If you have opioid use disorder, your doctor may prescribe either Sublocade (buprenorphine) or Vivitrol (naltrexone) for you. With opioid use disorder, you have a strong physical and mental dependence on opioids.

Sublocade and Vivitrol are both brand-name prescription drugs. Neither drug is available in a generic form.

Read on to learn more about similarities and differences between Sublocade and Vivitrol.

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

Sublocade contains the active drug buprenorphine. It belongs to a group of drugs called partial opioid agonists. This means the drug works similarly to opioids in your body.

Vivitrol contains the active ingredient naltrexone. It belongs to a group of drugs called opioid antagonists. This means the drug blocks the effects of opioids.

Sublocade and Vivitrol are used to treat opioid use disorder. Opioid use disorder is a strong physical and mental dependence on opioids. Sometimes it’s referred to as opioid dependence.

Both Sublocade and Vivitrol are used in the maintenance phase of opioid use disorder treatment. This means you’ll use the drugs after your opioid withdrawal symptoms are already well managed. Sublocade and Vivitrol are long-term treatments that may help lessen your opioid cravings.

With Sublocade, you’ll need to use a form of buprenorphine that dissolves under your tongue or inside your cheek. You’ll take this form of buprenorphine at least 7 days before starting Sublocade.

With Vivitrol, you’ll need to stop taking all opioids and buprenorphine products beforehand. You’ll wait at least 7 days after stopping these products before starting Vivitrol. This drug can cause your body to experience opioid withdrawal if there are any opioids still in your system.

Vivitrol is also prescribed to treat alcohol dependence. Alcohol dependence is a strong physical and mental desire to drink alcohol. Vivitrol treatment may help keep people from consuming alcohol after they’ve quit drinking.

Both Sublocade and Vivitrol are used with counseling and other mental health support.

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

Can Sublocade and Vivitrol be used together?

No, Sublocade and Vivitrol can’t be used together.

Sublocade is a partial opioid agonist. This means the drug works similarly to opioids in your body. But Vivitrol is an opioid antagonist. This means the drug completely blocks the effects of opioids in your body.

If you use these drugs together, Vivitrol will block the effects of Sublocade. If you have Sublocade in your system and you use Vivitrol, you might experience unpleasant opioid withdrawal symptoms. Examples of these symptoms include belly pain, diarrhea, nausea, or vomiting.

To avoid this, don’t use Sublocade or any other buprenorphine products for at least 7 days before starting Vivitrol. If you have questions about using Sublocade and Vivitrol together, talk with your doctor.

Will I experience withdrawal if I stop my Sublocade or Vivitrol treatment?

Yes, you might have withdrawal symptoms if you stop using Sublocade treatment. Sublocade works similarly to opioids in your body. So after you stop taking it, your body needs to adjust to functioning without it.

It takes time for Sublocade to completely leave your body. So you might not have any withdrawal symptoms until a few months after your last injection.

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

On the other hand, you aren’t likely to experience withdrawal symptoms if you stop Vivitrol treatment. This is because Vivitrol works differently than opioids in your body.

If you do experience any withdrawal symptoms after stopping Sublocade or Vivitrol, tell your doctor right away. They can recommend ways to help manage your condition.

Can I take Sublocade or Vivitrol to treat an opioid overdose?

No, you shouldn’t take Sublocade or Vivitrol to treat an opioid overdose.

Both Sublocade and Vivitrol are used to help lessen your opioid cravings. The drugs are long-acting and don’t work quickly enough to treat an opioid overdose.

Narcan (naloxone) is the preferred drug for treating opioid overdose. The drug acts within minutes to help reverse an overdose.

If you have any questions about how to treat an opioid overdose, talk with your doctor.

Both Sublocade and Vivitrol are given as an injection (shot) by a healthcare provider once a month.

Sublocade is injected under your skin, usually in your belly. Vivitrol is injected into your muscle, usually in your buttocks.

Below are a few mild and serious side effects you may have while using Sublocade or Vivitrol.

For more information about possible side effects, see the article on Sublocade’s side effects and the in-depth article on Vivitrol.

Mild side effects

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

SublocadeVivitrol*
Common coldX
ConstipationX
HeadacheXX
High blood pressureX
Itching, pain, or redness where the drug was injectedXX
Nausea and vomitingX
TirednessX
ToothacheX
Trouble sleepingX

* These side effects were reported in studies of people who took Vivitrol for opioid use disorder, not for alcohol dependence.

This chart may not include all mild side effects of these drugs. For more information on mild side effects of the two drugs, see the Sublocade medication guide and Vivitrol medication guide. Talk with your doctor to learn more about the possible side effects of Sublocade or Vivitrol.

Serious side effects

In addition to the mild side effects described above, serious side effects have been reported in people using Sublocade or Vivitrol. See the chart below for a list of possible side effects.

SublocadeVivitrol
Allergic reactionXX
Depression and suicidal thoughts or actionsX
Liver problems, such as hepatitisXX
PneumoniaX
Severe pain, swelling, or hives where the drug was injectedX
Orthostatic hypotension (low blood pressure when changing positions, such as standing up)X

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

You may wonder whether Sublocade and Vivitrol are effective at treating your condition.

Both Sublocade and Vivitrol have been found to be effective for treating opioid use disorder. The American Society of Addiction Medication and the Substance Abuse and Mental Health Services Administration list both drugs as treatment options for opioid use disorder.

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

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

To see cost estimates for Sublocade and Vivitrol based on where you live, visit WellRx.com. But keep in mind that what you’ll pay for either drug will depend on your treatment plan, 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 Vivitrol.

Sublocade and Vivitrol are both brand-name drugs. These drugs also have generic forms. You’ll usually pay more for brand-name drugs than for generics. If you’re interested in using the generic form of either drug, talk with your doctor.

Sublocade and Vivitrol 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 Vivitrol, 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

Sublocade 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. Sublocade should only be injected under your skin.

Sublocade becomes a solid mass after it’s injected into your body. So if the drug is injected into a vein, this mass can move through your body. As a result, the mass may block the blood supply to your vital organs. For this reason, you’ll need to receive Sublocade injections from a healthcare provider.

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

The location where you get Sublocade must also be certified through this 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 Sublocade’s boxed warning, Sublocade and Vivitrol have other warnings.

Before using Sublocade or Vivitrol, 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
    • if you have or recently had a head injury or brain problem
  • Warnings for Vivitrol:
  • Warnings for both Sublocade and Vivitrol:
    • if you’re pregnant or planning to become pregnant*
    • if you’re breastfeeding or planning to breastfeed
    • if you have liver problems, such as hepatitis

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

* Using Sublocade during pregnancy can cause neonatal opioid withdrawal syndrome in newborns. Be sure to talk with your doctor about the risks and benefits of using this drug while pregnant.

The short answer: It’s possible.

Details: You may be able to switch from Sublocade to Vivitrol or vice versa. However, this should only be done under close supervision by a healthcare provider.

Remember that Sublocade is a partial opioid agonist, so the drug works similarly to opioids in your body. Vivitrol is an opioid antagonist, meaning it completely blocks the effects of opioids in your body. And both drugs are long-acting and stay in your system for several weeks after your last dose.

If you have Sublocade and Vivitrol in your system at the same time, Vivitrol will block the effects of Sublocade. And if you have Sublocade in your system when starting Vivitrol, you might experience unpleasant opioid withdrawal symptoms.

For this reason, you’ll likely have to wait awhile after stopping Sublocade before starting Vivitrol. Your doctor will have you get bloodwork done. This way they can see the amount of medication still in your body and tell you when to switch. When switching from Vivitrol to Sublocade, you’ll likely have to wait until it’s time for your next monthly dose.

If you have questions about making the switch, talk with your doctor.

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

Both Sublocade and Vivitrol are effective for treating opioid use disorder. Both drugs are used as long-term treatment to keep your opioid cravings under control. Vivitrol is also prescribed to treat alcohol dependence.

Sublocade comes as an injection that’s given under your skin by a healthcare provider. Vivitrol comes as an injection that’s given into your muscle by a healthcare provider. Both drugs are given once a month.

If you have questions about whether Sublocade or Vivitrol is best for you, talk with your doctor.

Below are a few other questions you may want to ask your doctor about Sublocade and Vivitrol:

  • Is there a reason why either Sublocade or Vivitrol would be better for me?
  • What can I do to lower my risk for side effects from Sublocade or Vivitrol?
  • Will I have to go through an opioid detox program before I start taking Sublocade or Vivitrol?
  • Is my risk of having withdrawal symptoms higher when starting Sublocade treatment or when starting Vivitrol treatment?

Q:

Can I drink alcohol while using Sublocade or Vivitrol to treat opioid use disorder?

Anonymous patient

A:

No, you shouldn’t drink alcohol while taking these medications.

Sublocade may cause liver damage. Alcohol can increase this risk since it’s metabolized (broken down) by the liver. Drinking alcohol also carries a risk of breathing issues or central nervous system depression. In severe cases, it can cause death.

Vivitrol is used to treat alcohol dependence in addition to opioid dependence. You shouldn’t drink alcohol while taking Vivitrol.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.