Does Sublocade Have Naloxone in It?

Understanding the Chemical Formulation of Sublocade

Sublocade is a prescription medication injected once per month by a healthcare professional. It is a gel-like solution that comes in a syringe and is injected underneath the skin in the abdominal area. When it comes into contact with bodily fluids, Sublocade forms a solid mass.[1] From the solid mass, buprenorphine (the active ingredient in Sublocade) is slowly and consistently released over the course of one month. 

Sublocade is an extended-release injection of buprenorphine.[1] It does not contain naloxone, which is a medication designed to reverse the effects of an opioid overdose. 

Both Sublocade and naloxone are considered safe medications, whether for the immediate treatment of an opioid overdose, as in naloxone, or for the long-term management of an opioid use disorder, as Sublocade does. Naloxone may even be administered in the event of an overdose on Sublocade.[5]

Why Is Naloxone Not Present in Sublocade?

Naloxone is used for the rapid reversal of an opioid overdose. It attaches to opioid receptors in the brain and reverses or blocks the effects of opioids.[2] While naloxone is essential in the fight against the current opioid overdose epidemic, it can counteract the effects of Sublocade.

Buprenorphine is a synthetic opioid created to treat OUD. It binds to opioid receptors in the brain to significantly reduce opioid cravings and withdrawal symptoms. It effectively treats OUD by being taken as a type of substitute medication.[3] If naloxone were present and active in Sublocade, buprenorphine could not effectively attach to opioid receptors to reduce cravings and treat OUD. 

Although Sublocade does not have naloxone in it, treatment professionals recommend prescribing naloxone to anyone taking medications containing buprenorphine. While the risk is low, overdose on drugs containing buprenorphine is possible, particularly for those who are opioid-naïve. Having naloxone on hand can quickly reverse an opioid overdose.[4]

Choosing if Sublocade Is Right For You 

Sublocade can be prescribed to anyone with a moderate to severe OUD who has already been taking a medicine containing buprenorphine for at least seven days and has not experienced withdrawal symptoms for at least seven days.[5] Sublocade stays in your system for at least one month, so doctors must see that you have a safe reaction to buprenorphine before they inject it under your skin.

Sublocade may be right for you if you meet these criteria:[5]

• You tolerate buprenorphine well and do not experience significant side effects, including difficulty breathing, blurred vision, slurred speech, difficulty concentrating or thinking clearly, liver problems, physical dependence, an allergic reaction, or feeling faint, dizzy, or confused.
• You do not have a history of alcohol use disorder. 
• You are suffering from a moderate to severe OUD.
• Any co-occurring substance use or mental health issues are also being treated.
• You are not taking any medications that pose a risk of negative interactions with Sublocade.

Sublocade is only meant to be taken as part of a comprehensive treatment program. Sublocade may be a good medication for you if you are also participating in counseling, behavioral therapy, and psychosocial therapies to help you better understand your OUD and maintain long-term recovery.

Naloxone for Opioid Overdose

Naloxone is a valuable medication for the treatment of opioid overdose. In 2020, approximately 2.7 million people were estimated to have an OUD, with over 80,400 people dying of an opioid-related overdose in 2021. Naloxone can be administered while a person is having an opioid overdose to potentially save their life.[6]

Naloxone alone is not a treatment for OUD, but it can be the first step in helping someone recover from an overdose and begin their recovery journey.[2] Co-prescribing naloxone to people who are also taking prescription opioids may prevent accidental opioid overdoses. It is commonly recommended that anyone taking opioids (whether for valid medical purposes or recreationally) have naloxone on hand.[2] 

Buprenorphine Medications Containing Naloxone

While many people prefer injectable forms of buprenorphine like Sublocade due to the ease of use, various other forms are available. Suboxone is a transmucosal form that combines buprenorphine and naloxone.[8] The naloxone component is present to serve as an abuse-deterrent. If a person attempts to abuse Suboxone, the naloxone becomes active and pushes the user into immediate withdrawal.[7]

Buprenorphine/naloxone is also prescribed under the brand names Bunavail, Zubslov, and Cassipa. It is taken as tablets or films that are placed under the tongue and absorbed into the bloodstream.[8] As with Suboxone, anyone who attempts to abuse buprenorphine/naloxone by injecting it intravenously will experience significant and unpleasant withdrawal symptoms.[7] 

If you are interested in MAT for OUD, speak with your healthcare provider or reach out to us here at Boca Recovery Center. We can help you determine the most appropriate medication to take, given your history of substance abuse and treatment goals. Through a combination of medication and behavioral therapies, OUD can be effectively treated, and you can begin to build a more satisfying life in recovery.