If you’re considering treatment for opioid use disorder (OUD), your doctor may recommend Sublocade. It’s prescribed as part of a complete treatment program to manage opioid addiction in adults with OUD.

Opioids are a group of drugs used for pain management. Sublocade can help reduce your opioid cravings and prevent opioid withdrawal symptoms if you stop taking opioids.

For more information about how Sublocade is used for OUD, see the “What is Sublocade used for?” section below.

Sublocade basics

Sublocade comes as a solution inside prefilled syringes. It’s given as an injection under your skin by trained healthcare professionals. Because there are risks related to Sublocade injections, the drug is only given by trained healthcare professionals through a special program. See the “Boxed warnings” section just above for more details.

Sublocade contains the active drug buprenorphine. Although buprenorphine is available as a generic drug, there isn’t a generic form of Sublocade. The generic form of buprenorphine comes as tablets. But Sublocade has a different form of buprenorphine, so that’s why it’s given as an injection. Sublocade injections slowly release buprenorphine into your body over time.

Read on to learn more about how Sublocade is taken, its side effects, and other key information about the drug.

Sublocade and Suboxone are both used to treat opioid use disorder. These drugs have some similarities and some differences.

To see a side-by-side comparison of these medications, check out this article. Also, talk with your doctor about which medication is right for you.

Find answers to some commonly asked questions about Sublocade.

Will I have withdrawal symptoms if I stop taking Sublocade?

It’s possible. When you take Sublocade, it helps stop withdrawal symptoms from opioids. (Opioids are a group of drugs used for pain management.)

But your body may become physically dependent on Sublocade. (This means that your body needs the drug in order to function like usual.)

Usually, withdrawal from Sublocade is milder than withdrawal from opioids. Symptoms of withdrawal from Sublocade can include:

  • anxiety
  • nausea or vomiting
  • muscle aches
  • trouble sleeping

Keep in mind that Sublocade is a long-acting medication that stays in your body for a while. So, withdrawal from it may happen weeks to months after your last dose.

Tell your doctor if you’re having any withdrawal symptoms after stopping Sublocade. They can recommend ways to help manage your symptoms.

Does Sublocade contain naloxone?

No, Sublocade doesn’t contain naloxone. Instead, it contains a long-acting from of the drug buprenorphine.

Sublocade is prescribed to manage opioid cravings and withdrawal symptoms of opioid use disorder. (Opioids are a group of drugs used for pain management.)

Naloxone, on the other hand, blocks the effects of opioid medications in your body. And it’s used to reverse opioid overdose.

Some medications contain both buprenorphine and naloxone. An example is Suboxone, which is also used to manage opioid misuse. But Suboxone comes as film that dissolves in your mouth. That’s unlike Sublocade, which comes as a solution that’s given as an injection under your skin.

Can I take pain relievers while I’m taking Sublocade?

Possibly. You may be able to take over-the-counter pain relievers while you’re taking Sublocade. These pain relievers could include:

But be sure to check with your doctor before taking any medications with Sublocade.

On the other hand, you shouldn’t take any opioid medications with Sublocade. Doing so could increase your risk for opioid overdose. And this could cause slowed breathing, loss of consciousness, changes in your heart rate, and even death.

If you’re scheduled to have any surgeries and need pain management, you or a loved one should let your doctor know that you’re taking Sublocade. That way, if you’re given opioids, you’ll be monitored for symptoms of overdose.

And remember, Sublocade’s effect in your body lasts for weeks to even months after you stop taking the medication. So, don’t forget to let healthcare professionals know the date of your last Sublocade dose.

What’s the half-life of Sublocade?

Sublocade has a half-life of about 43 to 60 days. This means that it takes 43 to 60 days for your body to clear half a dose of the drug after it’s given to you. In general, it takes about five half-lives for your body to completely remove a drug from your system.

Does Sublocade make you feel ‘high’?

That’s not likely. Sublocade is a type of drug called an opioid partial agonist. It’s prescribed to help prevent opioid cravings and withdrawal symptoms of opioid use disorder. (Opioids are a group of drugs used for pain management.)

Opioids affect certain receptors (attachment sites) in your brain. They have a strong pain-relieving effect, but they can also make a person feel “high” (euphoric). But this effect isn’t likely with Sublocade.

If you have questions about how Sublocade will make you feel, talk with your doctor.

Your doctor will recommend the dosage of Sublocade that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.

Form

Sublocade comes as a solution inside prefilled syringes. It’s given as an injection under your skin by trained healthcare professionals. They’ll inject the drug under the skin of your belly.

Note: Because there are risks related to Sublocade injections, the drug is only given by trained healthcare professionals through a special program. See the “How is Sublocade given?” section just below for more details.

Recommended dosage

Your doctor will decide the dosage of Sublocade that’s right for you. And they may adjust your dosage depending on how you’re responding to the treatment.

You can start receiving Sublocade only if you’ve had induction treatment with buprenorphine that’s taken by mouth. (Buprenorphine is the active drug in Sublocade.) This could include taking a medication such as Suboxone. And you’ll need to receive induction treatment for at least 7 days before starting Sublocade.

Getting induction treatment helps you avoid having opioid withdrawal symptoms when you’re using Sublocade.

After induction treatment, you’ll receive one Sublocade injection each month. And your doctor will monitor your progress with the treatment.

Questions about Sublocade’s dosage

Here are answers to some common questions related to Sublocade’s dosage:

  • What if I miss a dose of Sublocade? You’ll get doses of Sublocade from your doctor on a monthly basis. If you miss an appointment for a dose, call your doctor’s office to reschedule your next dose. Do this as soon as you remember to help you avoid having opioid withdrawal symptoms. In general, as long as you get your next dose within 2 weeks of your last dose, you shouldn’t have withdrawal symptoms. To help you stay on schedule with your doses, try setting a reminder on your phone for your monthly appointments.
  • Will I need to use Sublocade long term? There’s no time limit on Sublocade use. As long as it’s helping you, you and your doctor can discuss your treatment progress and next steps. It’s important to talk with your doctor about the risks and benefits of treatment with Sublocade. Together, you can decide on a treatment plan that’s right for you.
  • Should I take Sublocade with food? Food doesn’t affect how Sublocade acts in your body. So, you can get your Sublocade injection with or without having eaten.
  • How long does Sublocade take to work? Sublocade starts to work soon after it’s been injected into your body. Once you start treatment, your cravings for opioids and opioid withdrawal symptoms should be more manageable.

Sublocade is only given by trained healthcare professionals.

Receiving Sublocade

Sublocade comes as a solution inside prefilled syringes. It’s given as an injection under your skin by trained healthcare professionals. They’ll inject the drug under the skin of your belly.

Boxed warning related to receiving Sublocade

Sublocade has a boxed warning regarding risk if the drug is injected into a vein. Boxed warnings are the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. The drug’s boxed warning is described below.

Risk if injected into a vein. After it’s injected, Sublocade becomes a solid mass. If the drug is injected into a vein, this mass can cause damage to your tissues and organs. It may even break off and move through your bloodstream, causing life threatening pulmonary embolism (blood clots in your lungs).

Because of this risk, Sublocade must not be injected into a vein. Instead, it’s only given as an injection under your skin by trained healthcare professionals. You can’t self-inject doses of Sublocade.

In addition, Sublocade is only available from your doctor through a special program called Sublocade Risk Evaluation and Mitigation Strategy (REMS). For safety reasons, only trained healthcare professionals who are REMS certified can give doses of Sublocade. And offices or clinics where Sublocade is given must also be REMS certified.

If you’d like to know more about the Sublocade REMS program, talk with your doctor. You can also visit the Sublocade REMS website or call 866-258-3905.

Receiving Sublocade with other drugs or therapies

While you’re taking Sublocade, your doctor will recommend other therapies to help manage your opioid use disorder. These therapies may include:

Sublocade and Narcan

Your doctor may recommend that you have naloxone (Narcan) on hand If you’re at risk of opioid overdose while taking Sublocade. Narcan is used to help reverse an opioid overdose. But a person still needs emergency medical attention, even after they receive Narcan.

If you want to know more about Narcan, see this article. Ask your doctor whether you should have Narcan available and how to take the medication properly.

Questions for your doctor

You may have questions about Sublocade and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will Sublocade affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

Like most drugs, Sublocade may cause mild or serious side effects. The lists below describe some of the more common side effects that Sublocade may cause. These lists don’t include all possible side effects.

Your doctor can tell you more about the potential side effects of Sublocade. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Sublocade can cause. To learn about other mild side effects, talk with your doctor or read Sublocade’s medication guide.

Mild side effects of Sublocade can include:

  • itching, redness, irritation, or pain at the injection site
  • nausea or vomiting

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Sublocade can occur, but they aren’t common. If you have serious side effects from Sublocade, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

* For more information on this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects that Sublocade may cause.

Boxed warning

Sublocade has a boxed warning regarding risk if the drug is injected into a vein. Boxed warnings are the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Risk if injected into a vein. If it’s injected into a vein, Sublocade becomes a solid mass. This mass can cause damage to your tissues and organs. It may even break off and move through your bloodstream, causing life threatening blood clots in your lungs (pulmonary embolism).

What might help

Because of this risk, Sublocade must not be injected into a vein. Instead, it’s only given as an injection under your skin by trained healthcare professionals. You can’t self-inject doses of Sublocade.

In addition, Sublocade is only available from your doctor through a special program called Sublocade Risk Evaluation and Mitigation Strategy (REMS). For safety reasons, only trained healthcare professionals who are REMS certified can give doses of Sublocade. And offices or clinics where Sublocade is given must also be REMS certified.

If you’d like to know more about the Sublocade REMS program, talk with your doctor. You can also visit the Sublocade REMS website or call 866-258-3905.

Tiredness

You may feel tired, sleepy, or less energetic than usual while you’re taking Sublocade. When you first start treatment with Sublocade, or if your doctor increases your dose of the drug, you may feel tired or drowsy.

What might help

Until you know how Sublocade affects you, ask someone to drive you to your appointments for Sublocade injections. And don’t drive or operate machinery until you understand the effects of the drug on your body.

If you’re concerned about tiredness with Sublocade, talk with your doctor. They may offer helpful tips to manage this side effect.

But if you have tiredness or drowsiness along with trouble breathing or other concerning symptoms, call 911 or your local emergency number. Or have someone take you to an emergency room right away.

Constipation

Sublocade can cause constipation. In studies, this was a common side effect of the medication.

Symptoms of constipation can include:

  • hard stools
  • trouble passing stool
  • pain during bowel movements

What might help

If you have constipation with Sublocade, drinking lots of water and engaging in physical activity can help relieve it.

Also, check with your doctor about taking over-the-counter medications, such as stool softeners or fiber supplements. And check out these at-home remedies for easing constipation.

Allergic reaction

Some people may have an allergic reaction to Sublocade.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Sublocade. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Sublocade and Vivitrol are both prescription medications used to manage opioid use disorder. In addition, Vivitrol is also used to treat alcohol use disorder.

To learn more about how these drugs compare with each other, check out this article. Also, ask your doctor about the treatment option that’s right for you.

If you’re considering treatment for opioid use disorder (OUD), your doctor may recommend Sublocade.

It’s prescribed as part of a complete treatment program to manage opioid addiction in adults with moderate-to-severe OUD.

Opioids are a group of drugs used for pain management. With opioid addiction, an opioid is taken even if it’s causing harm. This often results because of dependence on the opioid. (Dependence means that your body needs opioids in order to function like usual.)

Sublocade can help reduce your opioid cravings and prevent opioid withdrawal symptoms if you stop taking opioids.

You can start using Sublocade once you’ve received treatment for opioid withdrawal symptoms with a buprenorphine-containing medication that’s taken by mouth. But you’ll need to have received this medication for at least 7 days before starting Sublocade.

Sublocade is used together with counseling and support therapies. This combination of treatment helps promote long-term treatment success with Sublocade.

Before you start taking Sublocade, your doctor will order blood tests to make sure it’s safe for you to take the drug. Be sure to tell your doctor about any health conditions you have. And let them know about any medications or supplements you’re taking.

Here’s a look at some of the interactions and precautions you should know about before using Sublocade.

Interactions

Sublocade can interact with different drugs, supplements, and herbal products.

Taking medications or having vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions. Sometimes, interactions can increase a drug’s side effects. Other times, interactions can lower the effects of a drug.

Be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor can tell you about any interactions these items may cause with Sublocade.

Interactions with drugs or supplements

Drugs that may interact with Sublocade include:

  • Benzodiazepines. Taking benzodiazepines with Sublocade can increase your risk for serious side effects from Sublocade. These side effects include respiratory depression (slowed or shallow breathing), loss of consciousness, and even death. You shouldn’t take benzodiazepines while you’re using Sublocade and for several months after you stop using Sublocade, unless your doctor is aware and is prescribing a benzodiazepine together with Sublocade. It’s preferable that you eventually stop taking the benzodiazepine over a period of time. This is because the risk of serious side effects is very high when you’re taking a benzodiazepine with Sublocade. Examples of benzodiazepines include:
  • Opioids. Taking opioids with Sublocade can increase your risk for opioid overdose. Don’t take opioid medications while you’re using Sublocade and for several months after you stop using Sublocade. Examples of opioids include:
    • oxycodone
  • Antihistamines. Taking some types of antihistamines with Sublocade can increase your risk for side effects from Sublocade. These side effects include constipation, sleepiness, drowsiness, and respiratory depression. Examples of these antihistamines include:
    • chlorpheniramine
  • Certain antibiotics, certain antifungals, and certain seizure and HIV medications. Taking these medications with Sublocade can increase your risk for Sublocade’s side effects, such as sedation or slowed breathing. This is because the medications can affect how your body absorbs Sublocade. Examples of these medications include:
    • the antibiotic clarithromycin (Biaxin)
    • the antifungal ketoconazole, when it’s taken by mouth

This list does not contain all types of drugs that may interact with Sublocade. Your doctor can tell you more about these interactions and any others that may occur with use of Sublocade.

Other interactions

Sublocade can interact with supplements and herbs that increase dizziness or drowsiness. And this interaction can be dangerous.

A few examples of herbs and supplements that interact with Sublocade include:

Boxed warnings

Sublocade has a boxed warning regarding risk if the drug is injected into a vein. Boxed warnings are the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Risk if injected into a vein. After it’s injected, Sublocade becomes a solid mass. If the drug is injected into a vein, this mass can cause damage to your tissues and organs. It may even break off and move through your bloodstream, causing life threatening pulmonary embolism (blood clots in your lungs).

Because of this, Sublocade must not be injected into a vein. It’s only given as an injection under your skin by trained healthcare professionals. In addition, Sublocade is only available from your doctor through a special program called Sublocade Risk Evaluation and Mitigation Strategy (REMS).

For more information about this warning and REMS, see the “How is Sublocade given?” section above.

Other warnings

Sublocade may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Sublocade. Factors to consider include those in the list below.

  • Lung problems. If you have problems with breathing or any lung conditions, tell your doctor before taking Sublocade. These include conditions such as chronic obstructive pulmonary disease, sleep apnea, and asthma. Taking Sublocade with these conditions could increase your risk for breathing-related side effects, such as respiratory depression (slowed or shallow breathing), which can sometimes be fatal. Be sure to tell your doctor about any lung issues you have. They’ll determine if Sublocade is safe for you.
  • Allergic reaction. If you’ve had an allergic reaction to Sublocade or any of its ingredients, you shouldn’t take this drug. Ask your doctor about which other medications are better options for you.
  • Liver problems. If you’ve had liver disease or any problems with your liver, Sublocade may not be right for you. Sublocade can increase levels of liver enzymes. And in people with moderate-to-severe liver disease, it can lead to more serious side effects. Let your doctor know if you’ve ever had hepatitis or other liver problems. Before starting Sublocade, your doctor will check your liver function with lab tests. And they’ll monitor your liver function while you’re taking the drug. If your liver enzymes become abnormally high with Sublocade, your doctor will have you stop treatment and they’ll monitor you.
  • Adrenal gland problems, such as Addison’s disease or adrenal insufficiency. Sublocade can cause problems with your adrenal glands, which make and release certain hormones in your body. If you already have adrenal gland problems, talk with your doctor about whether Sublocade is the best treatment option for you.
  • A condition related to your brain or a recent head injury. Sublocade may increase the pressure of fluid in your brain and spinal cord. And this can be dangerous if you already have a head injury or brain condition. Tell your doctor about any head, back, or brain injuries you have before taking Sublocade.
  • Abnormal heart rate. You shouldn’t take Sublocade if you or an immediate family member has or has ever had a type of abnormal heart rhythm called long QT syndrome. Also, certain medications used for abnormal heart rate shouldn’t be taken together with Sublocade. Ask your doctor about which treatment may be a better choice for you.

Sublocade and alcohol

It’s not safe to drink alcohol with Sublocade. Having these together can increase your risk for serious side effects of Sublocade, including:

Talk with your doctor about the risks of drinking alcohol while using Sublocade. And remember, even after you stop Sublocade treatment, the medication stays in your body for several weeks to months. So, ask your doctor when it’s safe to drink alcohol after your Sublocade treatment has stopped.

Pregnancy and breastfeeding

Talk with your doctor about the risks and benefits of treatment with Sublocade during pregnancy or while breastfeeding.

Sublocade use during pregnancy may cause your baby to develop dependence to Sublocade. This is called neonatal opioid withdrawal syndrome. (With dependence, their body needs the drug in order to function like usual.)

Symptoms of neonatal opioid withdrawal syndrome can include:

  • diarrhea
  • irritability
  • crying a lot more than usual
  • trouble sleeping
  • lack of weight gain

If you use Sublocade during pregnancy, your baby may need treatment for neonatal opioid withdrawal syndrome after birth.

Sublocade does pass into breast milk. So, ask your doctor if it’s safe to breastfeed while you’re taking Sublocade. If you breastfeed while taking Sublocade, your child will need to be monitored carefully for certain symptoms. These can include trouble breastfeeding, being sleepier than usual, and not gaining weight. If you notice any of these symptoms, call your child’s doctor right away.

It’s important that you know the symptoms of overdose and that you call 911 immediately if your child has any. These symptoms may include inability to be woken up, having slowed or shallow breathing, or being unresponsive.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor. You can also visit the Sublocade manufacturer’s website to see if it offers any support options.

Sublocade is a treatment that’s used to manage opioid use disorder in adults. It’s used together with counseling and support therapies.

Talk with your doctor about questions you have about the drug, its side effects, and how long you’ll need to take it for. Also, ask your doctor about the drug’s effectiveness and what you can expect with treatment.

There are other treatment options available for opioid use disorder. Ask your doctor about the best treatment choice for you based on your needs. Also, talk with them about cognitive behavioral therapy and other support and counseling services that might benefit you during your Sublocade treatment.

If you’d like to ask your doctor about Sublocade, here are some questions to help get you started:

  • How will I know if Sublocade is working for me?
  • What should I expect when I first start using Sublocade?
  • What if I have a serious allergic reaction to Sublocade after a few days?
  • Which other pain medications are safe with Sublocade?

Q:

Should I carry naloxone with me while I’m using Sublocade?

Anonymous patient

A:

You should carry naloxone with you if your doctor recommends that you do so. (Naloxone is used to help reverse opioid overdose.)

You’re unlikely to experience overdose from Sublocade when it’s administered by a trained healthcare professional and is used as prescribed. Taking Sublocade as prescribed includes taking it only if you’ve already received treatment with buprenorphine that’s taken by mouth. (Buprenorphine is the active drug in Sublocade). And you’ll need to have received this treatment for at least 7 days before starting Sublocade.

But taking certain other medications while you’re using Sublocade could result in opioid overdose symptoms.

These medications include:

If you notice any symptoms of opioid overdose, seek emergency help or have someone take you to a nearby emergency room right away. When starting Sublocade, talk with your doctor about whether you need to carry naloxone with you. Also, talk with them about cravings, withdrawal symptoms, and using other medications to help avoid overdose while taking Sublocade.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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