Sublocade Injection
Generic name: buprenorphine (injection) [ BUE-pre-NOR-feen ]
Brand name: Sublocade
What is Sublocade?
Sublocade (extended-release buprenorphine injection) is used to treat adults with moderate to severe addiction (dependence) to opioid drugs (prescription or illegal) who:
- have started treatment with a single dose of a buprenorphine medicine in the form of a sublingual tablet or buccal film (transmucosal) followed by a one-hour observation period to confirm tolerability, or;
- are already being treated with buprenorphine.
This medication is part of a complete treatment plan that should include counseling and psychosocial support.
Sublocade extended-release injection belongs in a class of medications called opiate partial agonists. Buprenorphine works to prevent withdrawal symptoms when someone stops taking opioid drugs by producing similar effects to these drugs.
Sublocade is only available under a special program. You must be registered in the program and understand the risks and benefits of this medicine.
Sublocade is not for use as a pain medication.
This medication guide provides information about the Sublocade brand of buprenorphine injection. Buprenex is another brand of buprenorphine injection that is used to treat moderate to severe pain.
Sublocade side effects
Get emergency medical help if you have signs of an allergic reaction to Sublocade: hives, difficult breathing, swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Sublocade may cause serious side effects. Call your doctor at once if you have:
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weak or shallow breathing, breathing that stops;
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severe drowsiness or dizziness, loss of coordination;
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a light-headed feeling, like you might pass out;
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opioid withdrawal symptoms - shivering, goose bumps, increased sweating, feeling hot or cold, runny nose, watery eyes, diarrhea, vomiting;
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liver problems - loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
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decreased adrenal gland hormones - nausea, vomiting, stomach pain, loss of appetite, feeling tired or light-headed, muscle or joint pain, skin discoloration, craving salty foods.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Tell your doctor right away if you develop withdrawal symptoms or an allergic reaction even weeks or months after your last dose of Sublocade.
Common Sublocade side effects may include:
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feeling tired;
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nausea, vomiting, constipation;
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pain, redness, itching, burning, irritation, or skin changes where the injection was given;
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pain and burning when you urinate;
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trouble sleeping;
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headache; or
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abnormal liver function tests.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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Before taking this medicine
You should not be treated with Sublocade if you are allergic to buprenorphine.
Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with Sublocade could cause a serious condition called serotonin syndrome.
To make sure Sublocade is safe for you, tell your doctor if you have ever had:
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breathing problems, sleep apnea;
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a head injury or brain problem;
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alcoholism, mental illness;
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an allergy to latex;
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urination problems;
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heart problems;
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an electrolyte imbalance (such as low blood levels of potassium or magnesium);
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curvature of the spine that affects breathing;
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Addison's disease (or any other adrenal gland problem);
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problems with your gallbladder or thyroid; or
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liver or kidney disease.
Buprenorphine may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using this medicine.
If you use buprenorphine during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Tell your doctor if you are breastfeeding. If you are breastfeeding, tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.
How is Sublocade given?
Sublocade is injected under the skin of your abdomen, thigh, buttock, or back of the upper arm. A healthcare provider will give you this injection.
After each injection, you may see or feel a small lump under your skin where the medicine was injected. This could last for several weeks but the lump should eventually get smaller. Avoid rubbing or massaging the skin where an injection was given and wearing tight clothing over the area.
Your doctor will determine how often you will receive Sublocade.
You will need frequent blood tests to check your liver function.
Sublocade is only part of a complete treatment program that may also include counseling and other types of addiction support. Tell your doctor if you feel that this medicine is not helping to improve your symptoms of addiction.
In an emergency, your family or caregivers should tell medical personnel that you are using this medicine. Make sure any follow-up doctor knows you use this medicine.
Do not stop using Sublocade suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings).
Dosing information
Usual Adult Dose for Opiate Dependence - Maintenance:
Before administration: Patients not currently taking buprenorphine should receive an initial dose (for example, 4 mg) of transmucosal buprenorphine before administering the first injection of Sublocade.
- Initial dose: 300 mg subcutaneously once a month for 2 months
- Maintenance dose: 100 mg subcutaneously once a month
- The maintenance dose may be increased to 300 mg monthly for those tolerating lower dose and demonstrating a less than satisfactory clinical response, e.g. self-reported illicit opioid use or positive urine drug screens.
Comments:
Initiating therapy with subcutaneous injections has not been studied; subcutaneous injections should only be initiated following induction and dose-adjustment with a transmucosal buprenorphine-containing product.
Monthly doses should allow for a minimum of 26 days between doses; occasional delays in dosing of up to 2 weeks are not expected to have a clinically significant impact on treatment effect.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your Sublocade injection.
What happens if I overdose?
In a medical setting, an overdose would be treated quickly.
Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.
Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.
What should I avoid while receiving Sublocade?
Avoid driving or hazardous activity until you know how this medicine will affect you. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Do not drink alcohol. Dangerous side effects or death could occur.
Warnings
Fatal side effects may occur if you also drink alcohol or use other drugs that cause drowsiness or slow breathing.
Using opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Sublocade is available only under a special program. You must be registered in the program and understand the risks and benefits of this medicine.
What other drugs will affect Sublocade?
Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective. Tell your doctor if you also use an antibiotic, antifungal medication, seizure medication, or medicine to treat HIV or hepatitis C.
Many other drugs can be dangerous when used with opioid medicine. Tell your doctor if you also use:
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medicine for allergies, asthma, heart problems, motion sickness, irritable bowel, or overactive bladder;
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other opioid medicines;
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sleep medicine, muscle relaxers, or other medications that make you drowsy; or
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medications that affect serotonin, such as antidepressants, stimulants, or medicine for migraines or Parkinson's disease.
This list is not complete and many other drugs may interact with buprenorphine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Ingredients
Active ingredient: buprenorphine.
Inactive ingredients: ATRIGEL delivery system: biodegradable 50:50 poly(DL-lactide-co-glycolide) polymer and a biocompatible solvent, N-methyl-2-pyrrolidone (NMP).
Manufacturer
Curia Global Inc., Albany, NY 12203, USA.
Popular FAQ
What are the different brands of buprenorphine?
It is available in a number of dosage forms under the brand names Sublocade, Brixadi, Probuphine (discontinued), Belbuca, Butrans, Buprenex, and Subutex (discontinued). Continue reading
Is buprenorphine an opiate / narcotic?
Buprenorphine is classified as an opioid partial agonist and is considered a narcotic, but It activates the mu-opioid receptor to a lesser extent than the full opioid agonists (for example: oxycodone, methadone or morphine). It's used at higher doses for opioid use disorder (opioid dependence) while generally at lower doses to treat moderate to severe pain. Continue reading
What is the difference between Sublocade and Brixadi?
Sublocade and Brixadi are both subcutaneous long-acting buprenorphine injections that may be used for the maintenance treatment of opioid misuse disorder in adults. Sublocade was approved on November 30, 2017, and Brixadi was approved on May 23, 2023. Sublocade is administered once a month, with a minimum of 26 days between doses. If extended travel is deemed necessary, a single 300mg injection may be given to cover 2 months. Brixadi is given once a week or once a month. Continue reading
How and where is the Sublocade injection given?
Sublocade is administered as an injection just under the skin (subcutaneous) of your stomach (abdomen), thigh, buttock, or back of the upper arm. After the first two injections, you will receive it monthly (with at least 26 days between doses). Continue reading
Is Sublocade covered by Medicaid?
Most patients with Medicaid typically pay low or no cost for Sublocade (buprenorphine) if it is a preferred drug treatment by their state health plan. Your health plan and costs are determined by your state Medicaid program. Continue reading
Is Probuphine better than Sublocade?
Probuphine and Sublocade are long-acting forms of buprenorphine, but the Probuphine brand has been discontinued in the United States. There is no evidence that one was better than the other. They were both used in long-term medication-assisted treatment (MAT) for opioid use disorder (OUD). Continue reading
Who makes Sublocade in the U.S?
Sublocade (buprenorphine) is made by Indivior. Sublocade (buprenorphine) is an extended-release, once-monthly subcutaneous (under the skin) injection that steadily releases buprenorphine into your bloodstream for the treatment of opiate dependence (opioid use disorder). Sublocade is only given by a healthcare provider. Serious harm or death could result if administered intravenously. Continue reading
Is Sublocade a controlled substance?
Sublocade (buprenorphine) is classified by the DEA as a schedule 3 controlled substance with moderate abuse potential. Medicines in schedule 3 have a potential for abuse less than those in schedule 1 and 2 (for example, heroin or oxycodone). Abuse of schedule 3 substances may lead to moderate or low physical dependence or high psychological dependence. Sublocade is used for the treatment of opiate dependence (opioid use disorder or opioid addiction). Continue reading
How is Sublocade administered?
Sublocade is given by a health care provider once a month by subcutaneous (under the skin) injection (with at least 26 days between doses). Your doctor will order this medicine for you, and you will receive it in a clinic or doctor's office. Continue reading
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Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Sublocade only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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