Sublocade (buprenorphine) and Vivitrol (naltrexone) are prescription drugs used to treat opioid use disorder. Vivitrol is also prescribed for alcohol use disorder. Both drugs come as an injection given once per month. They’re not available as generic drugs.
Sublocade contains the active drug buprenorphine. It belongs to a group of drugs called partial opioid agonists. This means the drug works similarly to opioids in your body.
Vivitrol contains the active ingredient naltrexone. It belongs to a group of drugs called opioid antagonists. This means the drug blocks the effects of opioids.
Sublocade and Vivitrol are prescribed to treat opioid use disorder. Opioid use disorder is a strong physical and mental dependence on opioids. Sometimes it’s referred to as opioid dependence.
Both Sublocade and Vivitrol are prescribed in the maintenance phase of opioid use disorder treatment. This means you’ll take the drugs after your opioid withdrawal symptoms are already well managed. Sublocade and Vivitrol are long-term treatments that may help lessen your opioid cravings.
With Sublocade, you’ll need to use a form of buprenorphine that dissolves under your tongue or inside your cheek. You’ll take this form of buprenorphine at least 7 days before starting Sublocade.
With Vivitrol, you’ll need to stop taking all opioids and buprenorphine products beforehand. You’ll wait at least 7 days after stopping these products before starting Vivitrol. This drug can cause your body to experience opioid withdrawal if there are any opioids still in your system.
Vivitrol is also prescribed to treat alcohol use disorder. Alcohol use disorder, also called alcohol dependence, is a strong physical and mental desire to drink alcohol. Vivitrol treatment may help keep people from consuming alcohol after they’ve quit drinking.
Both Sublocade and Vivitrol are recommended along with counseling and other forms of support.
Get answers to some frequently asked questions about Sublocade and Vivitrol.
Can Sublocade and Vivitrol be used together?
No, Sublocade and Vivitrol can’t be used together.
Sublocade is a partial opioid agonist. This means the drug works similarly to opioids in your body. But Vivitrol is an opioid antagonist. This means the drug completely blocks the effects of opioids in your body.
If you use these drugs together, Vivitrol will block the effects of Sublocade. If you have Sublocade in your system and you use Vivitrol, you might experience unpleasant opioid withdrawal symptoms. Examples of these symptoms include abdominal pain, diarrhea, nausea, or vomiting.
To avoid this, do not use Sublocade or any other buprenorphine products for at least 7 days before starting Vivitrol. If you have questions about using Sublocade and Vivitrol together, talk with your doctor.
Will I experience withdrawal if I stop my Sublocade or Vivitrol treatment?
Yes, you might have withdrawal symptoms if you stop using Sublocade treatment. Sublocade works similarly to opioids in your body. So after you stop taking it, your body needs to adjust to functioning without it.
It takes time for Sublocade to completely leave your body. So you might not have any withdrawal symptoms until a few months after your last injection.
Because of the risk of withdrawal, you should not abruptly stop your Sublocade treatment unless your doctor recommends it.
On the other hand, you aren’t likely to experience withdrawal symptoms if you stop Vivitrol treatment. This is because Vivitrol works differently than opioids in your body.
If you do experience any withdrawal symptoms after stopping Sublocade or Vivitrol, tell your doctor right away. They can recommend ways to help manage your condition.
Can I take Sublocade or Vivitrol to treat an opioid overdose?
No, you should not take Sublocade or Vivitrol to treat an opioid overdose.
Both Sublocade and Vivitrol are used to help lessen your opioid cravings. The drugs are long-acting and don’t work quickly enough to treat an opioid overdose.
Naloxone (Narcan, RiVive, others) is the preferred drug for treating opioid overdose. The drug acts within minutes to help reverse an overdose.
If you or someone you love is at risk for an opioid overdose, talk with your doctor or pharmacist about having naloxone on hand. Ask them to explain the signs of an overdose and show you and your loved ones how to use naloxone. You can get naloxone at a pharmacy without a prescription.
If you have any questions about how to treat an opioid overdose, talk with your doctor.
Both Sublocade and Vivitrol are given as an injection (shot) by a healthcare professional once a month.
Sublocade is injected under your skin, usually in your abdomen. Vivitrol is injected into your gluteal (buttock) muscle.
Below are a few mild and serious side effects you may have while using Sublocade or Vivitrol.
For more information about possible side effects, see these in-depth side effects articles about Sublocade and Vivitrol.
Mild side effects
Sublocade and Vivitrol may cause mild side effects. The chart below lists examples of mild side effects that have been reported with these drugs.
| Sublocade | Vivitrol* | |
|---|---|---|
| common cold_ | — | ✓ |
| constipation | ✓ | — |
| headache | ✓ | ✓ |
| high blood pressure | — | ✓ |
| itching, pain, redness, or deepening of skin color where the drug was injected | ✓ | ✓ |
| nausea and vomiting | ✓ | — |
| tiredness | ✓ | — |
| toothache | — | ✓ |
| trouble sleeping | — | ✓ |
* These side effects were reported in studies of people who took Vivitrol for opioid use disorder, not for alcohol use disorder.
This chart may not include all mild side effects of these drugs. For more information on mild side effects of the two drugs, see the prescribing information for Sublocade and Vivitrol.
Serious side effects
In addition to the mild side effects described above, serious side effects have been reported in people using Sublocade or Vivitrol. See the chart below for a list of possible side effects.
| Sublocade | Vivitrol | |
|---|---|---|
| allergic reaction | ✓ | ✓ |
| depression and suicidal thoughts or actions | — | ✓ |
| liver problems, such as hepatitis | ✓ | ✓ |
| pneumonia | — | ✓ |
| severe pain, swelling, or hives where the drug was injected | — | ✓ |
| orthostatic hypotension (low blood pressure when changing positions, such as standing up) | ✓ | — |
To learn more about your risk for serious side effects from Sublocade or Vivitrol, talk with your doctor.
You may wonder whether Sublocade and Vivitrol are effective at treating your condition.
Both Sublocade and Vivitrol have been found to be effective for treating opioid use disorder. The American Society of Addiction Medication and the Substance Abuse and Mental Health Services Administration list both drugs as treatment options for opioid use disorder.
The American Academy of Psychiatry also recommends naltrexone (Vivitrol’s active ingredient) for treating alcohol use disorder.
Whether you have health insurance or not, cost may be a factor when you’re considering these drugs. You can visit Optum Perks* to get price estimates for Suboxone when you use coupons from the site. It’s important to note that Optum Perks coupons cannot be used with any insurance copays or benefits.
Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use. It may also depend on the cost of the visit to your healthcare professional to receive doses of Sublocade or Vivitrol.
Sublocade and Vivitrol are both brand-name drugs that are not currently available in generic form. (You’ll usually pay more for brand-name drugs than for generics.)
For details about the cost of Vivitrol treatment, you can refer to this article.
* Optum Perks is a sister site of Healthline.
Sublocade and Vivitrol may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below.
Before you start using Sublocade or Vivitrol, be sure to talk with your doctor to see if these warnings apply to you.
Boxed warning for Sublocade: Risk of serious harm or death if injected into a vein
Sublocade has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Sublocade should not be injected into a vein. Sublocade should be injected under your skin only.
Sublocade becomes a solid mass after it’s injected into your body. So if the drug is injected into a vein, this mass can move through your body. As a result, the mass may block the blood supply to your vital organs. For this reason, you’ll need to receive Sublocade injections from a healthcare professional.
Sublocade is only available through the Sublocade Risk Evaluation and Mitigation Strategy (REMS) program. Only healthcare professionals certified by this drug safety program are able to get, prescribe, and give Sublocade. The location where you get Sublocade must also be certified through this program. Sublocade is a controlled substance, meaning it’s regulated by the government due to its risk of misuse and dependence.
For more information about this program, talk with your doctor. You can also visit the Sublocade REMS website or call 866-258-3905.
Other warnings
In addition to Sublocade’s boxed warning, Sublocade and Vivitrol have other warnings.
Before using Sublocade or Vivitrol, talk with your doctor if any of the following conditions or health factors apply to you.
- Warnings for Sublocade:
- if you have an atypical heart rhythm
- if you have a lung disease, such as asthma or chronic obstructive pulmonary disease (COPD)
- if you have or recently had a head injury or brain problem
- if you have gallbladder problems
- Warnings for Vivitrol:
- if you have kidney problems, such as kidney failure
- Warnings for both Sublocade and Vivitrol:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or planning to become pregnant*
- if you’re breastfeeding or planning to breastfeed
- if you have liver problems, such as hepatitis
* Using Sublocade during pregnancy can cause neonatal opioid withdrawal syndrome in newborns. Be sure to talk with your doctor about the risks and benefits of using this drug while pregnant.
The short answer: It’s possible.
Details: You may be able to switch from Sublocade to Vivitrol or vice versa. However, this should only be done under close supervision by a healthcare professional.
Sublocade is a partial opioid agonist, so the drug works similarly to opioids in your body. Vivitrol is an opioid antagonist, meaning it completely blocks the effects of opioids in your body. And both drugs are long-acting and stay in your system for several weeks after your last dose.
If you have Sublocade and Vivitrol in your system at the same time, Vivitrol will block the effects of Sublocade. And if you have Sublocade in your system when starting Vivitrol, you might experience unpleasant opioid withdrawal symptoms.
For this reason, you’ll likely have to wait at least 2 weeks after stopping Sublocade before starting Vivitrol. Your doctor will have you get bloodwork done. This way they can see the amount of medication still in your body and tell you when to switch. When switching from Vivitrol to Sublocade, you’ll likely have to wait until it’s time for your next monthly dose.
If you have questions about making the switch, talk with your doctor.
Reminder: You should not switch drugs or stop your current treatment unless your doctor recommends it.
Both Sublocade and Vivitrol are effective for treating opioid use disorder. Both drugs are used as long-term treatment to keep your opioid cravings under control. Vivitrol is also prescribed to treat alcohol use disorder.
Sublocade comes as an injection that’s given under your skin by a healthcare professional. Vivitrol comes as an injection that’s given into your gluteal (buttock) muscle by a healthcare professional. Both drugs are given once a month.
If you have questions about whether Sublocade or Vivitrol is best for you, talk with your doctor.
Below are a few other questions you may want to ask your doctor about Sublocade and Vivitrol:
- Is there a reason why either Sublocade or Vivitrol would be better for me?
- What can I do to lower my risk of side effects from Sublocade or Vivitrol?
- Will I have to go through an opioid detox program before I start taking Sublocade or Vivitrol?
- Is my risk of having withdrawal symptoms higher when starting Sublocade treatment or when starting Vivitrol treatment?
Q:
Can I drink alcohol while using Sublocade or Vivitrol to treat opioid use disorder?
AnonymousA:
No, you should not drink alcohol while taking these medications.
Sublocade may cause liver damage. Alcohol can increase this risk since it’s metabolized (broken down) by the liver. Drinking alcohol also carries a risk of breathing issues or central nervous system depression. In severe cases, it can cause death.
Vivitrol is prescribed to treat alcohol use disorder as well as opioid dependence. You should not drink alcohol while taking Vivitrol.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.