Which Is Better For Treating OUD: Suboxone or Vivitrol?

Suboxone and Vivitrol are two similar drugs that are frequently provided to people who suffer from opiate addiction (OUD).

12/21/20224 min read

Suboxone and Vivitrol are two similar drugs that are frequently provided to people who suffer from opiate addiction (OUD). Both reduce opioid cravings and withdrawal symptoms, which helps to prevent relapse. However, there are numerous differences between the two drugs, including how they are taken.

What Exactly is Suboxone?

Suboxone is a brand-name medication that has been approved by the FDA in the United States. For the treatment of OUD, the Food and Drug Administration (FDA) has approved a drug. Buprenorphine and Naloxone are the two key medications in it.

They work together to lessen the severity of withdrawal symptoms and opioid dependency. Buprenorphine is a partial opioid agonist, meaning it binds to opioid receptors but does not activate them as powerfully as a full agonist would. Buprenorphine relieves withdrawal symptoms and drug cravings without causing euphoria. At larger doses, it blocks opioid receptors, reducing the risk of overdose and inhibiting the pleasurable effects of other opioids.

To put it another way, if someone is on Suboxone and they take an opioid, they will not feel the effects of the opioid. The opioid antagonist naloxone is also included in the formulation to avoid buprenorphine abuse.

Suboxone comes in two different forms: a sublingual tablet and a sublingual film. Within 15 minutes of being placed beneath the tongue or between the cheek and gums, both formulations disintegrate. The film/strip, on the other hand, dissolves faster and is more expensive than the tablet. Both formulations have distinct flavors, and patients may prefer one over the other depending on their preferences.

Suboxone Adverse Reactions
  • Suboxone is a safe and effective controlled substance, but it does have some minor side effects, such as:

  • Headache

  • stomach ache

  • Nausea and vomiting

  • Constipation

  • Insomnia

  • Arms and legs swollen

  • In the mouth, there is a loss of sensation.

Suboxone should only be started by patients with OUD under the supervision of a healthcare professional. This is due to the fact that if Suboxone is given while opioids are still present in the circulation, it can produce withdrawal symptoms.

What Exactly is Vivitrol?

Vivitrol is an FDA-approved medication that is provided to people suffering from OUD and alcoholism. It contains naltrexone, an opioid antagonist similar to naloxone, which is used in Suboxone.

Vivitrol, unlike Suboxone, which contains buprenorphine, does not contain an agonist. As a result, withdrawal symptoms will not be alleviated.

The opioid receptors in Vivitrol are blocked by naltrexone. This has a number of advantages:

  • It helps to curb narcotic cravings.

  • A person who utilizes an illicit opioid will not feel euphoric.

  • If a person relapses while on Vivitrol, there is a decreased risk of overdosing.

There is no risk of becoming dependent on Vivitrol or becoming addicted to it. There are no withdrawal symptoms in patients who stop using Vivitrol. The medicine is injected into the gluteal muscle as an injection. It stays in the system for one month and requires monthly doses to maintain its effectiveness. Only a healthcare provider should provide Vivitrol injections.

Side Effects of Vivitrol
  • Vivitrol, like Suboxone, is known to induce adverse effects, which include:

  • Nausea

  • Headache

  • Dizziness

  • Anxiety, nervousness, restlessness, and irritability are all symptoms of anxiety.

  • Despite a lack of hunger, there is an increase in thirst.

  • Aches in the muscles or joints

  • Weakness

  • Problems with sleep (insomnia)

  • Impotence, diminished sex drive, or difficulty obtaining orgasm.

Patients who intend to begin Vivitrol treatment must be opioid-free for at least 7 to 10 days prior to receiving their first dosage. Otherwise, individuals may undergo "acute abstinence syndrome" or "precipitated withdrawal," which is characterized by abrupt opiate withdrawal.

It's also important to be aware that Vivitrol comes with additional risks: if someone stops taking Vivitrol and starts using illicit opioids again, they're more likely to overdose, especially two months after their last shot, because Vivitrol removes the tolerance that people build up from frequent opioid use.

Comparison Between Suboxone and Vivitrol

While both Suboxone and Vivitrol are proven and effective Medication-Assisted Treatment (MAT) alternatives for OUD, the two drugs differ in several ways.

1. Make use of

Suboxone and Vivitrol are FDA-approved medicines for treating opioid use disorder. While both drugs reduce cravings for opioids, only Suboxone can relieve withdrawal symptoms. This is because naltrexone, the main ingredient in Vivitrol, is an opioid antagonist rather than an agonist, meaning it cannot stimulate opioid receptors in the absence of opioids or reduce withdrawal symptoms.

2. Possibility of Abuse
Both medicines have a minimal potential for abuse, however Vivitrol has a lower risk of abuse than Suboxone.

Suboxone is safe because it contains naloxone, which reduces the risk of buprenorphine misuse; nonetheless, there is still some opioid agonist action in Suboxone, which can increase the risk of severe overdose when coupled with benzodiazepines, and patients can develop Suboxone cravings.

Vivitrol has almost minimal potential for abuse because it is an opioid antagonist that does not cause euphoria when consumed, and it can only be given under expert supervision.

3. Dosage Variations

Suboxone is a once-daily pill that comes in four different dosage forms, each with a 4:1 buprenorphine-to-naloxone ratio.

  • 0.5 mg naloxone / 2 mg buprenorphine

  • 1 mg naloxone / 4 mg buprenorphine

  • 2 mg naloxone / 8 mg buprenorphine

  • 3 mg naloxone / 12 mg buprenorphine

Vivitrol, on the other hand, is given once a month in a set dose of 380 mg taken intramuscularly.

4. Administration and formulations

Suboxone is available in two sublingual formulations: film and tablet, which dissolve when placed on the inside of the cheek or beneath the tongue. Patients can take Suboxone at home because it is available in sublingual formulations.

Vivitrol is only accessible as an intramuscular injection, and patients must visit a healthcare provider for their monthly treatment.

5. Forms. (Brand vs. Generic)

There are no generic versions of Vivitrol available right now, however Sandoz and Alvogen are two businesses that make FDA-approved generic Suboxone.