OUD occurs when your body becomes used to having opioids, and you need to take them to feel normal. If you then stop taking opioids, you may experience withdrawal symptoms. These include vomiting, sweating, and feeling restless.
Zubsolv is a prescription medication that’s used to treat OUD in adults. It’s a tablet that dissolves under your tongue.
Zubsolv works by helping to prevent withdrawal symptoms from occurring when you use it after you stop taking opioids. Zubsolv has two active ingredients, buprenorphine and naloxone.
- Buprenorphine is an opioid, but its effects aren’t as strong as other opioids. It helps to decrease your withdrawal symptoms.
- Naloxone blocks opioid effects to help prevent misuse of Zubsolv.
This article describes the dosages of Zubsolv, including its form, strengths, and how to take the drug. To learn more about Zubsolv, see this in-depth article.
Note: This article covers Zubsolv’s typical dosages, which are provided by the drug’s manufacturer. But when using Zubsolv, always take the dosage that your doctor prescribes.
The Zubsolv dosage your doctor recommends for treating your opioid use disorder (OUD) depends on several factors. These include the type and amount of opioids you took in the past. Below are details on the form, strengths, and typical dosages for Zubsolv.
What is Zubsolv’s form?
Zubsolv comes as a tablet that dissolves under your tongue.
What strengths does Zubsolv come in?
Zubsolv contains two active ingredients, buprenorphine and naloxone. The drug comes in the following strengths:
- 0.7 milligrams (mg) of buprenorphine and 0.18 mg of naloxone
- 1.4 mg of buprenorphine and 0.36 mg of naloxone
- 2.9 mg of buprenorphine and 0.71 mg of naloxone
- 5.7 mg of buprenorphine and 1.4 mg of naloxone
- 8.6 mg of buprenorphine and 2.1 mg of naloxone
- 11.4 mg of buprenorphine and 2.9 mg of naloxone
What are the typical dosages of Zubsolv?
Typically, you’ll start on a higher dose of Zubsolv for the first few days of treatment. This is called the induction phase, and it allows your body to adjust to having Zubsolv instead of opioids. In the induction phase, your doctor may have you take the medication at their office. This way they can monitor your treatment.
After your induction phase, you’ll take a maintenance dose of Zubsolv each day. This is called the maintenance phase, and during this time you’ll take a dosage of Zubsolv that helps to prevent withdrawal symptoms. To achieve this goal, your doctor may adjust your dosage of the drug over time. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for opioid use disorder
The dosage of Zubsolv that your doctor will recommend to treat your OUD depends on many factors. Always take the dose of Zubsolv that your doctor prescribes for your specific treatment plan.
Usually, you’ll start taking Zubsolv when you begin to have withdrawal symptoms. But you should wait at least 6 hours after your last opioid dose before starting Zubsolv. This wait may help prevent you from having symptoms of withdrawal. Talk with your doctor about when you should take your first dose of Zubsolv.
Below is a dosage chart that shows examples of common dosages of Zubsolv for the induction and maintenance phases. Strengths are listed in milligrams (mg). The strength for buprenorphine appears before the strength for naloxone.
|Day 1 (induction)||Day 2 (induction)||Maintenance dosage|
|People with a history of heroin or short-acting opioid use||• Start with a dose of 1.4 mg/0.36 mg.|
• Take up to three more doses, which may be split into doses of one to two tablets of 1.4 mg/0.36 mg. Separate these doses by at least 1.5 to 2 hours.
• Maximum total dose on day 1 is 5.7 mg/1.4 mg.
|Take a single dose, maximum of 11.4 mg/2.9 mg, once on day 2.||• The recommended dosage is 11.4 mg/2.9 mg once daily.|
• Daily doses may range from 2.9 mg/0.71 mg to 17.2 mg/4.2 mg.
|People with a history of methadone or long-acting opioid use||Take buprenorphine alone.||Take buprenorphine alone, then switch to Zubsolv for maintenance treatment the next day.||• The recommended dosage is 11.4 mg/2.9 mg once daily.|
• Daily doses may range from 2.9 mg/0.71 mg to 17.2 mg/4.2 mg.
Depending on your recommended dose, you may need to take two or more Zubsolv tablets at the same time. If you do, be sure to put the tablets in different places under your tongue. This helps make sure that your body absorbs all of the medication.
Is Zubsolv used long term?
Yes, for many people Zubsolv is used as a long-term treatment.
It’s possible your doctor may slowly decrease your dose of Zubsolv so that you eventually stop taking it. But if you and your doctor determine that Zubsolv is safe and effective for you, it’s likely that you’ll use it long term.
Your doctor may adjust your dosage based on many factors. In the induction phase, your dose may depend on which opioids you took and how often you took them in the past. It may also depend on any withdrawal symptoms that you’re experiencing.
When you move on to the maintenance phase of treatment, your dosage of Zubsolv may change. Dosage adjustments in this phase will depend on withdrawal symptoms that you’re experiencing. Your doctor may increase or decrease your dose at this time to help ensure you’re benefiting from Zubsolv treatment.
Withdrawal symptoms may occur when you stop using opioids or while you’re taking Zubsolv. (Buprenorphine, one of the active ingredients in Zubsolv, is also an opioid.) These symptoms may include vomiting, sweating, and feeling restless. Withdrawal can occur when your body is used to getting a certain amount of opioids, but now it’s getting less.
You may have withdrawal symptoms when you first stop taking opioids and start taking Zubsolv. Also, because Zubsolv contains the opioid buprenorphine, you can have withdrawal symptoms if you stop treatment suddenly. You may also have withdrawal symptoms if your dose of Zubsolv is too low. If you have withdrawal symptoms at any point during your treatment, talk with your doctor.
Dependence may also occur while you’re taking Zubsolv. With opioid dependence, your body becomes used to having opioids in your system. As a result, you need opioids to feel normal. Zubsolv contains an opioid drug, so it’s possible to become dependent on Zubsolv.
Talk with your doctor if you have any concerns about withdrawal or dependence while you’re taking Zubsolv.
Below are answers to some common questions about Zubsolv.
How do the dosages for Zubsolv and Suboxone compare?
Both Zubsolv and Suboxone contain the same active drug ingredients, buprenorphine and naloxone. But these two medications are different in their forms. Zubsolv is a tablet that dissolves under your tongue. Suboxone is a film that dissolves under your tongue.
The dosages for Zubsolv and Suboxone are different as well.
To compare what dose of Zubsolv would be equivalent to a certain dose of Suboxone, see the dosing calculator provided by the manufacturer of Zubsolv. For example, the calculator indicates a Zubsolv tablet containing 5.7 milligrams (mg) of buprenorphine and 1.4 mg of naloxone is equivalent to a Suboxone film containing 8 mg of buprenorphine and 2 mg of naloxone.
If you want to switch medications, be sure to talk with your doctor first. They will recommend whether it’s possible for your treatment and how to make the switch.
For more information about the similarities and differences between Zubsolv and Suboxone, see the “Zubsolv vs. Suboxone” section in this article.
Can I crush, break, or chew my Zubsolv tablet?
No, you shouldn’t crush, break, or chew Zubsolv. This medication is meant to dissolve under your tongue. The drug may not work as well if you don’t take it as directed.
When taking your dose of Zubsolv, be sure to place the tablet under your tongue and allow it to completely dissolve. This should happen within 5 minutes.
If you have any questions about the proper way to take Zubsolv, see the “How is Zubsolv taken?” section below.
How should I take more than one Zubsolv tablet at a time?
If you’re taking more than one Zubsolv tablet for each dose, take all tablets at the same time. Place the tablets under your tongue in different areas. Be sure to separate the tablets when placing them under your tongue. This helps your body to absorb the medications.
Zubsolv is a tablet that you dissolve under your tongue. The drug may not work as well if you break or chew the tablet. If your mouth is dry before taking your dose, you may want to take a sip of water first.
To take your Zubsolv dose, open the packaging containing the tablet. Be sure not to push the tablet through the foil packaging, as this may break the tablet.
Put the tablet under your tongue and allow it to dissolve. This can take up to 5 minutes. You shouldn’t eat or drink while the tablet is dissolving. Talking while the tablet is dissolving may also decrease how well your body absorbs Zubsolv.
If you take more than one Zubsolv tablet for your dose, put the tablets in different areas under your tongue at the same time. This will help your body to properly absorb the medication.
You shouldn’t suddenly stop taking Zubsolv. This may cause you to experience withdrawal symptoms. If you wish to stop taking Zubsolv, talk with your doctor about the best way to stop treatment.
Before you take your first dose of Zubsolv, talk with your doctor or pharmacist about how to take the medication. For step-by-step instructions on how to take your Zubsolv dose, see the drug’s medication guide.
The dosage of Zubsolv you’re prescribed may depend on several factors. These include:
- the severity of your condition
- which opioids you took in the past
- how often you were taking opioids in the past
- withdrawal symptoms that you’re experiencing
- other conditions you may have
If you have any questions about factors that can affect your dosage, talk with your doctor.
If you miss a dose of Zubsolv, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Never take two doses at once unless your doctor recommends that you do this.
If you have any questions about when to take your next dose after missing a dose, talk with your doctor.
If you need help remembering to take your dose of Zubsolv on time, try using a medication reminder. This can include setting an alarm, downloading a reminder app, or setting a timer on your phone. A kitchen timer can work, too.
There is a risk of misuse with Zubsolv. “Misuse” refers to taking a drug in a way that’s different from what’s prescribed, or taking a drug that was prescribed to someone else.
Misuse of a drug may put you at risk for more side effects or overdose. This is because you aren’t using the medication in the way that it’s intended.
Misuse is possible because one of the drug ingredients in Zubsolv, buprenorphine, is an opioid. This means that people may take more Zubsolv than recommended. Or people who aren’t prescribed the drug may use the medication for its opioid effects.
If you’re concerned about possible misuse of Zubsolv, talk with your doctor. They may monitor your treatment more closely or recommend a different treatment plan for you.
Don’t use more Zubsolv than your doctor prescribes. Using more than this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- small pupils (also called pinpoint pupils)
- feeling sleepy
- decreased blood pressure
- trouble breathing or slowed breathing rate
In some cases, Zubsolv overdose may cause death.
Zubsolv should never be used as a treatment for pain. And for people who haven’t taken opioid drugs before, even the lowest dose of Zubsolv may cause overdose or death.
What to do in case you take too much Zubsolv
Call your doctor right away if you think you’ve taken too much Zubsolv. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.
The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Zubsolv for you, they will prescribe the dosage that’s right for you.
Remember, you shouldn’t change your dosage of Zubsolv without your doctor’s approval. Only take Zubsolv exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- Does my dosage of Zubsolv need to change if I’m taking other prescription medications?
- Will I have to come into the office for treatment, or can I take this medication at home?
- What is a good dosage schedule for me, and when should I start decreasing my dose?
- If I’m still having withdrawal symptoms, should my dosage of Zubsolv change?
- Would a change in dosage affect my risk for side effects?
Why do I have to take multiple doses of Zubsolv over the course of my first day of treatment but only one dose per day for maintenance treatment?Anonymous patient
Before you start taking Zubsolv, your doctor will ask what type of opioids you’re using, the last time you used an opioid, and your level of dependence. They will consider all of these factors when choosing your starting dose of Zubsolv.
It’s not known when you start Zubsolv if you will experience any withdrawal symptoms such as vomiting, sweating, and feeling restless. Your doctor will try to prevent you from experiencing withdrawal by starting you on 1.4 milligrams (mg) of buprenorphine and 0.36 mg of naloxone. They will then re-evaluate your need for additional doses of Zubsolv on the first day of treatment.
If you begin to have signs and symptoms of withdrawal, your doctor will likely recommend additional doses of Zubsolv on the first day of treatment.
Remember that dosing differs for each person. Once your doctor has found the right dose of Zubsolv for you, you will continue on a once-daily dose of Zubsolv for maintenance treatment.Melissa Badowski, PharmD, MPH, FCCPAnswers 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.