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What is the difference between Suboxone and Sublocade?
Suboxone is a daily medication taken under the tongue, while Sublocade is a monthly injection. Both contain buprenorphine, but differ in how they are administered and how dosing is managed.
The formulations
Same active medication, different delivery.
Suboxone (buprenorphine/naloxone) is taken sublingually — dissolved under the tongue or in the cheek — once daily. Sublocade and Brixadi are extended-release injectable buprenorphine formulations administered by a clinician that release buprenorphine gradually over time.
Suboxone (sublingual)
Contains buprenorphine and naloxone. Taken daily at home. Provides flexibility in dosing and does not require clinic visits for administration. The patient manages their own adherence.
Sublocade (monthly injection)
Extended-release buprenorphine subcutaneous injection administered monthly by a clinician. Does not contain naloxone. Helps maintain more consistent buprenorphine exposure without daily dosing decisions. Available in 100mg and 300mg doses.
Brixadi (weekly or monthly injection)
A newer extended-release injectable buprenorphine approved in 2023. Available in weekly and monthly formulations, offering more dosing flexibility than Sublocade. Also does not contain naloxone.
Clinical considerations
When each formulation may be preferred.
Reasons for injectable formulations
Extended-release injectables remove daily adherence demands and may reduce diversion risk, provide consistent blood levels without peaks and troughs, and may benefit patients for whom daily dosing is challenging — including those with unstable housing or complex daily circumstances.
Reasons for sublingual formulations
Sublingual Suboxone allows flexibility in dose adjustment based on clinical response. Patients can manage dosing at home, and the formulation is widely available at pharmacies. Initiation is straightforward and does not require clinic-based injection procedures.
Initiation requirement
Both Sublocade and Brixadi are generally initiated after a patient has first tolerated and stabilized on transmucosal buprenorphine, according to product-specific guidance. They are not used as initial induction agents. Patients usually begin with sublingual or other transmucosal buprenorphine before transitioning to an injectable formulation, though the exact timing depends on the product and clinical plan.
Sources
Where this information comes from.
DailyMed: Sublocade Prescribing Information
Official FDA-approved prescribing information for extended-release injectable buprenorphine (Sublocade).
Haight et al. — Sublocade Phase 3 RCT, Lancet (2019)
Randomized trial demonstrating efficacy and safety of extended-release injectable buprenorphine for OUD.
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Common questions
Frequently asked
Who is injectable buprenorphine most appropriate for?
Injectable buprenorphine may be considered for patients who prefer not to manage daily dosing, have concerns about diversion, or have had difficulty with sublingual adherence. The decision is made with your physician.
Does insurance cover Sublocade?
Coverage varies by plan. Sublocade and Brixadi are significantly more expensive than sublingual buprenorphine. Prior authorization is often required.
Is there a waiting period before starting Sublocade?
Many protocols require a period of stable sublingual buprenorphine before transitioning to the injectable form — typically to confirm tolerability and establish the right dose. The specifics vary by product and clinical judgment.
