Looking for treatment? Call or text (888) 835-9995 to start care today — or return to the homepage.
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.
FDA press announcement on the approval of extended-release injectable buprenorphine.
Haight et al. — Sublocade RCT (2019)
Randomized trial demonstrating efficacy and safety of extended-release injectable buprenorphine for OUD.