How to Switch From Suboxone to Sublocade Safely

Suboxone and Sublocade are brand-name drugs used in Medication for Addiction Treatment (MAT) programs.[1,2] Both contain buprenorphine, a critical therapy for opioid use disorders (OUDs). 

Before you can start Sublocade, you must use Suboxone. Switching is relatively easy. 

Your doctor can help you make the switch from one therapy to another. Know that it will take at least a week to do so. 

What Is Suboxone?

Suboxone is a brand-name medication containing buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist).[1] Dissolving pills, patches or films deliver ingredients into your bloodstream through your oral tissues. 

For people with OUD, a typical Suboxone dose is 16 mg of buprenorphine/4 mg of naloxone as a single daily dose.[1]

Take your Suboxone as directed, and you won’t notice the naloxone. But try to inject your medication, and this ingredient will activate to block your high. 

What Is Sublocade?

Sublocade is a brand-name medication containing buprenorphine in an injectable format. Needles come pre-loaded with either 100 mg or 300 mg of buprenorphine. One injection lasts for a month.[2] This medication must be administered by a medical provider.

For people with OUD, a typical Sublocade dose is 100 mg monthly. If that’s not enough to ease your symptoms, 300 mg monthly can be used instead.[2]

What Makes Them Different?

While Suboxone and Sublocade both contain buprenorphine, these medications work very differently to help you recover from OUD. Here are some of the ways they vary:[1,2] 

Administration 

Suboxone is designed to melt in your mouth. Your doctor writes a prescription you fill at a local pharmacy, and you take each dose at home. Most people use their medication first thing in the morning, but you can find a time that’s best for you. 

Sublocade requires a doctor’s appointment. Your provider will inject the medication into your body and deliver your dose once per month. 

Length of Protection 

Suboxone is made for daily dosing. After about 24 hours, you may notice that the drug is wearing off and it’s time to take it again.

Sublocade offers at least 30 days of protection. The buprenorphine in your shot is long-lasting and keeps working long after the pinch of the shot wears off. 

Ease of Use

Some people find Suboxone’s format easier to use. You won’t need an appointment or a professional’s help to address your OUD, as you’ll do all the work of taking the medication at home. 

But some people appreciate a once-monthly form of addiction care. Rather than taking Suboxone every day, they appreciate getting a shot of Sublocade just once per month. After that shot, they don’t have to remember their dosing schedule on a daily basis.

Cost

Generic forms of Suboxone are available, dramatically reducing your potential costs. No generic forms of Sublocade are available, so this medication is much more expensive. And some doctors charge fees for appointments and administering the drug. 

Misuse Protection 

Suboxone includes naloxone, ensuring you can’t get high if you try to inject the drug. Naloxone may also offer some protection if you slip and relapse to stronger drugs like heroin. Its presence also simply discourages attempts at misuse.

Sublocade doesn’t include naloxone. But it’s not designed for at-home use, so it’s difficult to misuse. But if you slip and use a stronger drug while on Sublocade, you could overdose. 

Attempts to overcome Sublocade’s effects by taking very high doses of opioids could be fatal. If you are feeling like you may relapse, talk to your treatment provider. They can help you determine next steps and support you, so you don’t relapse and potentially overdose.

How to Switch From Suboxone to Sublocade

You can’t use Sublocade during withdrawal. Doctors need to titrate your buprenorphine dose very carefully as you adjust from misusing opioids to MAT. Everyone who uses Sublocade has switched from a drug like Suboxone at some point. 

It involves two basic steps:

1. Start Suboxone. You must be on a Suboxone dose equivalent to 8 mg to 24 mg of buprenorphine daily for at least a week.[2] Your dose must be stable, meaning that you’re not taking more one day and less the next. Your doctor should consider your recovery stable. 
2. Get your shot. Your doctor will provide a 300 mg Sublocade shot to kick off your treatment.[3] Most people switch to a 100 mg monthly dose after a few months. But starting with a stronger dose is recommended. 

Because Sublocade doesn’t include misuse protection, your doctor may provide a naloxone spray.[2] If you relapse, this medication could reverse an overdose and save your life.[3,4] Keep it with you, and train your family and friends to use it if you’re unconscious.