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

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September 15, 2021

Opioid Use Disorder (OUD) continues to affect millions of people worldwide. Every year, thousands of people develop an OUD. And once it sets in, overdosing becomes a real risk. For those who survive, living with OUD can be a struggle, and numerous health complications can ensue. Fortunately, buprenorphine-based medications can help.

Suboxone and Zubsolv are brand-name medications that contain buprenorphine and naloxone. Despite having the same ingredients, there are some slight differences between them.

What Is Suboxone?

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

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

Naloxone is an opioid antagonist that blocks the opioid receptor and the effects of other opioids The addition of naloxone to Suboxone discourages people from abusing 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 15 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. 

First, suboxone tablets are less expensive than films. Second, the films/strips tend to dissolve faster than the tablets, but both should be kept under the tongue for at least 15 minutes. Lastly, 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. The most common include:

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

It's important to note that Suboxone can induce opioid withdrawal if taken while the patient still has opioids in their system. To prevent such an occurrence, Suboxone should be initiated only in collaboration with a healthcare provider.

What is Zubsolv?

Zubsolv is a brand-name medication for OUD that is also approved by the FDA. 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.

Zubsolv Side Effects

Since Zubsolv is made from the same ingredients as Suboxone, it has many of the same adverse effects. 

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

Zubsolv can also induce opioid withdrawal when consumed with opioids present in the system. Treatment with Zubsolv should be initiated only with guidance from a healthcare professional. 

Suboxone vs. Zubsolv Comparison

Suboxone and Zubsolv are equally effective medicines. They both contain buprenorphine and naloxone, as recommended by the American Society of Addiction Medicine. 

Here we compare how they differ so you can choose the best medication for you.

1. Abuse Potential

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

2. Dosage Differences

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

Suboxone

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

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. 

The Zubsolv 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

3. Formulations & Administration

Suboxone is available in tablet and film forms, both of which can be taken sublingually. This means 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.

4. Taste

Patients who have used both medications report that Zubsolv has a less aversive taste. 

5. Forms (Brand vs. Generic)

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.

6. Price Comparison

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

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

Treatment with Suboxone and Zubsolv

Medications for Addiction Treatment (MAT) programs can be residential or outpatient. Most patients opt for an outpatient program because it gives them more freedom to lead their normal lives. Buprenorphine-based medications increase the success of outpatient treatment. With outpatient MAT programs, patients can remain independent and receive treatment while also carrying on with their busy lives.

MAT programs usually also have a counseling component. The addition of medication to counseling has consistently been found to be more effective than behavioral intervention alone. 

On the one hand, medication works to keep people on track with their intention to stop or reduce their opioid use. It shields them from the discomfort of withdrawal and reduces their urges and cravings to return to use, which can persist for months or years of abstinence. Counseling equips people with OUD with coping skills to live a life free from opioid misuse.

Bicycle Health's MAT programs provide people in recovery with services including:

  • Individual counseling for opioid addiction
  • Group and family counseling
  • Planning for relapse prevention
  • Case management
  • Referral to community resources

With these services, participants can build a lasting and robust recovery plan.

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.

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