Sublocade is prescribed to help people who are living with opioid use disorder (OUD) to manage withdrawal symptoms that occur when they stop taking their opioid of choice.[1] It is a brand-name form of the drug buprenorphine that is administered monthly as a subcutaneous injection. Because of its unique formulation and transdermal placement, it stays in your system for far longer than the pill or sublingual film forms of buprenorphine.
How Sublocade Works
Since buprenorphine occupies opioid receptors, you won’t experience strong opioid withdrawal symptoms or cravings while on Sublocade. The medication will also block or inhibit the effect of other opioids, making them less effective. This reduces the likelihood of relapse.
Due to its long-lasting formulation, Sublocade can help with treatment compliance. You won’t forget to take Sublocade since it’s injected once a month in a doctor’s office or clinic.
How Long Does Sublocade Stay in Your System?
Everyone is different when it comes to metabolizing medications, but in general, Sublocade is designed to remain in your system, at least to some degree, for up to a year.[2] However, the substance is only active in the body for six weeks to two months after the injection.[3] To ensure that levels of the drug stay high enough to be effective, most doctors will recommend that patients receive a new injection of Sublocade each month.
After cessation of active use, levels of Sublocade will remain in the body but continually decrease. This means that levels may not be sufficient to aid in the recovery process, but the drug may continue to show up on drug tests that test for buprenorphine for up to a year.
Though Sublocade remains in your system for a long time, skipping an injection can mean that the medication stops working and the withdrawal symptoms it is designed to prevent during opioid detox may occur. Relapse to opioid misuse is likely during this time if there isn’t a treatment plan in place.
Taking Sublocade may affect the way the body processes other pain medications, so it is important to let your doctor know that you have taken the drug if you require pain management.
Factors That Influence the Sublocade Timeline
Various physiological and behavioral factors can impact how long it takes for Sublocade to fully process out of the body. Some of these factors include the following.
Weight
Medications may move more slowly out of people who carry more weight compared to those who are similar in every other way but weigh less. Buprenorphine is lipid soluble, which means that it is redistributed among fatty tissue. With more fatty tissue to disperse the medication through, more time is needed to fully process all of the medication out of one’s system.[4]
Metabolism
Metabolism is the process of breaking down a substance in the body. People who have a naturally high metabolism or take other medications that increase their metabolism will find that their levels of Sublocade drop more quickly compared to those with a lower metabolism.
Liver Function
Buprenorphine is metabolized in the liver. If the person taking the drug has any liver dysfunction (such as liver disease or hepatitis A, B or C), their metabolism of the drug may be altered.[5]
Those who have liver function issues will require close monitoring to ensure that the dose is never too high and their bodies are able to make use of the drug.
Overall Health
Metabolism may be slower or higher in individuals who struggle with overall health issues, depending on the nature of their co-occurring disorders.
Age
Older people tend to metabolize medications more slowly than younger adults as their liver mass decreases and their “first pass” metabolism level is decreased.[6] This means that the drug may be less bioavailable when processed by the liver before it is released into the system.
Duration & Frequency of Use
There is a required minimum of 26 days between doses of Sublocade, but patients may take the medication once every 30, 45 or 60 days, depending on their doctor’s recommendation.[1]
The more frequently that someone takes the medication, the more it will build up in their system, and the longer it will take to process out of their system.
Use of Other Substances
Other substances, including other prescribed medications, may impact the efficacy of Sublocade as well as how long it takes to metabolize out of the system and no longer be detectable on drug tests.
What Is the Half-Life of Sublocade?
The half-life of any drug is the amount of time it takes for half of the dose to fully process out of the body. For Sublocade, the half-life is anywhere from 43 to 60 days.[3] This is equal to the amount of time it is active and effective in the body and the reason why most doctors will have their patients repeat their dose once a month to maintain effective levels of the medication.
This long half-life is why it takes so long for Sublocade to no longer be detectable in the system.
Is Sublocade Available in an Extended-Release Formula?
Sublocade is an extended-release version of buprenorphine, which is otherwise available in sublingual film or pills. These other forms of buprenorphine have a much shorter half-life and therefore a decreased period of efficacy.[7] There is not an immediate-release form of Sublocade.
MAT for Opioid Misuse & OUD
Medication for Addiction Treatment (MAT) is the most recommended treatment for people with OUD. While Sublocade can be a part of an MAT treatment plan, it is not recommended very early in recovery. A person has to be on Suboxone for at least seven days before getting Sublocade.
At Bicycle Health, we offer a comprehensive MAT program with Suboxone via our telehealth services. You can meet with an addiction treatment professional from home, no matter where you live, and receive a prescription for Suboxone that you can pick up locally.
Once you’re stable in recovery, if you decide you’d like to switch from Suboxone to Sublocade, you can talk to your treatment team about how to proceed.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Keep patients moving toward recovery with once monthly Sublocade. Indivior. Accessed December 20, 2023. https://www.sublocadehcp.com/.
- Boyett B, Nadipelli VR, Solem CT, Chilcoat H, Bickel WK, Ling W. Continued posttrial benefits of buprenorphine extended release: RECOVER study findings. Journal of Addiction Medicine. 2023;17(2):182-189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022675/
- Sublocade prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed December 10, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/209819s017s018lbl.pdf
- Kitzmiller JP, Barnett CJ, Steiner NS, et al. Buprenorphine: revisiting the efficacy of transdermal delivery system. Therapeutic Delivery. 2015;6(4):419-422. https://doi.org/10.4155/tde.15.3
- Buprenorphine. National Library of Medicine. Published November 30, 2023. Accessed December 20, 2023. https://www.ncbi.nlm.nih.gov/books/NBK459126/
- Mangoni AA, Jackson SHD. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology. 2004;57(1):6-14. https://doi.org/10.1046/j.1365-2125.2003.02007.x
- Buprenorphine quick start guide. Substance Abuse and Mental Health Services Administration. Accessed December 10, 2023. https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf.
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