive than films, depending on your State
  • Films/strips dissolve slightly faster than the tablets, but both should be kept under the tongue for at least 5 minutes.
  • Some patients may prefer the taste of one over the other, but this preference is highly individualized.

Suboxone Side Effects

Suboxone, like many medicines, can have some adverse effects.[1] The most common include the following:

  • Headache
  • Nausea
  • Vomiting
  • Constipation
  • Sweating
  • Sleeping problems
  • Swelling in the hands and legs
  • Stomachache
  • Numbness in the mouth

What Is Zubsolv?

Zubsolv is a brand-name medication for OUD that is also approved by the FDA.[4] Like Suboxone, it contains a mix of buprenorphine and naloxone. Zubsolv exists as a sublingual pill that dissolves when placed under the tongue. It is available in six distinct strengths, each with a unique pill form and a 4:1 buprenorphine-to-naloxone ratio. In terms of efficacy, there is no reason to use Zubsolv vs Suboxone or its generic equivalent. They both work equally well. Some people chose Zubsolv because it has a slightly more tolerable taste. However, this may mean paying significantly more for the brand name medication. You will have to decide for yourself if Zubsolv is affordable and/or with the extra cost. 

Zubsolv Side Effects

Because Zubsolv is made from the same ingredients as Suboxone, it has the same adverse effects.

  • Headache
  • Nausea
  • Vomiting
  • Constipation
  • Fatigue
  • Difficulty sleeping
  • Mouth, throat, or tongue pain
  • Tingling sensation in the mouth

Suboxone vs. Zubsolv Comparison

Suboxone and Zubsolv are equally effective medicines. They both contain buprenorphine and naloxone, and they’re both part of OUD treatment programs. Here we compare how they differ so you can choose the best medication:

Suboxone vs Zubsolv
SuboxoneZubsolv
Misuse PotentialMinimalMinimal
Dosage OptionsFour dosage forms availableSix dosage forms available
Administration MethodDissolving tablet or filmDissolving tablet
Generic Forms Available?YesNo

Misuse Potential of Suboxone & Zubsolv

Both Suboxone and Zubsolv have a minimal misuse risk. Buprenorphine alleviates withdrawal symptoms and cravings, whereas naloxone discourages buprenorphine injections or snorting by blocking opioid-induced euphoria and inducing withdrawal.

Dosage Differences of Suboxone & Zubsolv

Due to differences in bioavailability, Suboxone and Zubsolv come in various dosages. Bioavailability is the rate at which the body absorbs these medications.[5]

Suboxone contains a buprenorphine-to-naloxone ratio of 4:1. It exists in four dosage forms:

  • 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

Zubsolv is available in six different doses, each with its distinct shape. Similar to Suboxone, Zubsolv also has a buprenorphine-to-naloxone ratio of 4:1.

Zubsolv comes in these dosage forms:

  • Oval shape: 0.7 mg buprenorphine/0.18 mg naloxone
  • Triangular shape: 1.4 mg buprenorphine/0.36 mg naloxone
  • D shape: 2.9 mg buprenorphine/0.71 mg naloxone
  • Round shape: 5.7 mg buprenorphine/1.4 mg naloxone
  • Diamond shape: 8.6 mg buprenorphine/2.1 mg naloxone
  • Capsule shape: 11.4 mg buprenorphine/2.9 mg naloxone

Suboxone is available in tablet and film forms, both of which can be taken sublingually. You can take the tablet or film by placing it inside your cheek or under your tongue.

On the other hand, Zubsolv is only available as a sublingual pill that is also taken by placing it under the tongue. No other Zubsolv formulation exists.

Taste of Suboxone & Zubsolv

Some patients who have used both medications report that Zubsolv has a less aversive taste. However, this may not be true for all individuals, and these differences are pretty minimal. 

Forms (Brand vs. Generic) of Suboxone & Zubsolv

At the moment, there are no generic versions of Zubsolv, but generic versions of Suboxone do exist. Drug manufacturers such as Sandoz and Alvogen produce FDA-approved generic forms of Suboxone.

Price Comparison of Suboxone & Zubsolv

Brand-name medicines such as Zubsolv are often more expensive than generic equivalents. Generic forms of Suboxone are cheaper than their brand counterparts.

For a complete breakdown of OUD treatment costs, explore Bicycle Health pricing options.

Treatment With Suboxone & Zubsolv

Both Suboxone and Zubsolv are part of Medication for Addiction Treatment (MAT) programs for OUD. These medications help ease cravings and reduce withdrawal symptoms, so you can focus on putting your life back together.

OUD continues to affect millions of people worldwide.[6] Every year, thousands of people develop an OUD. Fortunately, buprenorphine-based medications like Suboxone and Zubsolv can help.

MAT medications are safe to use for months, years or even indefinitely to treat OUD and prevent relapse. [7] 

Which Medication Is Right for You?

Both Suboxone and Zubsolv are safe and effective medications. Generally, Suboxone or its generic equivalent is more affordable and are therefore more often covered by insurance. Zubsolv is a brand name medication and is usually more expensive and may not be covered by insurance. In terms of efficacy, there is little reason to use Zubsolv over Suboxone, although some people do prefer the taste of Zubsolv.

If you are interested in treatment for OUD with either Suboxone or Zubsolv, reach out to your doctor, or to us here at Bicycle health.

Learn More About Bicycle Health

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

Medically Reviewed By 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 ... Read More

Sources
  1. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. 2018. Accessed September 2022.
  2. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. July 2022. Accessed September 2022.
  3. Naloxone. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK441910/. July 2022. Accessed September 2022.
  4. Buprenorphine/Naloxone. A Review in Opioid Dependence. https://pubmed.ncbi.nlm.nih.gov/30117074/. September 2018. Accessed September 2022.
  5. Bioavailability and Bioequivalence in Drug Development. Wiley Interdisciplinary Review. https://pubmed.ncbi.nlm.nih.gov/25215170/. 2014. Accessed September 2022.
  6. Opioid Use Disorder. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK553166/. June 2022. Accessed September 2022.
  7. Medication-Assisted Treatment. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment. July 2022. Accessed September 2022.

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