Brixadi vs. Sublocade: Two Buprenorphine Injections Compared
Brixadi and Sublocade are the two long-acting buprenorphine injections approved for opioid use disorder. They contain the same medicine, but the dosing schedules, starting rules and injection details differ.
Written by Benjamin Zohar, NCACIP · Edited by Ezra Zohar, M.S. Ed. · Published · Updated · Medically reviewed by Brandon McNally, RN on
Quick answer
Both Brixadi and Sublocade are extended-release buprenorphine injections given by a healthcare professional. Sublocade is monthly only. Brixadi offers weekly and monthly options. Per their current FDA labels, both can be started after a single dose of transmucosal buprenorphine, and both allow several injection sites.
- Same medicine (buprenorphine), different delivery systems.
- Sublocade: monthly only. Brixadi: weekly or monthly.
- Both now allow several injection sites, including the upper arm.
- Both are given only in certified healthcare settings under FDA safety programs.
Brixadi vs. Sublocade at a glance
| Feature | Brixadi | Sublocade |
|---|---|---|
| Ingredient | Buprenorphine extended-release | Buprenorphine extended-release |
| Schedule options | Weekly or monthly | Monthly only |
| Injection sites | Buttock, thigh, abdomen or upper arm (per label) | Abdomen, thigh, buttock or back of upper arm (per 2025 label) |
| Starting | After a single buprenorphine test dose, or from existing buprenorphine | After a single transmucosal dose, or from existing buprenorphine (per 2025 label) |
| Lower-dose options | Weekly strengths allow smaller adjustments | Two monthly strengths |
| Safety program | FDA REMS; certified settings only | FDA REMS; certified settings only |
Based on current FDA prescribing information. Labels change; your prescriber follows the latest version.
Why two versions of the same medicine exist
Both products use an extended-release system that slowly releases buprenorphine after injection. The goal is the same: steady levels without a daily dose.
The practical differences are scheduling and flexibility. Brixadi's weekly option can help during the first weeks, when a prescriber may want to check in and adjust more often. Sublocade's monthly-only schedule means fewer visits once someone is stable.
How treatment starts
Per its FDA label, Brixadi can be started after a single test dose of transmucosal (under-the-tongue) buprenorphine, or in people already taking daily buprenorphine.
A 2025 update to the Sublocade label describes a similar single-dose start. Labels change over time, so the prescriber follows the current version for both products.
Injection experience
Both can cause pain, itching, redness or a lump at the injection site. Both labels now allow rotation across several body areas, which some people find more comfortable over time.
Neither injection can be self-administered. Both are given by a healthcare professional in a certified setting, and both carry a boxed warning about serious harm if injected into a vein.
Switching between them
Because both contain buprenorphine, switching does not require an opioid-free period the way switching to naltrexone would. A prescriber times the switch around the next scheduled dose.
Side effects and safety
- Both carry a boxed warning: serious harm or death can occur if the medicine enters a vein. Both are given only in certified settings under FDA safety programs (REMS).
- Both can cause injection-site pain, itching, redness or a lump.
- Both carry standard buprenorphine risks with benzodiazepines, alcohol and other sedatives.
- Common side effects for both include constipation, nausea and headache.
Questions about switching to ask a clinician
Switching between these medications should only be planned with a prescriber. These questions can help that conversation.
- When is my next dose due, and how would the switch be timed around it?
- Would I start the new product at a weekly or monthly strength?
- Which injection sites would be used, and can they be rotated?
- Does my insurance cover the new product before I switch?
Insurance and access
- Ask the office which long-acting product it stocks. Some offer only one.
- If you prefer more frequent check-ins at first, ask whether weekly Brixadi is an option.
- Ask your plan whether either product needs prior authorization, and whether one is preferred on its formulary.
Finding care on Long Island
Across Nassau and Suffolk counties, office-based buprenorphine prescribers are more common than clinics offering injectables. Methadone for opioid use disorder is only available through certified opioid treatment programs.
- Ask directly: "Do you offer Brixadi and Sublocade, and do you keep them in stock?"
- First visit: ask what the assessment includes and how soon medication can start.
- Insurance: call the number on your card and ask about prior authorization before the first dose.
- Scheduling: ask how often visits happen in the first month and later.
- Continuity: ask who to call between visits, and what happens if you move or change plans.
New York State lists certified programs through the OASAS provider directory.
Appointment checklist
Bring these to your first visit:
- A list of every medicine and supplement you take, including doses.
- Your recent substance use, including the last time you used opioids.
- Your insurance card and any prior authorization paperwork.
- Questions about the schedule, side effects and what to do if you miss a visit.
- Contact details for any other doctors involved in your care.
Evidence and uncertainty
FDA-approved medications for opioid use disorder are strongly supported by research, according to NIDA. Direct head-to-head trials between specific long-acting products are limited. Choices depend on history, goals, other health conditions and access.
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Call 844-338-6969Sources and editorial information
- FDA: Brixadi (buprenorphine extended-release) prescribing information
- FDA: Sublocade (buprenorphine extended-release) prescribing information
- FDA: Information about Medications for Opioid Use Disorder (MOUD)
- NIDA: Medications to Treat Opioid Use Disorder research report
- NIH StatPearls: Buprenorphine
Written by Benjamin Zohar, NCACIP, and edited by Ezra Zohar, M.S. Ed. Medically reviewed by Brandon McNally, RN. See our editorial guidelines.
Medical disclaimer: This article is for education only and is not medical advice. Long Island Rehab Helpline is an independent treatment-navigation resource, not a treatment provider. Talk with a licensed prescriber about your situation.
Questions about medication options?
If you would like help finding licensed providers on Long Island that offer these medications, you can explore MAT options or talk with a treatment navigator at (844) 338-6969.