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Switching (Safely) From Suboxone to Sublocade

Sublocade and Suboxone are two medications used for the treatment of opioid use disorder (OUD). Both medications contain buprenorphine, which reduces opioid cravings and withdrawal symptoms, allowing users to achieve and maintain recovery.

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However, the medications vary somewhat and have slightly different indications for use. Keep reading to learn how and when to switch from Suboxone to Sublocade. 

Switching From Suboxone to Sublocade

Switching from Suboxone to Sublocade must be done under the care of a medical professional. While Suboxone can be taken at home, Sublocade is only administered by trained professionals in a medical setting.[3]

Suboxone

Suboxone (buprenorphine/naloxone) is prescribed to treat OUD when a person initially begins the withdrawal process as well as for extended management of OUD. Buprenorphine helps to reduce withdrawal symptoms and cravings, while naloxone blocks the effects of opioids, discouraging abuse of the medication. 

Suboxone is taken daily as a tablet or film that dissolves underneath the tongue. It can be prescribed in varying doses to patients and self-administered at home.[2]

Sublocade

Sublocade is designed for the long-term treatment of moderate to severe OUD. Once a person has become stabilized on a medication containing buprenorphine, like Suboxone, they may wish to switch to Sublocade.[1] 

Sublocade may be more appealing for some people, as they don’t need to remember to take it every day. The medication also poses little risk of misuse since it must be injected by a medical professional.

Sublocade is injected under the skin once per month, and a steady amount of medication remains in the person’s system, managing opioid withdrawal symptoms and cravings. For people who are in a stable state of withdrawal and no longer actively misuse opioids, Sublocade can help them maintain recovery for as long as necessary.[1]

Recommended Steps to Switch Safely to Sublocade

Sublocade can be beneficial for some people since it means they don’t have to remember to take their daily dose of Suboxone. This can simplify the recovery process for many, increasing treatment compliance. 

Review the steps below for how to switch safely to Sublocade: 

1. Consult With Your Doctor

If you want to switch to Sublocade, speak with your healthcare provider or the treatment professional who has been managing your withdrawal and recovery process thus far. They must see that you have been on a stable dose of a buprenorphine medication, like Suboxone, for at least seven days, and that your withdrawal symptoms have been effectively managed.[4] They will help you decide if Sublocade is the best and safest treatment option for you moving forward. 

2. Take Suboxone for at Least One Week

Suboxone, or another medication containing buprenorphine, must be taken for at least one week before you can safely switch to Sublocade.[3] Suboxone is administered daily in much smaller doses than Sublocade, so any negative side effects that occur can be quickly addressed. If you have not had a negative reaction to buprenorphine and it effectively manages your OUD symptoms, your doctor may decide you are ready for Sublocade.

3. Receive Your Sublocade Injection 

Once you and your doctor have decided it is safe for you to switch to Sublocade, it is time to receive your first injection. The recommended starting dose of Sublocade is 300 mg for the first two months, followed by monthly injections of 100 mg as maintenance treatment for as long as you need it.[1]

Sublocade can only be administered by a trained professional, as doing it yourself poses a risk of injecting intravenously (into a vein), which can cause serious health problems. The Risk Evaluation and Mitigation Strategy (REMS) program helps to ensure that Sublocade is properly injected by trained medical professionals. Sublocade is only dispensed directly to healthcare providers and never directly to patients.[3]

4. Participate in a Treatment Program

Sublocade is meant to be used as one part of a comprehensive addiction treatment program. Anyone receiving Sublocade injections should also be receiving counseling and other forms of support to increase the efficacy of treatment. Behavioral treatment is often recommended as part of an MAT program.[1] 

Participating in a comprehensive treatment program while taking Sublocade helps reduce the risk of relapse and potential overdose. People who participate in MAT programs, which include medication and therapy, reduce their risk of death from all causes by 50%, says the FDA.[3]

5. Monitor Any Side Effects

Once you have received your Sublocade injection, monitor the occurrence of any side effects. Common side effects are likely to occur and go away on their own. However, more serious side effects may not resolve themselves and may require medical attention. 

Common side effects of Sublocade include the following:[4]

Serious side effects of Sublocade that warrant medical attention include the following:[4]

Can You Take Suboxone on Sublocade? 

You cannot take Suboxone while on Sublocade because it contains the same active ingredient—buprenorphine. While buprenorphine is a Schedule III drug, meaning it has a low to moderate risk of abuse, it is possible to develop a dependency on it or even overdose (if you are opioid naïve). 

The dose of Sublocade prescribed is carefully decided by your doctor based on your substance use, health history, and treatment needs. Combining Suboxone and Sublocade would significantly increase the amount of buprenorphine being consumed, which could cause dangerous side effects. These two medications would not be prescribed together by a doctor.

If you have been taking Suboxone for at least one week and feel you are ready to transition to Sublocade for the long-term management of your OUD, speak with your treatment team. They can review your treatment options and goals, and create a plan for the safest way for you to switch to Sublocade. 

Updated March 18, 2024
Resources
  1. Clinical review report: Buprenorphine extended-release injection (Sublocade). Canadian Agency for Drugs and Technologies in Health. Published July 2019. Accessed February 23, 2024.
  2. Buprenorphine/naloxone (Suboxone). National Alliance on Mental Illness. Published January 2023. Accessed February 23, 2023.
  3. FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder. U.S. Food & Drug Administration. Published November 30, 2017. Accessed February 23, 2024.
  4. Prescribing information: Sublocade (buprenorphine extended-release) injections, for subcutaneous use. Published December 2023. Accessed February 23, 2024.
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