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Zubsolv
Zubsolv (generic name: buprenorphine and naloxone) is a medication used to treat opioid dependence. It is a combination of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Zubsolv helps reduce cravings and withdrawal symptoms in individuals with opioid use disorder, while naloxone is included to prevent misuse by injection. It is commonly used as part of a comprehensive treatment plan that includes counseling and behavioral therapy.
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Frequently Asked Questions
How long does it take for Zubsolv to start working?
Zubsolv begins to reduce withdrawal symptoms and cravings within 1 to 2 hours of the first dose.
Can I take Zubsolv with other medications?
Certain medications, especially CNS depressants (e.g., alcohol, benzodiazepines), can interact dangerously with Zubsolv. Always inform your healthcare provider of all medications and supplements you are taking.
Can Zubsolv be used for pain management?
Zubsolv is not indicated for pain management. It is used specifically for the treatment of opioid dependence.
What should I do if I miss a dose of Zubsolv?
If you miss a dose, take it as soon as you remember. If it’s close to the next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.
Can Zubsolv be stopped abruptly?
No, stopping Zubsolv suddenly can lead to withdrawal symptoms. Your healthcare provider will advise you on how to taper off the medication safely if needed
Comprehensive Drug Guide
How Does Zubsolv Work?
- Buprenorphine: A partial opioid agonist, buprenorphine binds to opioid receptors in the brain to reduce withdrawal symptoms and cravings while producing less euphoria and respiratory depression compared to full opioid agonists (e.g., heroin or oxycodone).
- Naloxone: An opioid antagonist, naloxone is inactive when Zubsolv is taken as directed (sublingually). If the medication is misused (e.g., injected), naloxone blocks the effects of opioids, reducing the risk of misuse.
Common Dosages
- Buprenorphine/Naloxone: 0.7 mg/0.18 mg, 1.4 mg/0.36 mg, 2.9 mg/0.71 mg, 5.7 mg/1.4 mg, 8.6 mg/2.1 mg, 11.4 mg/2.9 mg.
Typical Dosing
- The typical starting dose for Zubsolv in opioid-dependent patients is 1.4 mg/0.36 mg or 2.9 mg/0.71 mg of buprenorphine/naloxone sublingually, adjusted based on response.
- Maintenance doses range from 2.9 mg/0.71 mg to 11.4 mg/2.9 mg taken once daily.
Typical Dosing
FDA Approved Indications
- Maintenance treatment of opioid dependence as part of a comprehensive treatment plan that includes behavioral therapy and counseling.
Who Shouldn't Take Zubsolv?
- Hypersensitivity to buprenorphine, naloxone, or any other components of the formulation.
- Severe respiratory impairment or severe liver impairment (e.g., cirrhosis).
- Acute intoxication from alcohol, benzodiazepines, or other CNS depressants.
Advice From The Pharmacist
- Take Zubsolv exactly as prescribed: Place the tablet under your tongue and let it dissolve completely. Do not swallow or chew the tablet.
- Avoid alcohol and other CNS depressants (e.g., benzodiazepines), as these can increase the risk of sedation, respiratory depression, and overdose.
- Do not share Zubsolv with others, as it is a controlled substance with potential for abuse.
- Store Zubsolv securely and out of reach of children, as accidental ingestion can lead to fatal overdose.
Side Effects of Zubsolv
Common Side Effects
- Headache
- Nausea
- Sweating
- Constipation
- Drowsiness
- Insomnia
Uncommon/Severe Side Effects
- Respiratory depression (especially when combined with alcohol or other CNS depressants)
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Liver problems (yellowing of the skin or eyes, dark urine)
Risks and Warnings of Zubsolv
- Respiratory Depression: Zubsolv can cause serious or life-threatening respiratory depression, particularly when taken with alcohol, benzodiazepines, or other CNS depressants.
- Abuse and Dependence: While Zubsolv is used to treat opioid dependence, it contains buprenorphine, which has the potential for misuse and abuse. Naloxone is included to reduce the risk of misuse by injection.
- Hepatitis and Liver Damage: Buprenorphine has been associated with liver injury. Patients with a history of liver disease should be monitored closely during treatment.
Interactions with Zubsolv
Common Drug Interactions
- CNS depressants: The combination of Zubsolv with alcohol, benzodiazepines, or other sedatives can increase the risk of life-threatening respiratory depression.
- CYP3A4 inhibitors: Medications that inhibit CYP3A4 (e.g., ketoconazole, clarithromycin) may increase buprenorphine levels and the risk of side effects.
- Opioid antagonists: Medications like naltrexone may block the effects of buprenorphine and precipitate withdrawal in patients dependent on opioids.
Alternatives to Zubsolv
- Suboxone (buprenorphine/naloxone): Another buprenorphine/naloxone combination for opioid dependence, available in sublingual film.
- Subutex (buprenorphine): A monotherapy for opioid dependence used in certain patients who cannot tolerate naloxone.
- Methadone: An opioid agonist used in the treatment of opioid addiction and chronic pain.
- Naltrexone (Vivitrol): An opioid antagonist used for opioid dependence and alcohol dependence.
