Suboxone and Sublocade are brand names for two different formulations of Buprenorphine, a partial opioid agonist used to treat opioid use disorder (OUD).
Suboxone is a sublingual formulation that is taken daily whereas Sublocade is an injection form of Buprenorphine that is injected once a month.
Both Suboxone and Sublocade are used to treat opioid use disorder as part of Medication for Addiction Treatment (MAT).
Key Facts About Suboxone & Sublocade
Some key facts to consider about Suboxone and Sublocade include the following:[1]
- Both medications contain buprenorphine, a partial opioid agonist that can suppress opioid cravings and reduce or eliminate withdrawal symptoms.
- Both medications are significantly easier to get than methadone, which is the other common medication used to treat OUD, but is only provided through a methadone clinic.
- Both medications are thought to be equally efficacious at treating OUD
- Suboxone is more readily available and generally less expensive/more likely to be covered by insurance than Sublocade, which may require special authorization
Medications For Opioid Use Disorder
There are several medications that can be used to manage opioid use disorder (OUD) as part of an MAT program, including methadone, Buprenorphine, and Naltrexone. Buprenorphine comes in multiple formulations. Suboxone and Sublocade are two of those formulations.
What Is Suboxone?
Suboxone is a sublingual film containing buprenorphine and the drug naloxone, which is used to combat OUD.[2] It is taken orally, usually once or sometimes up to three times a day.
What Is Sublocade?
Sublocade is an extended-release buprenorphine injection that is also used to treat OUD.[3] It is not intended to be injected by the patient. It is instead available from providers participating in the SUBLOCADE REMS Program, who perform the injection for you once a month at a visit.
Its biggest advantage is that it’s a once-monthly injection, unlike Suboxone which is taken more regularly. This helps to ensure adherence to the medication, and may be easier than remembering to take a strip on a daily basis.
How Do These Medications Work?
As two buprenorphine-based medications, both these drugs help with addiction in similar ways.
Buprenorphine is technically an opioid, although it’s important to note that it’s what is called a partial opioid agonist, unlike the full opioid agonists more commonly misused and which are generally more dangerous. This means it acts on the same parts of the brain as opioids, helping to suppress cravings for those drugs and withdrawal symptoms.
Because it is a partial opioid agonist, buprenorphine doesn’t have the same intense effect as full opioid agonists. This significantly reduces both its misuse potential and overdose risk.
Main Differences Between Suboxone and Subocade
Frequency Taken
The frequency with which one takes these medications is one of the biggest differences between them. Suboxone is usually taken daily, sometimes more frequently up to three times a day. Sublocade in contrast is an injection, administered in a doctor’s office once a month.
Dose
While dosing is often highly dependent on the patient and where they are in the treatment process, Sublocade is generally taken at a much higher dose that releases slowly (over the course of a month) in the body.
Sublocade shots are generally given at two monthly initial doses of 300 mg followed by 100 mg monthly maintenance doses. Some patients may have their maintenance dose raised to 300 mg every month depending on the severity of their opioid use disorder. [4]
Suboxone is usually administered at a dose of 2 mg daily to upwards of 24 mg daily, depending on the severity of a person’s opioid use disorder. Patients may take doses of suboxone once, twice, or even three times a day.
Duration of Action
As an extended-release medication, Sublocade lasts significantly longer than Suboxone. When it works as intended for a patient, this is one of its biggest advantages, as some people prefer a shot once a month to having to take a pill or film every day.
Availability
Suboxone is covered by most insurances. In contrast, Sublocade is more expensive and might be harder to obtain. In addition, Patients are required to get their shot from certified providers. Not all providers administer Sublocade, and therefore this may be another reason that its use is more limited than Suboxone.
FDA Approval
Suboxone is a well-established buprenorphine treatment, approved by the FDA for use to treat addiction in 2002.[6] Sublocade came later, getting approval in late 2017.[7]
This isn’t to suggest Suboxone is necessarily “better” because it is more established or that Sublocade is “better” because it is newer. Both medications are thought to be equally good at treating OUD.
Summary of Main Differences
Comparing Side Effects
On a chemical level, the buprenorphine in these medications means they will have similar side effects.
Suboxone
Suboxone’s most common side effects include the following:
- Headache
- Nausea
- Constipation
- Increased sweating
- Vomiting
- Pain
- Insomnia
Sublocade
Sublocade’s most common side effects include the following:
- Headache
- Nausea
- Constipation
- Increased sweating
- Vomiting
- Insomnia
- Increase in liver enzymes
- Itching or pain at injection site
Can I Use Both Medications at the Same Time?
Not usually, no. Most patients choose either one or the other medication to treat OUD. There may be certain circumstances in which a patient receiving a monthly Sublocade injection may also take Suboxone for additional pain control or other symptoms, but this would be on a case by case basis.
Are There Other Medications Used to Manage Opioid Use Disorders?
Yes. Suboxone and/or Sublocade, or other Buprenorphine based treatments for OUD may not be right for some people. There are other options, primarily Methadone and - less commonly - Natrexone.
Bear in mind that while both formulations of Buprenorphine - Suboxone and Sublocade - are highly effective at treating OUD, the best results are always achieved with a combination of medication as well as behavioral interventions and other forms of psychosocial support.
For more information about Suboxone, Sublocade, or other Buprenorphine based treatments for OUD< reach out to Bicycle Health. We can explain your options. If you decide to get treatment with us, we make the process simple. We have telehealth offerings, so care is accessible and convenient. And we offer support at every step of your recovery journey. Reach out to us today for more information.
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