From the Guidelines
No, a patient should not take Sublocade and Suboxone together as they contain the same active ingredient, buprenorphine, which can lead to excessive buprenorphine levels in the body and potentially cause serious side effects. Sublocade is a monthly injectable form of buprenorphine, while Suboxone is a daily sublingual film or tablet containing buprenorphine and naloxone. Taking both medications simultaneously would result in excessive buprenorphine levels, potentially causing serious side effects including respiratory depression, sedation, or overdose 1.
Key Considerations
- Sublocade provides steady buprenorphine levels for a full month, eliminating the need for daily dosing with Suboxone.
- Patients are typically transitioned from Suboxone to Sublocade after being stabilized on 8-24 mg of oral buprenorphine daily for at least 7 days.
- After receiving a Sublocade injection, patients should discontinue Suboxone completely.
- The transition between these medications should always be supervised by a healthcare provider who specializes in addiction medicine, as noted in guidelines for the management of opioid use disorder 1.
Potential Risks
- Excessive buprenorphine levels can cause respiratory depression, sedation, or overdose.
- Combining Sublocade and Suboxone can lead to increased risk of adverse events, such as headache, constipation, and other buprenorphine side effects 1.
- The use of buprenorphine for chronic pain management should be carefully considered, and alternative treatments should be explored before initiating or combining buprenorphine products 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Mechanism of Action Buprenorphine is a partial agonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor. The FDA drug label does not answer the question.
From the Research
Medication Interactions
- There is no direct evidence in the provided studies to suggest that Sublocade (a long-acting injectable formulation of buprenorphine) and Suboxone (a combination of buprenorphine and naloxone) can or cannot be taken together 2, 3, 4, 5, 6.
- However, it is known that both Sublocade and Suboxone contain buprenorphine, which is a partial opioid agonist, and taking them together may increase the risk of adverse effects such as overdose, respiratory depression, and sedation.
Buprenorphine Treatment
- Buprenorphine is a commonly prescribed medication for the treatment of opioid use disorder, and it has been shown to be effective in reducing opioid withdrawal symptoms and cravings 3, 4, 5, 6.
- There are different formulations of buprenorphine, including oral tablets, sublingual films, and long-acting injectable formulations like Sublocade 3, 4, 5.
Treatment Considerations
- When considering treatment for opioid use disorder, it is essential to take into account individual patient factors, such as medical history, substance use history, and personal preferences 4, 5, 6.
- Treatment decisions should be made in consultation with a healthcare provider, and patients should be closely monitored for potential adverse effects and treatment outcomes 2, 3, 4, 5, 6.