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Is Probuphine better than Sublocade?

Medically reviewed by Sally Chao, MD. Last updated on May 12, 2021.

Official answer

by Drugs.com

Probuphine and Sublocade are long-acting forms of buprenorphine. There is no evidence that one is better than the other. They are both used in long-term medication-assisted treatment (MAT) for opioid use disorder (OUD).

Probuphine is implanted under the skin for several months, and Sublocade is a monthly injectable. Both of these drugs improve recovery from OUD because they eliminate the possibility of missing daily doses of buprenorphine that may lead to a relapse.

Buprenorphine is an opioid drug, but when used in treatment of opioid addiction at the proper dose, it can block the effects of stronger opioids like heroin. Taken by mouth on a daily basis, implanted or injected, the constant low dose decreases the cravings caused by addiction. Along with counseling and support therapies, buprenorphine as prescribed can reduce OUD and the risk of overdose and death from OUD.

Both Probuphine and Sublocade increase compliance of OUD treatment. Patients do not need to show up for daily treatment at a clinic. They both reduce the cravings for opioids and reduce withdrawal symptoms.

  • Probuphine was approved by the U.S. Food and Drug Administration (FDA) in 2016. It was the first long-acting buprenorphine. It is approved to treat OUD after a patient has been stable on daily, oral buprenorphine. To take Probuphine, 4 one-inch-long rods are inserted under the skin of the upper arm. The rods give off a low and steady dose of buprenorphine over 6 months. After 6 months, the rods must be removed. New rods may be placed in the other arm for continued treatment if needed for one more treatment course. Insertion and removal of the rods must be done by a trained and certified health care provider.
  • Sublocade is buprenorphine injected once per month under the skin. The FDA approved this treatment in 2017. Like Probuphine, it is approved for OUD patients who have already been stable on oral buprenorphine. After buprenorphine is injected, a deposit forms under the skin that gives off a slow and steady amount of the medicine. It comes in a prefilled syringe that must be injected by a trained and certified health care provider.

Both drugs have similar side effects common to all buprenorphine drugs. These include, among others:

  • Constipation
  • Headache
  • Nausea
  • Vomiting

Probuphine may cause insertion site reactions. There is also some risk of the rods extruding or migrating under the skin.

Sublocade may cause injection site irritation or itching.

You can decide which drug fits your needs best after discussing the risks and benefits with your certified OUD health care provider.

References
  1. U.S. Food and Drug Administration (FDA). FDA approves first buprenorphine implant for treatment of opioid dependence. November 30, 2017. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-first-buprenorphine-implant-treatment-opioid-dependence. [Accessed April 15, 2021].
  2. U.S. Food and Drug Administration (FDA). FDA approves first once-monthly buprenorphine injection, a medication-assisted treatment option for opioid use disorder. November 30, 2017. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-first-once-monthly-buprenorphine-injection-medication-assisted-treatment-option-opioid. [Accessed April 15, 2021].
  3. Substance Abuse and Mental Health Services Administration (SAMHSA). Buprenorphine. March 12, 2021. Available at: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. [Accessed April 15, 2021].

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