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Sublocade Side Effects: What to Expect

Danny Nieves-Kim, MD profile image
By Danny Nieves-Kim, MD • Updated Oct 10, 2023 • 5 cited sources

Sublocade is a once-monthly injectable form of buprenorphine.[1] Most side effects are mild, and typically, they stem from the shot that delivers your medication. Needles can hurt, and sometimes, those pokes cause bruises or infections. 

More serious side effects, including those related to allergic reactions and organ damage, are rare. But it’s important to understand what they are, so you can make an informed decision about your Medication for Addiction Treatment (MAT) program. 

What Is Sublocade?

Sublocade is a brand-name, injectable form of buprenorphine approved by the U.S. Food and Drug Administration (FDA) in 2017.[1] 

FDA officials approved Sublocade to treat opioid use disorder (OUD) in people who have used the same oral dose of buprenorphine for at least seven days.[1] If you’re still using drugs like heroin or OxyContin, Sublocade can’t help you through withdrawal and detox. 

But Sublocade can help simplify MAT for people who have completed detox. Instead of taking buprenorphine products every day, you’ll get one monthly Sublocade shot. For many people, this is a more convenient option since they don’t have to remember to take a pill or film strip every day.

And unlike other buprenorphine products, Sublocade can’t be misused. Your doctor administers the shot, and you don’t get anything to take home. There simply isn’t a way for you to misuse the drug. 

If you’re worried about misusing your MAT, Sublocade could be a smart choice. You won’t face this temptation. 

Common Side Effects of Sublocade

Like all medications, Sublocade can cause side effects. Understanding what they are can help you know what to expect when you start this form of therapy.

The FDA says 5% or fewer people experienced the following adverse reactions in Sublocade tests:[2]

  • Constipation
  • Headache
  • Nausea 
  • Pain and itching at the injection site
  • Vomiting 

Know that these are the side effects researchers spotted most frequently. You may have other complications we didn’t list here. And you may not experience any of the problems we’ve discussed. Each person’s experience is different.

But in studies of the drug, these were the issues most people experienced when they used Sublocade. 

Mild Sublocade Side Effects

A side effect is considered mild if it’s not strong enough to make you quit using the medication. In early studies of Sublocade, just 4% of people quit using the medication due to side effects.[2] 

If you do experience Sublocade side effects, expect them to be mild. Most studies suggest that problems just aren’t serious enough for most people to quit their MAT program.

Serious Sublocade Side Effects

About 3% of people using Sublocade in studies experienced a serious side effect.[3] These problems are serious enough to make you consider quitting MAT. And sometimes, they’re strong enough to put your long-term health at risk.

Serious side effects include the following:[2]

  • Serotonin syndrome: A buildup of this neurotransmitter leads to heart problems, vomiting, diarrhea or shivering.
  • Adrenal insufficiency: When the adrenal gland is damaged, you may feel dizzy or fatigued. 
  • Allergic reactions: Some people experience hives, rashes and swelling due to their injections. 

What Other Side Effects Should I Know About?

Some people experience unusual but serious health problems caused by their Sublocade therapy. 

Those problems include the following:[2]

  • Liver problems: Some people develop yellowing skin or unusual liver test results while using Sublocade. 
  • Severe injection problems: While most cases of injection site pain are mild, some people experience moderate or severe symptoms that cause them to stop this form of MAT.  
  • Androgen deficiency: Low libido, impotence, erectile dysfunction or a lack of periods are potential symptoms of this condition.

Your doctor can monitor your health with blood tests during your MAT appointments. But you should report any new health problems or symptoms you notice. In some cases, they may opt to change your treatment plan. 

Sublocade Dependence & Withdrawal Symptoms

Buprenorphine products (including Sublocade) do not get rid of opioid dependence so stopping them often leads to withdrawal symptoms.

The buprenorphine in Suboxone is a partial opioid receptor activator. It latches onto the same receptors activated by heroin and OxyContin, and eliminates opioid cravings and withdrawal symptoms.

This trait makes buprenorphine an excellent MAT option. But buprenorphine medications like Sublocade don’t eliminate a person’s physical dependence on opioids. So people who abruptly stop taking it may experience withdrawal symptoms. However, these symptoms are often more mild and delayed. This is because Sublocade is a longer-lasting medication than other buprenorphine products, so it will wear off slowly. Studies show that an injection can last 2 to 5 months in the body.

If you do experience withdrawal, you may develop flu-like symptoms such as the following:[2]

  • Aches and pains
  • Nausea
  • Diarrhea
  • Sweating 

Withdrawal can also cause drug cravings, raising your relapse risks. If you’re ready to quit Sublocade, talk to your doctor and craft a weaning strategy. It’s safer to quit the drug a little at a time rather than cold turkey. You can work together with your doctor to create a tapering plan that works best for you. 

Can You Overdose on Sublocade?

Sublocade is administered by professionals. You can’t take the drug home, take too much and overdose. But if you take opioids or benzodiazepines while on Sublocade, you could experience an overdose. 

Opioid overdoses typically cause the following symptoms:[5]

  • Slow breathing
  • Slow heartbeat
  • Unconsciousness
  • Sedation 

Without rapid treatment with with an opioid receptor blocker like naloxone, people can die of an overdose. 

If you’re using Sublocade and tempted to misuse other drugs, talk with your doctor. Your MAT program likely needs an adjustment to maintain your recovery and prevent potential overdose from a relapse. 

Can Addiction Treatment Programs Prescribe Sublocade?

Doctors with a valid license to prescribe controlled substances can offer Sublocade to their patients. If your MAT partner includes a physician with the right license, you could get a Sublocade prescription there. 

Additionally, at Bicycle Health, we prescribe Sublocade as well as Suboxone for those looking to recover from opioid use disorder.

If you’re looking for a convenient treatment option you can use at home, Sublocade or Suboxone might be right for you. And with our telehealth services, you can easily and quickly get a prescription from the comfort and privacy of your own home. Contact us to find out more. 

By Danny Nieves-Kim, MD

... Read More

  1. FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder. U.S. Food and Drug Administration. Published November 30, 2017. Accessed August 16, 2023.
  2. Sublocade prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed August 16, 2023.
  3. Clinical review report: Buprenorphine extended-release injection (Sublocade). : (Indivior Canada, Ltd.): Indication: For the management of moderate-to-severe opioid use disorder in adult patients who have been inducted and clinically stabilized on a transmucosal buprenorphine-containing product. Canadian Agency for Drugs and Technologies in Health. Published July 2019. Accessed August 16, 2023. 
  4. Recommendations for Sublocade and considerations for informed consent. College of Physicians and Surgeons of Manitoba. Accessed August 16, 2023. 
  5. Opioid overdose. Substance Abuse and Mental Health Services Administration. Published March 2023. Accessed August 16, 2023. 

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