Brixadi Treatment on Long Island: Weekly & Monthly Buprenorphine Injections

What Is Brixadi?

Brixadi is the brand name for an extended-release formulation of buprenorphine administered by subcutaneous injection.

Buprenorphine is a partial opioid agonist used in medication treatment for opioid use disorder. Brixadi was approved by the FDA for moderate-to-severe opioid use disorder and is available in both weekly and monthly formulations.

After the medication is injected beneath the skin, it forms a depot that gradually releases buprenorphine into the body.

This provides continuous medication exposure without requiring a patient to take buprenorphine every day.

What Is Brixadi Used For?

Brixadi is used as part of treatment for opioid use disorder, including opioid dependence involving substances such as:

• fentanyl
• heroin
• prescription opioids
• other opioid drugs

Brixadi is not an emergency opioid-overdose treatment and should not be confused with naloxone.

Treatment should be determined by a qualified healthcare professional and incorporated into a broader opioid-use-disorder treatment plan when clinically appropriate.

Brixadi Weekly and Monthly Doses

Brixadi is available in seven FDA-approved strengths across its weekly and monthly formulations. These are available medication strengths, not instructions for choosing or changing a dose.

Brixadi Weekly Doses

• 8 mg
• 16 mg
• 24 mg
• 32 mg

Brixadi Monthly Doses

• 64 mg
• 96 mg
• 128 mg

The appropriate formulation and dose depend on prior buprenorphine treatment, response, tolerability, and the treating clinician's assessment.

How Does Brixadi Work?

Brixadi contains buprenorphine, a partial opioid agonist that binds strongly to opioid receptors. When used appropriately for opioid use disorder, buprenorphine can reduce withdrawal symptoms and cravings while helping stabilize patients during treatment.

• Available as weekly or monthly extended-release injections
• Provides sustained buprenorphine exposure without daily home dosing
• Can reduce opioid withdrawal symptoms and cravings
• Has a ceiling effect on some opioid effects, including respiratory depression, although serious respiratory depression can still occur
• Must be administered by a healthcare professional
• Approved injection areas include the abdomen, thigh, buttock, and upper arm, subject to specific administration instructions

How Long Does a Brixadi Injection Last?

Brixadi is formulated for either:

• approximately seven days with Brixadi Weekly, or
• approximately 28 days with Brixadi Monthly.

That does not mean all buprenorphine disappears from the body exactly seven or 28 days after an injection. Brixadi is an extended-release medication, and its pharmacokinetics are considerably longer than the dosing interval.

Where Is Brixadi Injected?

Brixadi is administered subcutaneously, meaning underneath the skin.

Approved administration areas include the:

There are additional site-rotation instructions, particularly for weekly treatment, and the upper arm has specific considerations for people who are new to buprenorphine.

Can You Inject Brixadi Yourself?

No. Brixadi is administered by a healthcare professional.

Because of the potential for serious harm if Brixadi were incorrectly injected intravenously, it is subject to a restricted distribution program under the Brixadi REMS.

It is not intended to be picked up from a retail pharmacy and injected at home.

How Do You Start Brixadi?

Starting treatment depends partly on whether a patient is already receiving buprenorphine.

Someone who is not currently taking buprenorphine generally receives a test dose of transmucosal buprenorphine to establish tolerability before beginning Brixadi Weekly.

People already being treated with transmucosal buprenorphine may be candidates for transition to a weekly or monthly Brixadi regimen according to the FDA prescribing information and their clinician's judgment.

For that reason, patients should not attempt to determine their own induction timing from information found online.

How to Find a Brixadi Provider on Long Island

Not every healthcare professional who prescribes buprenorphine also administers long-acting Brixadi injections. People searching for a Brixadi provider in Nassau County or Suffolk County should confirm availability directly with the treatment program or medical practice.

Questions to ask include:

• Do you currently administer Brixadi?
• Do you offer both weekly and monthly Brixadi?
• Are you accepting new patients?
• What evaluation is required before the first injection?
• Do you accept my insurance plan?
• Is prior authorization required?
• Do you also offer Sublocade or other buprenorphine options?
• Are counseling or behavioral health services available?

Long Island Rehab Helpline & Crisis Intervention is an independent educational and treatment-navigation resource and does not itself prescribe or administer Brixadi. We provide information about treatment options and help people identify appropriate resources serving Nassau and Suffolk County.

Brixadi vs. Sublocade vs. Daily Suboxone

Brixadi, Sublocade, and Suboxone all contain buprenorphine, but they differ in how they are administered, how often they are taken, and how treatment is started.

The milligram strengths of Brixadi and Sublocade should not be compared directly because the products use different extended-release formulations and dosing protocols.

For a more detailed clinical review of weekly and monthly doses, injection-site rules, side effects, withdrawal considerations, and the pharmacologic differences between the two long-acting injections, see the Brixadi dosing and Sublocade comparison guide published by ISSUP.

Is Brixadi Better Than Sublocade?

There is no universal answer.

Potential differences that a clinician may consider include:

• weekly versus monthly dosing availability
• available strengths
• previous buprenorphine treatment
• treatment response
• appointment frequency
• insurance coverage
• individual clinical circumstances

Patients should not attempt to convert a Brixadi dose into an equivalent Sublocade dose based solely on the milligram number.

Brixadi Injection Side Effects

The most commonly reported adverse reactions in FDA-reviewed Brixadi studies included:

Buprenorphine can also present more serious risks, including respiratory depression, particularly when combined with alcohol, benzodiazepines or other central-nervous-system depressants.

Patients should discuss medications, alcohol use, other substance use and relevant medical conditions with their healthcare provider.

Does Brixadi Cause Withdrawal?

Physical dependence can occur with buprenorphine treatment.

Because Brixadi releases medication for an extended period, withdrawal following discontinuation may not follow the same timing as withdrawal from short-acting or daily buprenorphine products.

Patients who want to discontinue or change treatment should work with their treating clinician rather than simply stopping follow-up injections without a treatment plan.

Insurance and Brixadi Cost on Long Island

Coverage for Brixadi varies by insurer, health plan, provider, and whether the medication is processed under the medical or pharmacy benefit. Prior authorization may be required.

Commercial insurance, Medicare, and New York Medicaid plans may provide coverage depending on the patient's specific benefits and eligibility. Manufacturer assistance may also be available to some commercially insured patients.

Because coverage requirements change, patients should verify benefits with their insurer and the healthcare provider administering the medication before assuming a specific out-of-pocket cost.

Brixadi and Fentanyl Use Disorder

Many people researching Brixadi today are doing so because of fentanyl dependence.

Buprenorphine can be an evidence-based medication option for opioid use disorder, including OUD associated with fentanyl use.

However, initiation requires clinical judgment.

Starting buprenorphine at an inappropriate point after using a full opioid agonist may result in precipitated withdrawal. Someone regularly using fentanyl should discuss the safest treatment-initiation strategy with an addiction-medicine professional.

Is Brixadi Medication-Assisted Treatment?

Brixadi is a medication used for opioid use disorder.

The terminology medication for opioid use disorder (MOUD) is now commonly used alongside the older term medication-assisted treatment (MAT).

Looking for a prescriber? See how to find a Brixadi doctor in New York. To see how it differs from other options, compare Brixadi and Sublocade or Brixadi and daily Suboxone.

FDA-recognized medication options for OUD include formulations of:

• buprenorphine
• methadone
• naltrexone

Brixadi and Sublocade are both extended-release buprenorphine options.

Brixadi Treatment and Other Levels of Care on Long Island

Medication needs vary from person to person. A treatment plan may include Brixadi alongside:

Frequently Asked Questions About Brixadi