Sublocade vs. Suboxone: What You Should Know

Introduction

If you have opioid use disorder, your doctor may prescribe treatments such as Sublocade (buprenorphine) or Suboxone (buprenorphine and naloxone). Opioid use disorder causes a strong desire to keep using opioid drugs despite the harmful effects they might cause.

Sublocade and Suboxone are both brand-name prescription drugs. Suboxone also has a generic form called buprenorphine and naloxone.

Read on to learn more about how Sublocade and Suboxone are alike and different.

Note: For more information about these drugs, see the in-depth articles on Sublocade and Suboxone.

What are the side effects of Sublocade and Suboxone?

Below are examples of mild and serious side effects you may have while using Sublocade or Suboxone.

For more information about the possible side effects of Sublocade, see this article. And for more information about the possible side effects of Suboxone, talk with your doctor.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Sublocade or Suboxone, visit MedWatch.

Mild side effects

Sublocade and Suboxone may cause mild side effects in some people. The chart below lists examples of mild side effects that have been reported with these drugs.

This chart may not include all mild side effects of these drugs. For more information on the mild side effects of these two drugs, see Sublocade’s medication guide and Suboxone’s medication guide.

Serious side effects

In addition to the mild side effects described above, serious side effects may occur in people using Sublocade or Suboxone. See the chart below for a list of serious side effects that have been reported with these drugs.

To learn more about your risk for serious side effects from Sublocade or Suboxone, talk with your doctor.

What are the dosage and forms of Sublocade and Suboxone?

Sublocade and Suboxone come in different dosage forms.

Sublocade is an injection that’s given under your skin.* You’ll get Sublocade injections once each month from a healthcare professional. You won’t be able to give yourself Sublocade injections at home.

Suboxone is a film that you place under your tongue or between your gums and cheek. This film dissolves in your mouth and releases the drug into your body. You’ll typically take Suboxone once each day.

Your doctor will decide if you’ll be given Suboxone at their office or if you can take your doses at home.

* Sublocade has a boxed warning regarding risks if injected into a vein. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “What are the warnings of Sublocade and Suboxone?” section below.

What are Sublocade and Suboxone used for?

Sublocade and Suboxone are used to treat opioid use disorder in adults. This condition is sometimes called opioid dependence. Opioid use disorder causes a strong desire to keep using opioid drugs despite the harmful effects they might cause.

You might use Suboxone during different phases of opioid use disorder treatment.

When you first stop taking opioids, you may have withdrawal symptoms. In the induction phase, you’ll take Suboxone to help reduce these symptoms. In the maintenance phase, you’ll take Suboxone long term to help keep opioid cravings managed.

You’ll take Sublocade only during the maintenance phase, once any withdrawal symptoms are managed. For at least 7 days before starting Sublocade, you’ll need to use a different form of buprenorphine. This form dissolves under your tongue or inside your cheek.

Both Sublocade and Suboxone are used alongside counseling and other mental health support.

For more details about each drug’s approved uses, see the in-depth articles on Sublocade and Suboxone.

What are the ingredients in Sublocade and Suboxone?

Both Sublocade and Suboxone contain the active drug buprenorphine. Buprenorphine is in a class of drugs called partial opioid agonists. Drugs in this class work in a similar way to opioids.

In addition to buprenorphine, Suboxone contains naloxone. Naloxone is in a class of drugs called opioid antagonists. It works by blocking the effects of opioids.

FAQs about Sublocade and Suboxone

Get answers to some frequently asked questions about Sublocade and Suboxone.

Can you take Sublocade while taking Suboxone?

Your doctor won’t prescribe these drugs for you at the same time. Instead, they’re each given for different phrases of opioid use disorder treatment. To learn more about this condition, see the “What are Sublocade and Suboxone used for?” section above.

Sublocade and Suboxone both contain the active drug buprenorphine. So treatment with both medications at once could increase the risk of side effects. And it would likely cause overdose.

It’s possible that you’ll switch from Suboxone to Sublocade during your treatment course. For details about this, see the “Can I switch between Sublocade and Suboxone?” section below.

Talk with your doctor if you have more questions about taking Sublocade and Suboxone together.

Will I have withdrawal symptoms if I stop using Sublocade or Suboxone?

Yes, you might have withdrawal symptoms if you stop taking Sublocade or Suboxone. This is because Sublocade and Suboxone can cause physical dependence. This means that your body gets used to a drug and needs to adjust to functioning without it.

Examples of withdrawal symptoms include:

• abdominal pain
• diarrhea, nausea, or vomiting
• muscle aches
• runny nose
• shaking
• sweating more than usual

With Sublocade, you may not have withdrawal symptoms until months after your last injection. This is because it takes about a year or longer for the drug to leave your body. With Suboxone, you may have withdrawal symptoms within a few days after you stop taking the drug.

Because of your risk for withdrawal, you shouldn’t stop your current treatment unless your doctor recommends it.

When your doctor says it’s safe to stop Suboxone, they’ll help you gradually lower your doses over time. This should reduce the severity of your withdrawal symptoms.

With Sublocade, your doctor will monitor you for withdrawal symptoms for several months after your last injection. If you have withdrawal symptoms, your doctor may prescribe a few doses of a different form of buprenorphine. This form dissolves under your tongue or inside your cheek.

Tell your doctor right away if you experience any withdrawal symptoms after stopping Sublocade or Suboxone. They can prescribe medications to help treat your symptoms. They may also recommend other ways to help manage your condition.

Can I take any pain relievers while I’m using Sublocade or Suboxone?

Yes, in certain situations.

Under most circumstances, you should avoid taking any opioids to relieve pain while you’re using Sublocade or Suboxone. Taking opioids while receiving these medications can raise your risk for respiratory depression (slowed breathing), which can be fatal.

Non-opioid pain relievers, such as Tylenol (acetaminophen) and Advil (ibuprofen), are preferred.

You may have an unexpected and urgent need to use opioid pain relievers, such as for surgery or a medical emergency. If this happens, make sure the medical staff treating you know that you’re taking Sublocade or Suboxone. They’ll need to closely monitor your breathing while you’re taking the opioid.

Can Sublocade or Suboxone cause breathing problems?

Yes, it’s possible. High doses of Sublocade or Suboxone can cause respiratory depression. Breathing problems weren’t reported in studies of Sublocade or Suboxone. But these problems have been reported since these drugs were made available to the public.

Taking Sublocade or Suboxone can also cause sleep-related breathing problems, such as sleep apnea and a decrease in oxygen levels in your blood while sleeping.

Your risk for breathing problems while taking Sublocade or Suboxone is higher if you have a lung condition such as asthma or chronic obstructive pulmonary disease (COPD). Drinking alcohol or taking certain drugs while using Sublocade or Suboxone can also raise your risk. Examples of these drugs include:

• opioids, such as OxyContin (oxycodone) and Dilaudid (hydromorphone)
• benzodiazepines, such as Xanax (alprazolam) and Valium (diazepam)
• sleep medications, such as Lunesta (eszopiclone) and Ambien and Ambien CR (zolpidem)

Unless your doctor says it’s safe, you should avoid drinking alcohol or taking these drugs while using Sublocade or Suboxone. You may also need to avoid these drugs for a while after your last Sublocade injection. This is because Sublocade can stay in your system for over a year after your last dose.

Breathing problems while taking Sublocade or Suboxone can be a medical emergency. In severe cases, breathing may stop completely and lead to coma or death. If you have trouble breathing while taking Sublocade or Suboxone, call 911 or your local emergency number right away.

Talk with your doctor about your risk for breathing problems while taking Sublocade or Suboxone.

Can Sublocade or Suboxone cause low hormone levels?

Yes, it’s possible. Taking Sublocade or Suboxone for more than a month might cause your adrenal glands to make less of a hormone called cortisol. This condition is called adrenal insufficiency.

Symptoms of adrenal insufficiency can include:

• extreme fatigue (lack of energy)
• diarrhea, nausea, or vomiting
• loss of appetite
• depression
• unintentional weight loss
• low blood pressure

If you have any of these symptoms while taking Sublocade or Suboxone, tell your doctor. They may give you a cortisol test to check the cortisol level in your blood. If the test shows that you have a low cortisol level, your doctor might prescribe corticosteroids such as prednisone to raise your cortisol level.

What is the cost of Sublocade and Suboxone?

Whether you have health insurance or not, cost may be a factor when you’re considering these drugs.

But keep in mind that what you’ll pay for either drug will depend on your treatment plan, your health insurance, and the pharmacy you use. It may also depend on the cost of the visit to your healthcare provider to receive doses of Sublocade or Suboxone.

Sublocade and Suboxone are both brand-name drugs. Suboxone also has a generic form called buprenorphine and naloxone. You’ll usually pay more for brand-name drugs than for generics. If you’re interested in using the generic form of Suboxone, talk with your doctor.

How effective are Sublocade and Suboxone?

You may wonder whether Sublocade and Suboxone are effective at treating opioid use disorder.

Both Sublocade and Suboxone have been found effective for treating this condition. Buprenorphine is the active drug in both Sublocade and Suboxone. It’s recommended by the American Society of Addiction Medicine as a treatment option for opioid use disorder.

If you’d like to read more about how each drug performed in clinical studies, see the prescribing information for Sublocade and Suboxone.

What are the warnings of Sublocade and Suboxone?

Sublocade and Suboxone may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below.

Before you start using Sublocade or Suboxone, be sure to talk with your doctor to see if these warnings apply to you.

Boxed warning for Sublocade: Risk of serious harm or death if injected into a vein

This drug has a boxed warning. This is 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.

Sublocade shouldn’t be injected into a vein. This is because the drug becomes a solid mass after it’s injected into your body. If the drug is injected into a vein, the solid mass can move through your bloodstream. It could end up blocking the blood supply to vital organs.

For this reason, Sublocade should be injected only under your skin and only by a healthcare professional. Having your injections managed by a healthcare professional helps reduce the risk of the drug being injected incorrectly.

Sublocade is only available through a drug safety program called the Sublocade Risk Evaluation and Mitigation Strategy (REMS) program. Only healthcare professionals certified by this program are able to get, prescribe, and give Sublocade.

The location where you get Sublocade must also be certified through the REMS program.

For more information about this program, talk with your doctor. You can also visit the Sublocade REMS website or call 866-258-3905.

Other warnings

In addition to the boxed warning for Sublocade above, Sublocade and Suboxone have other warnings.

Before using Sublocade or Suboxone, talk with your doctor if any of the following conditions or health factors apply to you.

• Warnings for Sublocade:
  • if you have an abnormal heart rhythm
• Warnings for Suboxone:
  • if you have underactive adrenal glands
• Warnings for both Sublocade and Suboxone:
  • if you’ve had an allergic reaction to either drug or any of their ingredients
  • if you’re pregnant* or breastfeeding
  • if you have a lung condition, such as asthma or chronic obstructive pulmonary disease (COPD)
  • if you have liver problems, such as hepatitis
  • if you have or have recently had a head injury or brain problem
  • if you have gallbladder problems

To learn more about these drugs, see the in-depth articles on Sublocade and Suboxone.

* Using Sublocade or Suboxone during pregnancy can lead to a condition called neonatal opioid withdrawal syndrome in newborns. Talk with your doctor about the risks and benefits of using these drugs while pregnant.

Can I switch between Sublocade and Suboxone?

The short answer: Yes.

Details: Before you can receive Sublocade injections, you’ll need to take another form of buprenorphine for 7 days. (Buprenorphine is the active drug in Sublocade.) This form dissolves under your tongue or inside your cheek.

Suboxone is an example of this form of buprenorphine. So, you may switch from Suboxone to Sublocade after 7 days of treatment with Suboxone.

You can also switch from Sublocade to Suboxone. But you’ll likely have to wait until it’s time for your next Sublocade injection before you make the switch. This is because Sublocade can take a while to clear from your body.

Your doctor will decide the amount of time that’s right for you to wait before switching from Sublocade to Suboxone.

Reminder: You shouldn’t switch drugs or stop your current treatment unless your doctor recommends it.

What should I ask my doctor?

Both Sublocade and Suboxone are effective for treating opioid use disorder. Suboxone can be used to help reduce the withdrawal symptoms that happen when you first stop taking opioids. It can also be taken as a long-term treatment to keep opioid cravings managed.

Sublocade can be used as a long-term treatment after your initial withdrawal symptoms are under control.

Sublocade is given by a healthcare provider. Suboxone can be given in your doctor’s office or taken at home.

If you have questions about the drug that’s best for you, talk with your doctor.

Here are a few questions that you may want to ask your doctor about Sublocade and Suboxone:

• Do I have a high risk for side effects from Sublocade or Suboxone?
• If I’m able to use both Sublocade and Suboxone, what are the reasons you might prescribe one drug over the other?
• Are there any interactions between Sublocade or Suboxone and the medications I’m already taking?
• Is my insurance more likely to cover Sublocade or Suboxone?

Ask a pharmacist

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 another 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.