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Does Sublocade Have Naloxone In It?

Danny Nieves-Kim, MD profile image
By Danny Nieves-Kim, MD • Updated Oct 15, 2023 • 5 cited sources

Sublocade does not have naloxone in it.

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Sublocade is an injectable version of buprenorphine. It does not contain other active ingredients, including naloxone.[1]

Drug companies add naloxone to at-home oral forms of buprenorphine (such as Suboxone). It’s not required in long-lasting, injectable forms of buprenorphine (such as Sublocade). 

What Is Sublocade?

Sublocade is an injectable, long-lasting form of buprenorphine. If you’re struggling with opioid use disorder (OUD), Sublocade could be part of your Medication for Addiction Treatment (MAT) program. 

Buprenorphine is a partial opioid agonist. It latches weakly to receptors used by drugs like heroin and OxyContin, eliminating drug cravings and stopping withdrawal symptoms.

When buprenorphine is used properly, it offers the following benefits:[2]

  • Fewer opioid withdrawal symptoms
  • Reduced opioid cravings
  • Moderate overdose protection 

Sublocade shots offer these protections for about a month.[1] If Sublocade is part of your MAT program, you’ll keep a monthly appointment for an injection and participate in therapy to support your long-term recovery. 

What Is Naloxone?

Naloxone is a generic opioid antagonist, capable of binding to opioid receptors and reversing an overdose in minutes.

Naloxone is combined with buprenorphine to discourage misuse via injection. When naloxone is taken orally, it is basically inactive because very little gets absorbed. But if naloxone is injected intravenously with buprenorphine, it is supposed to block the effects of buprenorphine, theoretically reducing the chances of experiencing a “high” or euphoria. 

Why Doesn’t Sublocade Contain Naloxone?

Most buprenorphine/naloxone combination medications are administered orally. The naloxone only kicks in when people attempt to inject their drugs for a quick high.[4]

Sublocade is an injectable form of buprenorphine, not an oral one. It’s already designed to enter your body via a needle, so naloxone’s protections aren’t needed. 

Sublocade is also designed for administration by a health care professional  — another form of misuse protection. Unlike oral drugs, which people use at home, Sublocade requires an appointment. Manufacturers didn’t need to add naloxone to get it approved by officials as safe for at-home use. 

Which Buprenorphine Medications Contain Naloxone?

Multiple oral forms of buprenorphine contain naloxone, including Suboxone. If you use these medications as directed, you won’t notice this ingredient at all. But if you try to inject these oral medications, the naloxone should kick in and prevent any potential mind-altering effects of buprenorphine. 

It’s rare for people with OUD to misuse their medications. Researchers say almost three-fourths of adults taking buprenorphine don’t misuse their MAT options.[5] 

But people who don’t have OUD can get high when they take buprenorphine. The inclusion of naloxone ensures they can’t misuse this drug via a needle. 

Who Should Use Sublocade? 

Sublocade is designed for people with moderate to severe OUD who have used an oral buprenorphine product for at least seven days.[1]

Moving from an opioid to buprenorphine is a process called induction, and it takes time. Most people need a day or two to find a buprenorphine dose that eases their withdrawal symptoms without causing sedation. 

Once induction is complete, you could switch to Sublocade. Alternatively, you could switch to Sublocade after using a medication like Suboxone for a long period. 

By Danny Nieves-Kim, MD

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Sources
  1. Sublocade prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed August 17, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/209819s017s018lbl.pdf 
  2. Buprenorphine. Substance Abuse and Mental Health Services Administration Published July 18, 2023. Accessed August 17, 2023. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
  3. Naloxone. Substance Abuse and Mental Health Services Administration. Published April 25, 2023. Accessed August 17, 2023. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naloxone
  4. Yokell MA, Zaller ND, Green TC, Rich JD. Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review. Curr Drug Abuse Rev. 2011;4(1):28-41. doi:10.2174/1874473711104010028
  5. Han B, Jones CM, Einstein EB, Compton WM. Trends in and Characteristics of Buprenorphine Misuse Among Adults in the US. JAMA Netw Open. 2021;4(10):e2129409. doi:10.1001/jamanetworkopen.2021.29409 

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