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Sublocade vs. Vivitrol

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Oct 24, 2023 • 10 cited sources

Sublocade and Vivitrol are injected by trained professionals once per month to help maintain recovery 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. Sublocade is essentially an injectable version of Suboxone that is administered once a month. 
  • Naltrexone 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 other opioid drugs.

Either Sublocade or Vivitrol can benefit your treatment, depending on your specific needs and goals. Learn more here. 

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Key Facts About Sublocade and Vivitrol

  • About 3 million American citizens have an active opioid use disorder (OUD).[1]
  • Less than half of private sector treatment programs offer OUD medications, even though these therapies can help people live sober lives and promote success in long-term recovery.[2]
  • The list price of Sublocade is $1,829 per month. Some insurance programs can cover the cost of this medication, but if you don’t have insurance, this therapy is very expensive.[3]
  • The list price of Vivitrol is $2,000 per month. Some programs, such as Prescription Hope, offer discounts.[4] But without insurance or a program like this, Vivitrol is also very expensive.

Medication for Addiction Treatment

People with OUD benefit from a combination of counseling and medication. MAT programs provide psychological support to manage cravings, so the individual can focus on behavioral treatment to ultimately overcome OUD.

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.[5] The injection releases buprenorphine, a partial opioid agonist, into the body steadily over 28 days.

Long-acting medications like this prevent breakthrough cravings that might occur if a patient misses a dose of their daily Suboxone. Therefore, stable patients on Suboxone might prefer to switch from a daily Suboxone tablet or film to a monthly injection.

Sublocade was approved by the U.S. Food and Drug Administration (FDA) in 2017.[6] 

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 they likely know providers that do, and they can refer patients.

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

What Is Vivitrol?

Vivitrol (generic name: naltrexone) is also a prescription injectable medication used to treat OUD.[7] It can also treat alcohol use disorder.

The active ingredient in Vivitrol is naltrexone, an opioid antagonist that prevents patients from getting “high” on opioids if they do take them. It acts as a treatment for OUD because it blocks the euphoric effects of opioids and therefore deters people from taking an opioids. 

Some people prefer Naltrexone to Sublocade or Suboxone because it has no addictive potential. It also does not cause any withdrawal symptoms if you stop taking it.[8] Conversely, it does not address the physical and psychological cravings for opioids in the same way that Subxone and Sublocade do, and therefore is overall considered to be slightly less efficacious than opioid based therapies for addiction treatment. However, it may be the right choice for certain individuals, particularly those who are already in sustained recovery and are not experiencing acute physical withdrawal from opioids. 

Comparing Side Effects: Sublocade vs. Vivitrol 

Both Sublocade and Vivitrol come with side effects. Like all medications, side effects tend to be strongest at first and fade with time. They can be split into the following categories. 

Common Side Effects

Researchers say the following side effects are typical in people who use Sublocade or Vivitrol.[9,10]

SublocadeVivitrol (for OUD)
Nausea X
Swelling or pain at the injection siteXX
Liver enzyme abnormalitiesXX
Inflammation of the nose and throatX

Serious Side Effects 

Some people using Sublocade or Vivitrol have serious reactions to their drugs.[9,10] If you experience any of these side effects, talk to your doctor about a switch to a different OUD solution. 

SublocadeVivitrol (for OUD)
Suicidal thoughtsX
Accidental opioid overdoseXX
Allergic reactionsXX

Similarities Between Sublocade & Vivitrol 

These are similarities between Sublocade and Vivitrol:

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

Can You Take Sublocade & Vivitrol Together?

You cannot take these two medications at the same time. The reason for this is that one is an opioid partial agonist (turns “on” opioid receptors) and the other is an “antagonist” (turns “off” opioid receptors). Thus, they oppose each other and will negate each other’s effects if used at the same time. Patients can chose to use one or the other, depending on what they think will be the best treatment that will be right for them. 

Which Medication Is Better for Opioid Use Disorder Treatment? 

Sublocade and buprenorphine based therapies have been shown to be slightly more efficacious at treating OUD because, unlike Vivitrol, they work by blocking the unpleasant physical effects of withdrawal. On the other hand, Sublocade and buprenorphine based therapies have more side effects that may prevent patients from tolerating the medication. Therefore, there is no “better option” overall. The “better” option is merely which medication is right for you given your body, addiction history, and goals of treatment. 

If you are interested in either of these injectable medications for OUD treatment, your doctor can best advise you on what option might be best for you.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Opioid Addiction. StatPearls. September 2022. Accessed December 2022.
  2. Medications to Treat Opioid Use Disorder Research Report. National Institute on Drug Abuse. December 2021. Accessed December 2022.
  3. Sublocade Pricing. Sublocade. Accessed December 2022.
  4. Vivitrol. Prescription Hope. Accessed December 2022.
  5. Homepage. Accessed December 2022.
  6. FDA Approves First One-Monthly Buprenorphine Injection, a Medication-Assisted Treatment Option for Opioid Use Disorder. U.S. Food and Drug Administration. November 2017. Accessed December 2022.
  7. Homepage. Accessed December 2022.
  8. Naltrexone. Substance Abuse and Mental Health Services Administration. November 2021. Accessed December 2022.
  9. Sublocade Prescribing Information. U.S. Food and Drug Administration. January 2017. Accessed December 2022.
  10. Vivitrol Prescribing Information. U.S. Food and Drug Administration. October 2010. Accessed December 2022.

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