What is the Difference Between Suboxone and Vivitrol?

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Medically Verified: March 19, 2024

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What is the Difference Between Suboxone and Vivitrol

What is the Difference Between Suboxone and Vivitrol?

Medication-assisted treatment (MAT) is a comprehensive approach to addiction treatment that combines medications with counseling and behavioral therapy. By addressing both the physical and psychological aspects of addiction, MAT is thought to provide a whole-person approach to recovery. Two of the most popular medications used in MAT are Suboxone and Vivitrol.

In this article, you will learn what Suboxone and Vivitrol are, what differentiates them, and what similarities they share. If you or a loved one are struggling with addiction and think MAT is right for you, please contact our team at The Living Room at Princeton today. 

What is Suboxone?

Suboxone is a prescription medication used in the treatment of opioid addiction. It was approved by the FDA in 2002 and is one of the most widely used medications in MAT. 

Suboxone contains buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, meaning it binds to the same receptors in the brain as other opioids but produces weaker effects. It helps to reduce opioid cravings and withdrawals without causing the same level of euphoria or sedation as full opioid agonists like heroin or oxycodone.

Naloxone is an opioid antagonist, meaning it blocks the effects of opioids by binding to opioid receptors in the brain. In Suboxone, naloxone is included to deter misuse by injection. If Suboxone is injected, naloxone can precipitate withdrawal symptoms in individuals who are dependent on opioids, discouraging misuse of the medication.

What is Vivitrol?

Vivitrol is a prescription medication used in the treatment of opioid addiction and alcohol dependence. It contains an extended-release formulation of the active ingredient naltrexone, which is an opioid antagonist. Unlike opioid agonists, which activate opioid receptors in the brain, opioid antagonists like naltrexone block the effects of opioids by binding to the opioid receptors without activating them. This mechanism helps reduce cravings for opioids and alcohol.

Vivitrol was approved by the FDA for the treatment of alcohol dependence in 2006 and for the prevention of relapse in people who are in recovery from opioid dependence in 2010.

Differences Between Suboxone and Vivitrol

The key differences between Suboxone and Vivitrol are as follows.

Active Ingredient and Mechanism of Action

Suboxone contains two main active ingredients: buprenorphine and naloxone. Buprenorphine works by binding to the same opioid receptors in the brain that other opioids bind to, reducing withdrawal symptoms and cravings without producing the same level of euphoria or sedation. Naloxone helps prevent misuse of Suboxone by blocking the effects of opioids if the medication is injected, which can lead to withdrawal symptoms.

Vivitrol contains naltrexone, a different active ingredient. Naltrexone works by binding to opioid receptors in the brain and blocking the effects of opioids. Unlike Suboxone, which is a partial opioid agonist, Vivitrol does not activate opioid receptors or produce any opioid-like effects. Instead, it helps prevent relapse by blocking the euphoric effects of opioids if a person tries to use them while on Vivitrol.

FDA-Approved Uses

The FDA approved Vivitrol to treat both alcohol use disorder and opioid use disorder, but Suboxone is only intended for the treatment of opioid use disorder.

Method of Administration

Suboxone comes in the form of a sublingual film or tablet. Patients are instructed to place the film or tablet underneath their tongue or between their cheek and gums. The medication dissolves and is absorbed into the bloodstream. By contrast, Vivitrol comes in the form of an intramuscular injection. It is administered in the gluteal muscle (buttocks) by a licensed healthcare provider.

Initiation of Treatment

While Suboxone can help alleviate opioid withdrawal symptoms, it can make symptoms worse if it is taken too early. People must abstain from opioids and other drugs for 12-24 hours before starting Suboxone. Ideally, people should be in moderate to severe withdrawal before starting Suboxone. Waiting this amount of time ensures opioids have left the system and that precipitated withdrawal is no longer a risk.

In comparison, people must wait 7-10 days after taking opioids or drinking alcohol before starting Vivitrol. Unlike Suboxone, the Vivitrol shot does not alleviate symptoms of withdrawal. It is used after a period of withdrawal to alleviate cravings. However, other medications can be used during detox to alleviate withdrawal symptoms.

Dosage Frequency

Suboxone must be taken every day, typically in the morning. Vivitrol, on the other hand, is a monthly injection that is administered every 28-30 days. Vivitrol is only administered in a medical office while Suboxone can be taken home.

Side Effects

The two medications share some similar side effects, but injection site reactions may occur with Vivitrol while numbness, tingling, or painful mouth is more likely to occur with Suboxone.

Common side effects of Suboxone are:

  • Headache
  • Body aches
  • Abdominal cramps
  • Anxiety
  • Insomnia
  • Sweating
  • Depression
  • Constipation
  • Nausea
  • Weakness
  • Fatigue
  • Back pain
  • Redness in the mouth or burning mouth

Common side effects of Vivitrol are:

  • Nausea
  • Mild injection site reactions
  • Headache
  • Reduced appetite
  • Dizziness
  • Fainting
  • Insomnia
  • Toothache

Addiction Potential

The buprenorphine in Suboxone can be physically habit-forming. People who stop taking Suboxone abruptly after long-term use may experience withdrawal symptoms, so they should be slowly tapered off the medication when they are ready to stop taking it.

Vivitrol is not habit-forming. Individuals will not experience withdrawal symptoms when they stop taking it.

Similarities Between Suboxone and Vivitrol

Despite their many differences, Suboxone and Vivitrol are both designed to help people who struggle with addiction achieve recovery. Similarities include:

  • Both medications are available via prescription only
  • Suboxone and Vivitrol are both approved by the FDA to treat opioid use disorder
  • Both are intended to be used in combination with counseling and behavioral therapy
  • Can improve retention in treatment as well as overall treatment outcomes
  • Can reduce the risk of relapse in people struggling with opioid addiction

Find out if Medication-Assisted Treatment (MAT) is Right for You

If you or a loved one are struggling with addiction, MAT may be right for you. To learn more about MAT or to discuss your various treatment options, please contact our team at The Living Room at Princeton today.

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