Vivitrol vs. Suboxone: How Are They Different?

Vivitrol and Suboxone are both prescription drugs used in Medication for Addiction Treatment (MAT) programs for opioid use disorder. 

Vivitrol is a long-lasting naltrexone formulation, which blocks the effects of opioids and reduces your risk of relapse. Suboxone contains naloxone and buprenorphine, addressing cravings and withdrawal symptoms due to opioids.

Key Facts About Vivitrol vs. Suboxone

What Is Suboxone?

The FDA approved Suboxone in October 2002 for the treatment of opioid use disorder (OUD).[3]

Suboxone contains two ingredients:

• Buprenorphine, a partial opioid agonist, is the active ingredient in Suboxone. Buprenorphine binds to receptors in the brain to ease cravings and withdrawal symptoms.[4]
• Naloxone, a fast-acting opioid antagonist, only becomes active if the medication is used intravenously, preventing overdose, and serving as a safety mechanism if the individual attempts to misuse the medication.[5]

Suboxone comes in tablets and films, and it’s typically taken once per day.

What Is Vivitrol?

The U.S. Food and Drug Administration (FDA) approved Vivitrol in April 2006 for the treatment of OUD.[1]

Vivitrol is an injectable form of naltrexone, an opioid antagonist. Doctors use naltrexone to help patients overcome alcohol use disorder and/or opioid use disorder, as the antagonist nature of this prescription blocks the euphoric effects of both drugs.[2]

One intramuscular shot releases a consistent amount of medication into your body for roughly one month.

If someone using Vivitrol relapses to opioids or alcohol, they will not feel the same high or pleasure. Experts say this can break a drug’s psychological hold. If you use a substance and don’t feel the euphoric effects of that drug, you may not be as tempted to use again.[6]

How Do Suboxone & Vivitrol Work?

Chronic misuse of opioids like heroin, Vicodin and OxyContin causes significant changes in the brain that make controlling drug use difficult. Medications like Vivitrol and Suboxone help to treat symptoms of OUD caused by these neurological changes, but they work in very different ways.

Suboxone works in two important ways. The buprenorphine ingredient is a partial opioid agonist, which attaches to opioid receptors in the brain and reduces opioid withdrawal symptoms and cravings. Second, naloxone, which is an opioid antagonist and opioid overdose antidote, helps to deter misuse.

On the other hand, Vivitrol works by preventing your ability to get high. If you return to opioid misuse, you won’t experience euphoria or relaxation. Over time, this can help break the association between opioids and pleasure and reduce cravings. 

How Is Suboxone Different From Vivitrol?

Both Suboxone and Vivitrol are clinically proven to help people overcome OUD. But the two medications work very differently. 

Suboxone Vivitrol IngredientsBuprenorphine and naloxoneNaltrexoneWhat does it do?Reduces cravings, eases withdrawal symptoms, offers overdose protectionOffers overdose protection, renders opioids inactive (so if someone returns to drug use it is less rewarding)Delivery methodOralIntramuscular injectionHow long does one dose last?About 24 hoursRoughly 1 month 

What Are the Similarities Between Vivitrol & Suboxone?

Vivitrol and Suboxone share a few similarities. Most importantly, both of these medications are FDA-approved for OUD treatment. 

Researchers say up to 90% of people with OUD relapse within the first year of treatment. Risks are especially high within the first three months of abstinence.[8]

Medications like Vivitrol and Suboxone offer a second line of defense against relapse. If you slip while on either of these drugs, you won’t get high. Your next relapse is less likely as a result. 

Since Vivitrol and Suboxone block opioids from latching, they can both cause withdrawal symptoms in active users. A short waiting period before using these MAT solutions is required. Otherwise, you’ll feel very sick when you use them for the first time. 

Vivitrol and Suboxone can also increase your overdose risks if you quit them and relapse. Brain cells heal during even short periods of sobriety. Returning to an opioid dose you took before you started MAT could overwhelm your system and lead to life-threatening sedation. 

Which Is Better for Treating OUD?

In a study comparing Suboxone to Vivitrol, researchers found Suboxone to be a more effective treatment for OUD due to the following:[7]

• Less opioid use: People taking Suboxone had an average of 10 opioid-free days compared to 4 among those taking Vivitrol.
• Abstinence: Over the course of 144 days, people taking Suboxone reported an average of 81 abstinent days, while those taking Vivitrol reported 39 abstinent days.
• Relapse: People taking Suboxone abstained longer on average before relapse — 14 weeks compared to Vivitrol’s 8 weeks.

However, for patients who cannot tolerate Suboxone, naltrexone can be a very good alternative. Its benefits include the following:[1],[2]

• Naltrexone does not cause physical dependence.
• Naltrexone is dosed by injection once a month, which may be more realistic or convenient than a daily medication commitment.
• Even though the risk of sedation, dizziness and respiratory depression is extremely low with Suboxone, it exists. Naltrexone does not have these risks, which is another reason some patients may prefer it.

Can Suboxone Be Used With Vivitrol?

Suboxone and Vivitrol cannot be taken together. Vivitrol binds more strongly to opioid receptors in the brain than Suboxone does. Taking Vivitrol after taking Suboxone will therefore render the Suboxone ineffective or even cause withdrawal symptoms.

Usually, a patient and their doctor will decide to take one or the other at a time as the mainstay of their treatment for OUD. Talk to your doctor about which medications might be right for you.

How Bicycle Health Can Help With Opioid Use Disorder

Bicycle Health offers Suboxone therapy to people struggling with OUD. Meet with a caring, trained doctor via a secure telemedicine link, and pick up your prescription at your local pharmacy. 

Getting started is quick and easy, and Bicycle Health works with most major insurance providers. Find out more about Bicycle Health and MAT. 

Vivitrol vs. Suboxone FAQs

We’ve compiled some of the most frequently asked questions about Vivitrol vs. Suboxone below. 

Where can I get a Vivitrol injection? Treatment providers offering MAT can deliver your Vivitrol injection. Some primary care physicians also offer these shots to their patients.

How long does Vivitrol last? A Vivitrol injection should last for a month. You’ll need another intramuscular shot when it wears off.

Does Suboxone work while on Vivitrol? No. Suboxone and Vivitrol contain competing medications, and they should never be used simultaneously.

Is Vivitrol addictive? No. Vivitrol does not contain any addictive substances.

How successful is Vivitrol? Vivitrol can make a relapse less rewarding. While it doesn’t typically address drug cravings or withdrawal symptoms, if it helps break the association between drug use and euphoria/pain relief, could help curb addiction. For some people, Vivitrol is a very effective solution.