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Zubsolv vs. Suboxone: Comparing MAT Medications

Suboxone and Zubsolv are both medications that have been approved by the Food and Drug Administration (FDA) for the purposes of treating opioid use disorder (OUD).[1,2] They are one facet of a comprehensive medication-assisted treatment (MAT) program that helps people to stop abusing opioids without experiencing the most extreme withdrawal symptoms that can make the detox experience difficult to navigate. 

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Both medications include two active ingredients: buprenorphine and naloxone. These medications work together to reduce cravings for opioids during recovery, diminish the experience of opioid withdrawal symptoms, and decrease the risk of relapse and opioid overdose.

Either Zubsolv or Suboxone may be an effective part of a comprehensive addiction treatment program. Depending on the dosing needed for the specific individual, one or the other may be a better fit. If you have questions about Zubsolv or Suboxone for yourself or a loved one, speak with your doctor for clarification. 

Understanding Zubsolv & Suboxone

Zubsolv and Suboxone are very similar in terms of chemical makeup, safety profile, efficacy, and potential for misuse.[1,2]

Both contain buprenorphine and naloxone. Both may come with side effects like headache, nausea, insomnia, and other issues that usually fade as the body adjusts to the medication. 

Both Zubsolv and Suboxone have been proven to be effective in the treatment of opioid addiction.[3] Both have a low potential for misuse due to the inclusion of naloxone in each formulation, a medication that blocks the euphoric effects of opioids.[4]

In most cases, the choice comes down to preference, cost considerations, and the dictates of an individual’s health insurance coverage.[5]

How Does Zubsolv Work?

Zubsolv comes in the form of a sublingual tablet designed to dissolve under the tongue. Some users have reported that Zubsolv tastes more pleasant than Suboxone and is easier to use.[6] Zubsolv was approved for use shortly after Suboxone, and like Suboxone, it combines buprenorphine with naloxone. 

Buprenorphine, a partial opioid agonist, binds to opioid receptors in the brain taking the place of full opioid agonists like heroin or oxycodone. In so doing, it works to stave off withdrawal symptoms without creating a high in those who are physically dependent on opioids.[7]

Naloxone serves as a deterrent to the euphoric effects that can come with opioid use. It pushes people into precipitated opioid withdrawal if they take any opioids while Zubsolv is in their system.[8]

How Does Suboxone Work?

Suboxone works much like Zubsolv. Both medications contain buprenorphine and naloxone, so Suboxone also helps people through opioid detox and ongoing recovery by minimizing cravings and withdrawal symptoms and preventing overdose if relapse does occur. 

Suboxone, however, is available in both a film and tablet form that is designed to dissolve inside the cheek or under the tongue, respectively. It was approved for the treatment of opioid dependence first. As a result, many doctors prescribe Suboxone after a few days on buprenorphine when people seek outpatient MAT. 

Comparing Zubsolv & Suboxone 

While there are a number of similarities between Zubsolv and Suboxone, there are a few differences as well. The key difference is their bioavailability, which means that absorption efficiency in the body is a little different for each medication. 

Zubsolv has a slightly higher bioavailability. This means that lower doses of the drug can produce the same effect as higher doses of Suboxone. In most cases, this primarily impacts dosing choices made by the prescribing doctor. It can also potentially affect how a health insurance company might choose to cover the costs of the medication. 

This chart breaks down how Zubsolv and Suboxone compare:[1-5,9]

UseTreatment of opioid addiction as part of a comprehensive treatment plan that also includes therapy and group or peer supportUsed as part of a comprehensive treatment plan for opioid addiction that also includes therapeutic intervention and peer support
Drug ScheduleSchedule IIISchedule III
FormsSublingual tabletsSublingual film and tablets
How They Are UsedPlaced under the tongue to dissolvePlaced under the tongue or inside the cheek to dissolve
Common Side EffectsHeadache, nausea, vomiting, constipation, sweating, insomnia, and mouth irritationHeadache, nausea, vomiting, constipation, sweating, insomnia, and mouth irritation
Addiction PotentialLow potential for abuse and addiction due to the buprenorphine and naloxone combinationLow potential for abuse or addiction due to the interaction of buprenorphine and naloxone
CostGenerally higher due to being a newer brand-name medication with no generic versions availableLower, especially for generic versions of the medication
Insurance CoverageCoverage varies by insurance plan; may require prior authorizationBroadly covered by many insurance plans, including Medicaid; generic versions are more likely to be covered
Efficacy & SafetyComparable efficacy and safety with Suboxone for opioid addiction treatmentComparable to efficiency and safety of Zubsolv for the treatment of opioid addiction

Does One Medication Have a Higher Abuse Potential?

No, one medication does not have a higher abuse potential than the other. Both Zubsolv and Suboxone contain naloxone, which subverts the euphoric effects of opioids. This ingredient reduces the potential for abuse of the buprenorphine within the medication.[4,8]

Choosing the Right Medication for Opioid Abuse & OUD

Both Zubsolv and Suboxone are effective choices when considering MAT for OUD, especially if the person would like to undertake treatment on an outpatient basis. 

There are a few more options in dosing for Zubsolv, so if a specific dose is required that Suboxone does not offer, Zubsolv may be the solution.[10]

If cost is a primary consideration due to a lack of insurance, underinsurance, or coverage by Medicaid, Suboxone may be the better choice. It is covered by Medicaid and also available in cheaper generic versions. 

It is important to work with a medical professional who is well-versed in addiction treatment when making any choices in medication. Supervision is needed throughout the treatment process, and other interventions will be needed for comprehensive treatment.[11] 

While medication can be an essential piece of the recovery process, it isn’t enough on its own. Therapy is also needed to address the root issues that led to opioid abuse.[12]

Updated April 2, 2024
  1. Highlights of prescribing information for Suboxone sublingual film. U.S. Food and Drug Administration. Revised August 2010. Accessed March 15, 2024.
  2. Zubsolv (buprenorphine and naloxone) sublingual tablets. Zubsolv. Accessed March 15, 2024.
  3. Gunderson EW, Hjelmström P, Sumner M. Effects of a higher bioavailability buprenorphine/naloxone Sublingual tablet versus buprenorphine/naloxone film for the treatment of opioid dependence during induction and stabilization: A multicenter, randomized trialClinical Therapeutics. 2015;37(10):2244-2255.
  4. The risk of misuse and diversion of buprenorphine for opioid use disorder in Medicare Part D continues to be low: 2022. Department of Health and Human Services, Office of Inspector General. Published November 2023. Accessed March 15, 2024.
  5. How effective are medications to treat opioid use disorder? National Institute on Drug Abuse. Published December 2021. Accessed March 15, 2024.
  6. Gunderson EW, Sumner M. Efficacy of buprenorphine/naloxone rapidly dissolving sublingual tablets (BNX-RDT) after switching from BNX sublingual filmJournal of Addiction Medicine. 2016;10(2):124-130.
  7. How do medications to treat opioid use disorder work? National Institute on Drug Abuse. Published 2021. Accessed March 15, 2024.
  8. Naloxone. Substance Abuse and Mental Health Services Administration. Published January 25, 2023. Accessed March 15, 2024.
  9. Medicaid coverage of medications for the treatment of opioid use disorder state benefits at a glance. American Society of Addiction Medicine. Accessed March 15, 2024.
  10. Heo Young-A, Scott LJ. Buprenorphine/naloxone (Zubsolv®): A review in opioid dependence. CNS Drugs. 2018;32(9):875-882.
  11. Maglione MA, Raaen L, Chen C, et al. Effects of medication-assisted treatment (MAT) for opioid use disorder on functional outcomes: A systematic review. Rand Health Quarterly. 2020;8(4):RR–2108-OSD.
  12. Deyo-Svendsen M, Cabrera Svendsen M, Walker J, Hodges A, Oldfather R, Mansukhani MP. Medication-assisted treatment for opioid use disorder in a rural family medicine practice. Journal of Primary Care & Community Health. 2020;11.
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