From the Guidelines
The proper procedure for switching from Suboxone to Sublocade requires patients to be on a stable oral buprenorphine dose before transitioning, with a recommended daily dose of 8-24 mg for at least 7 days before receiving their first Sublocade injection. When considering this transition, it's crucial to prioritize a safe and comfortable tapering regimen to avoid abrupt withdrawal or major dose reduction, as emphasized in the consensus panel recommendations 1. This approach is essential to prevent unacceptable medical care and potential risks of overdose during care transition.
Key Considerations for Transitioning
- Patients should be taking a stable dose of oral buprenorphine for at least 7 days before the first Sublocade injection.
- The initial Sublocade dose is typically 300 mg monthly for the first two months, followed by maintenance doses of 100 mg monthly, although some patients may require continued treatment at 300 mg.
- The transition should occur without a gap, with patients taking their last oral dose the day before or morning of their first injection.
- After starting Sublocade, oral buprenorphine is discontinued completely.
Administration and Monitoring
- The Sublocade injection must be administered by a healthcare professional in the abdomen as a subcutaneous depot.
- Patients should be aware of potential injection site reactions, including pain, itching, or redness.
- Regular follow-up appointments are essential to monitor treatment response and side effects, ensuring a safe and effective transition from Suboxone to Sublocade.
From the Research
Switching from Suboxone to Sublocade
To switch from Suboxone (buprenorphine) to Sublocade (buprenorphine extended-release), the following steps can be considered:
- A minimum 7-day induction period with a transmucosal buprenorphine-containing product is recommended before administering Sublocade 2.
- However, some studies suggest that a rapid transition to Sublocade within 7 days or even 24 hours is feasible and well-tolerated 3.
- A rapid micro-induction protocol, where buprenorphine/naloxone is administered for 3 days, can be used to initiate Sublocade, minimizing withdrawal symptoms 2.
Key Considerations
- Patient characteristics, such as history of opioid use disorder, mental health disorders, and social stressors, should be taken into account when switching from Suboxone to Sublocade 2, 4.
- The dosage of Sublocade should be determined based on the patient's previous buprenorphine dosage and medical history 3, 5.
- Close monitoring of the patient's response to the transition and adjustment of the dosage as needed is crucial 3, 5.
Potential Outcomes
- Successful transition to Sublocade can lead to improved treatment adherence and reduced risk of overdose 3.
- However, some patients may experience withdrawal symptoms or require additional opioid support during the transition period 3, 4.
- The effectiveness of Sublocade in maintaining long-term treatment retention and reducing opioid use disorder symptoms is still being researched 4, 6.