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Sublocade

Sublocade is a long-acting injectable formulation of buprenorphine, used to treat moderate to severe opioid use disorder (OUD) in adults as part of a comprehensive treatment plan that includes counseling and psychosocial support. Buprenorphine is a partial opioid agonist, which helps reduce cravings and withdrawal symptoms associated with opioid dependence. Sublocade is designed to be administered once a month, providing consistent, long-term relief from opioid dependence while reducing the risk of misuse.

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Frequently Asked Questions

How long does it take for Sublocade to start working?
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Sublocade begins to work shortly after the first injection, as buprenorphine is gradually released into the bloodstream. Full effects are seen as the depot releases buprenorphine steadily over the course of the month.

Can I take Suboxone while on Sublocade?
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No, you should not take additional buprenorphine-containing medications, such as Suboxone, while on Sublocade. Sublocade provides a continuous release of buprenorphine, and taking more could increase the risk of side effects or overdose.

Can Sublocade cause withdrawal symptoms?
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Once Sublocade is discontinued, patients may experience withdrawal symptoms. Your healthcare provider will develop a plan to taper off the medication safely, if necessary.

How long will I need to stay on Sublocade?
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The length of treatment with Sublocade varies depending on the individual and their progress in opioid addiction recovery. Some patients may stay on the medication for months or even years under their healthcare provider's supervision.

Is Sublocade covered by insurance?
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Many insurance plans, including Medicaid, cover Sublocade as part of opioid addiction treatment. Check with your healthcare provider and insurance company to confirm coverage.

Comprehensive Drug Guide

How Does Sublocade Work?

Sublocade contains buprenorphine, a partial opioid agonist that binds to opioid receptors in the brain, producing a weaker effect than full opioid agonists such as heroin or oxycodone. By doing so, it helps reduce cravings and withdrawal symptoms without producing the intense "high" associated with opioid misuse. Sublocade provides a sustained release of buprenorphine over the course of a month, offering steady opioid blockade and reducing the need for daily dosing.

Common Dosages

  • 300 mg monthly for the first two months.
  • Maintenance dose of 100 mg monthly, though some patients may require a maintenance dose of 300 mg.

Typical Dosing

  • Induction phase: Sublocade is administered once monthly, starting with 300 mg for the first two months.
  • Maintenance phase: After the induction phase, the typical maintenance dose is 100 mg once monthly, though some patients may require the 300 mg maintenance dose.

Sublocade is administered as a subcutaneous injection into the abdominal area by a healthcare professional. It should not be self-administered.

Typical Dosing

FDA Approved Indications

  • Maintenance treatment of opioid use disorder (OUD) in patients who have initiated treatment with a transmucosal buprenorphine-containing product (such as Suboxone) and are clinically stable on a low-to-moderate dose of buprenorphine. It should be used as part of a comprehensive treatment plan, including counseling and psychosocial support.

Who Shouldn't Take Sublocade?

  • Known hypersensitivity to buprenorphine or any component of the formulation.
  • Severe respiratory or liver impairment, as buprenorphine can exacerbate these conditions.

Advice From The Pharmacist

  • Sublocade is injected once a month by a healthcare provider. It is not intended for self-administration, and you must visit your doctor or clinic for each dose.
  • The injection is given subcutaneously in the abdomen, and the medication forms a depot under the skin that slowly releases buprenorphine over the month.
  • Do not massage or rub the injection site after administration, as this could affect the absorption of the medication.
  • Report any unusual side effects or signs of infection at the injection site, such as swelling, redness, or warmth, to your healthcare provider.
  • Avoid consuming alcohol or using sedatives such as benzodiazepines while on Sublocade, as this increases the risk of serious side effects, including respiratory depression.
  • Carry identification or a medical card indicating that you are receiving Sublocade, in case of emergencies where opioid-based medications may be used.

Side Effects of Sublocade

Common Side Effects

  • Injection site reactions (pain, redness, or swelling)
  • Nausea
  • Vomiting
  • Headache
  • Constipation
  • Drowsiness
  • Fatigue

Uncommon/Severe Side Effects

  • Respiratory depression, especially when combined with other sedatives or alcohol.
  • Liver problems: Signs include yellowing of the skin or eyes (jaundice), dark urine, or severe abdominal pain.
  • Serious allergic reactions: Rash, swelling, difficulty breathing, or severe dizziness.
  • Risk of overdose: Although buprenorphine has a ceiling effect (it produces a limited opioid effect), overdose is still possible, especially when combined with other opioids, alcohol, or sedatives.

Risks and Warnings of Sublocade

  • Respiratory depression: Buprenorphine, the active ingredient in Sublocade, can cause respiratory depression, especially when taken with alcohol, sedatives, or other CNS depressants. Patients should avoid these substances while on Sublocade.
  • Injection site reactions: Some patients may experience injection site reactions, including pain, swelling, or infection. Any severe or persistent symptoms should be reported to a healthcare provider.
  • Potential for misuse: While Sublocade is designed to minimize misuse, buprenorphine is still an opioid, and improper use can lead to dependence or overdose.
  • Neonatal opioid withdrawal syndrome: Babies born to mothers who receive Sublocade during pregnancy may experience withdrawal symptoms after birth. This requires medical treatment.

Interactions with Sublocade

Common Drug Interactions

  • Alcohol and CNS depressants: Combining Sublocade with alcohol, benzodiazepines (e.g., lorazepam, diazepam), or other sedatives can increase the risk of severe respiratory depression, coma, or death.
  • Other opioids: Taking additional opioids with Sublocade can reduce its effectiveness and increase the risk of overdose.
  • Certain medications for mental health: Some antipsychotics, antidepressants, and sedatives can interact with Sublocade, increasing the risk of drowsiness or respiratory depression.

Alternatives to Sublocade

  • Suboxone (buprenorphine/naloxone): A daily sublingual film or tablet that combines buprenorphine and naloxone for opioid dependence treatment.
  • Probuphine: An implantable form of buprenorphine that provides long-term treatment for opioid dependence, lasting up to six months.
  • Vivitrol (naltrexone): A monthly injectable opioid antagonist used to treat opioid and alcohol dependence. Unlike Sublocade, Vivitrol blocks opioid receptors entirely.