Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component. To date, there are three medications that are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. All brand name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolv. There are unique characteristics and side effects associated with each medication. This page focuses specifically on the brand name ZubSolv.
ZubSolv is the brand name for buprenorphine/naloxone sublingual tablets. The term “sublingual tablet” refers to the medication’s route of administration. Buprenorphine can come in several forms including, buccal film, sublingual film, sublingual tablet, injection, or implant. Buprenorphine/naloxone (ZubSolv) sublingual tablets are placed beneath the tongue and dissolved into the mouth. When administered sublingually, the effects of the buprenorphine last between 24-42 hours. The effects of the naloxone last between 2-12 hours.
Some medications for opioid use disorder (MOUD), like Subutex or Belbuca, are forms of buprenorphine-monotherapy. Buprenorphine-monotherapy is strictly composed of buprenorphine. Unlike buprenorphine-monotherapy, buprenorphine/naloxone (ZubSolv) is a combination of buprenorphine and naloxone. Therefore, to fully understand how ZubSolv works, we need to understand how buprenorphine works, how naloxone works, and how the two work together when combined.
As previously mentioned, buprenorphine is one of the three FDA-approved medications used to treat OUD. It is available in various forms, such as a buccal film, sublingual film or tablet, injection, or implant. Buprenorphine is known as a partial opioid agonist. A partial opioid agonist helps to reduce opioid cravings and withdrawal symptoms in individuals with OUD. It does this by interacting with the same opioid receptors that are activated by full opioid agonists. Examples of a full opioid agonist include oxycodone, heroin, fentanyl, and methadone. Unlike a full agonist, buprenorphine does not fully activate the opioid receptors. Buprenorphine has a “ceiling effect” because it only partially activates opioid receptors. Therefore, it is nearly impossible for those with OUD to get “high” or experience euphoric effects with buprenorphine. Buprenorphine is a maintenance medication that can be used temporarily or as a long-term treatment for patients with OUD.
Naloxone is an opioid antagonist. Opioid antagonists bind to the same opioid receptors that full agonists activate. By doing this, naloxone blocks full agonists from binding and can reverse an opioid overdose. When combined with buprenorphine, naloxone deters individuals from misusing the medication. Because buprenorphine/naloxone (ZubSolv) contains the opioid antagonist naloxone, it is important to start the medication only after an individual has stopped taking a full opioid agonist. An individual can start buprenorphine/naloxone treatment only after objective and clear signs of moderate withdrawal are evident. If buprenorphine/naloxone (ZubSolv) is taken before then, it poses a substantial risk of precipitating withdrawal. Precipitated withdrawal is when an opioid antagonist rejects any active opioids on the receptors, causing acute withdrawal symptoms.
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.