What is the difference between Sublocade and Brixadi?

Sublocade and Brixadi are both long-acting subcutaneous (SC) (under the skin) 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.

How often is Sublocade administered compared to Brixadi?

Sublocade is administered once a month, with a minimum of 26 days between doses. Occasional delays of up to two weeks are not expected to have a significant impact on the treatment effect. If extended travel is deemed necessary, a single 300mg injection may be given to cover 2 months.

Brixadi is an SC injection that can be given once a week or once a month. It is injected as a liquid which then forms a gel once it is under the skin.

Where is Brixadi administered compared to Sublocade?

Brixadi may be administered under the skin (subcutaneously) of your buttock, thigh, stomach (abdomen), or upper arm. If you are new to buprenorphine treatment, the upper arm should only be used after 4 doses of Brixadi.

The abdomen is the only site Sublocade can be administered.

Can Sublocade or Brixadi be removed?

You should never attempt to remove Sublocade or Brixadi depot yourself, even though you may be able to feel the depot under your skin.

If the depot of Sublocade needs to be removed, it can be done under local anesthesia within 14 days of injection. The removed depot should be properly disposed of as Schedule III biohazardous waste, and according to federal, state, and local regulations.

Brixadi forms a biodegradable liquid crystalline gel upon injection that is not always possible to feel and may not be possible to surgically remove. Removal by a surgeon is not recommended.

Where do you get Sublocade or Brixadi from?

Both Sublocade and Brixadi can only be prescribed under a REMS Program by physicians who meet certain qualifying requirements, and who have been assigned a unique identification number that must be included on every prescription. Pharmacies that dispense Sublocade or Brixadi must be certified in this program and comply with the REMS requirements.

Both Sublocade and Brixadi must be administered as part of a complete treatment program that includes counseling and psychosocial support.

Related questions

• How long does opioid withdrawal last?
• How long does buprenorphine stay in your system?
• What are the different brands of buprenorphine?

Are there any differences in side effects between Sublocade and Brixadi?

Side effects for both Sublocade and Brixadi are similar because they both contain long-acting buprenorphine. Common side effects include:

• feeling tired
• nausea, vomiting, constipation
• itching, redness, pain, or a lump where the medicine was injected
• headache or
• abnormal liver function tests
• trouble sleeping (insomnia).

Is there any cost difference between Brixadi and Sublocade?

Copay assist programs mean most patients will pay $10 or less for Sublocade or Brixadi.

How are Sublocade or Brixadi supplied?

Sublocade is available in two strengths:

• 100 mg/0.5 mL
• 300 mg/1.5 mL.

Brixadi is supplied as weekly (50 mg/mL) or monthly (356 mg/mL) pre-filled, single-dose syringes.

Brixadi weekly strengths

• 8mg (0.16mL)
• 16mg (0.32mL)
• 24mg (0.48mL)
• 32mg (0.64mL).

Brixadi monthly strengths

• 64mg (0.18mL)
• 96mg (0.27mL)
• 128mg (0.36mL).

Do Sublocade or Brixadi require refrigeration?

Sublocade should be kept refrigerated at 2 - 8°C (35.6 - 46.4°F) but it may be taken out of the refrigerator up to 7 days before administration as long as it is kept at room temperature (15 – 30°C [59 – 86°F]), and discarded if not used within 7 days.

Brixadi does not require refrigeration. It should be stored at room temperature 20°C to 25°C (68°F to 77° F); with excursions permitted at 15°C to 30° C (59°F to 86°F).