Sublocade vs. Subutex: Injectable Depot vs. Sublingual Tablet

Why buprenorphine-only tablets are still used

Mono-product buprenorphine has historically been used in pregnancy and for people who cannot tolerate naloxone. Current guidance also considers the combination product acceptable in pregnancy for many patients. A prescriber decides.

Diversion concerns

Without naloxone, tablets can be misused by injection. That is one reason many prescribers prefer the combination or an injectable. Sublocade cannot be handled by the patient.

Moving from tablets to Sublocade

People taking daily buprenorphine may be candidates for Sublocade. The prescriber follows the FDA label for timing and dose.

Side effects and safety

• Buprenorphine-only tablets have no naloxone, so they are easier to misuse by injection. Safe storage at home is important.
• Both carry the same buprenorphine risks with sedatives and alcohol.
• Tablets must dissolve fully under the tongue; swallowing them lowers how much medicine is absorbed.
• Sublocade can cause injection-site pain or a lump, and carries a boxed warning about entry into a vein.

Questions about switching to ask a clinician

Switching between these medications should only be planned with a prescriber. These questions can help that conversation.

• Is my current tablet dose a good starting point for Sublocade?
• If I am pregnant or planning pregnancy, which buprenorphine product does my care team recommend?
• Would I still need tablets for breakthrough cravings early on?
• How often would I need visits in the first months on the injection?

Insurance and access

• Generic buprenorphine tablets are widely stocked by pharmacies. Some pharmacies may need to order them.
• If you are pregnant, ask for a prenatal provider who works with addiction specialists, so both teams share one plan.
• Ask your plan whether it prefers the combination product, which can affect coverage of mono-product tablets.

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 Sublocade and Subutex, 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.

Related guides

• Suboxone treatment overview
• What is medication-assisted treatment (MAT)?
• MAT options on Long Island
• Opioid addiction on Long Island
• Naloxone (Narcan) basics

More medication comparisons

• Sublocade vs. Suboxone
• Brixadi vs. Suboxone
• Brixadi vs. Sublocade
• Sublocade vs. Methadone
• Sublocade vs. Vivitrol
• Brixadi vs. Vivitrol