What is the difference between Zubsolv and Suboxone?
Zubsolv and Suboxone are both brand name drugs that combine buprenorphine and naloxone to treat opioid addiction in conjunction with counseling and behavioral therapy. However, the two drugs come in different forms. Zubsolv is given as a tablet placed under the tongue. Suboxone is typically given via film that is placed on the inside of the cheek or under the tongue. It can also be administered as a tablet.
Buprenorphine and naloxone pack a one-two punch against opioid addiction. Buprenorphine reduces withdrawal symptoms and curbs cravings, while naloxone blocks the effects of other opioids and can reverse an opioid overdose. It is primarily added to the mix to discourage injection of the buprenorphine.
These differences may affect preferences. Research has shown that individuals may prefer the overall minty taste, feel and ease of administration of Zubsolv. The under-the-tongue tablet form appears to be easier to take than a film form. Suboxone can leave a person’s mouth feeling tingly, and it has an unpleasant orangey taste. This is significant, as individuals are more likely to continue taking a medication if they find it tolerable.
Because of differences in bioavailability, or the rate at which the drugs are absorbed by the body, Zubsolv and Suboxone can be given as different doses.
Suboxone is available in four strengths:
- 2 mg buprenorphine/0.5 mg naloxone
- 4 mg buprenorphine/1 mg naloxone
- 8 mg buprenorphine/2 mg naloxone
- 12 mg buprenorphine/3 mg naloxone
Zubsolv comes in six strengths:
- 0.7 mg buprenorphine /0.18 mg naloxone
- 1.4 mg buprenorphine/0.36 mg naloxone
- 2.9 mg buprenorphine/0.71 mg naloxone
- 5.7 mg buprenorphine/1.4 mg naloxone
- 8.6 mg buprenorphine/2.1 mg naloxone
- 11.4 mg buprenorphine/2.9 mg naloxone
Zubsolv is more bioavailable, meaning that it dissolves quicker, so smaller doses can be used. The fact that there is a wider dose variety with Zubsolv also allows for more individualized treatment, which could increase adherence.
The American Society of Addiction Medicine does not recommend one of these two drugs over the other.
The two medications share a similar side effect profile. The most common side effects include:
- Difficulty sleeping
- Swelling in the lower legs and hands
- Stomach pain
- Mouth numbness
- Pain in the mouth, throat or tongue
There are currently no generic forms of Zubsolv available, but generic forms of Suboxone do exist. Brand name medications tend to cost more than their generic counterparts.
- Gunderson EW, Sumner M. Efficacy of Buprenorphine/Naloxone Rapidly Dissolving Sublingual Tablets (BNX-RDT) After Switching From BNX Sublingual Film. Journal of Addiction Medicine. 2016;10:124-130. Available at: https://journals.lww.com/journaladdictionmedicine/fulltext/2016/04000/Efficacy_of_Buprenorphine_Naloxone_Rapidly.8.aspx. [Accessed March 16, 2021].
- U.S. National Library of Medicine. Suboxone. March 17, 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a5edcf9-828c-4f97-b671-268ab13a8ecd. [Accessed March 16, 2021].
- U.S. National Library of Medicine. Zubsolv. March 1, 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5f5cfcfe-d52b-49e6-8fe4-550477332dd2. [Accessed March 16, 2021].
- Zubsolv Patient Information. Zubsolv. Available at: https://www.zubsolv.com/healthcareprofessionals/about-zubsolv/administration-dosing/. [Accessed March 16, 2021].
- American Society of Addiction Medicine (ASAM). National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. June 1, 2015. Available at: https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf. [Accessed March 16, 2021].
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