Zubslov and Suboxone are two types of medication-assisted treatment approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorder (OUD) and the management of opioid withdrawal symptoms.
They are to be combined with behavioral therapy.
Zubsolv and Suboxone: What Do They Do?
Both Suboxone and Zubsolv are buprenorphine-based medications designed to treat opioid addiction:
- They contain the same active ingredients: buprenorphine and naloxone.
- Each of the two medications has a ratio of buprenorphine to naloxone at 4:1.
- They bind to the same receptors.
- They are started after the opioid withdrawal symptoms have been controlled.
Buprenorphine functions as a partial opioid agonist that partially occupies and activates opioid receptors in the brain, replacing the much stronger, full agonist opioids.
Full agonists like morphine and oxycodone attach to and produce maximum activation of the opioid receptors in the brain, resulting in strong pain relief as well as euphoria and sedation.
However, that’s the gateway to dependence, tolerance, and overdose that lead to being afflicted by opioid use disorder.
Naloxone acts as an opioid antagonist, effectively obstructing the opioid receptor and counter-affecting other opioids.
Its inclusion in the formula serves as a deterrent against misuse, whether through injection or snorting, as it produces immediate unwanted side effects.
Common Side Effects Shared
Both medications may cause:
- Common withdrawal symptoms such as headache, body aches, or rapid heart rate
- Gastrointestinal manifestations such as nausea and vomiting, constipation, diarrhea, or abdominal pain
- Psychiatric manifestations such as anxiety, depression, or trouble sleeping
- Respiratory manifestations such as cough, fever, chills, sweating, runny nose, or sore throat
- Generalized weakness and fatigue
Zubsolv vs Suboxone
Here’s what sets the two medications apart:
Forms of Administration
Zubsolv is available as a tablet designed to dissolve under the tongue. Suboxone can either be a sublingual tablet or a thin film applied to the inner cheek or placed under the tongue.
A randomized controlled trial in 2018 has concluded that Zubsolv had markedly dissolved faster compared to Suboxone at both lower and higher doses:
- At higher doses, Zubsolv took 8.5 minutes in contrast with the 16.2 minutes it took for Suboxone to dissolve.
- At lower doses, Zubsolv took 7.6 minutes, while Suboxone took 9.1 minutes.
Zubsolv dissolving faster makes it more convenient and less uncomfortable for you to adhere to since both medications are not meant to be taken with food or water.
Since both Zubsolv and Suboxone are buprenorphine medications that dissolve in the mouth, they are included in the Food and Drug Administration (FDA) warning that they can cause an increased risk of dental issues.
It is useful to schedule initial and regular dental visits and remember that the benefits of being prescribed these medications can far surpass the risks.
Dosages and Strengths
Suboxone is offered in four strengths, each presenting a different buprenorphine-to-naloxone ratio:
- 2 mg buprenorphine combined with 0.5 mg naloxone
- 4 mg buprenorphine combined with 1 mg naloxone
- 8 mg buprenorphine combined with 2 mg naloxone
- 12 mg buprenorphine combined with 3 mg naloxone
Zubsolv provides a broader selection of six strengths combining buprenorphine and naloxone, including:
- 0.7 mg buprenorphine combined with 0.18 mg naloxone
- 1.4 mg buprenorphine combined with 0.36 mg naloxone
- 2.9 mg buprenorphine combined with 0.71 mg naloxone
- 5.7 mg buprenorphine combined with 1.4 mg naloxone
- 8.6 mg buprenorphine combined with 2.1 mg naloxone
- 11.4 mg buprenorphine combined with 2.9 mg naloxone
Zubsolv offers more options, which means you have a wider range of dosing based on your needs and medical requirements.
Bioavailability
Zubsolv is designed to provide a higher bioavailability of buprenorphine-naloxone, especially at higher doses. This means a higher proportion of the active ingredient entering the bloodstream to achieve the desired effects.
MAT medications such as Zubsolv and Suboxone are schedule III controlled medications. This classification means that they carry the risk of abuse and dependence.
Some studies have shown that Zubsolv can notably reduce the likelihood of buprenorphine abuse by delivering comparable buprenorphine levels with approximately 30% less dosage than Suboxone.
Cost
Brand-name medications are different from generic drugs. They are typically trademarked and cost more.
Zubsolv is a brand-name medication, while Suboxone is available as a generic buprenorphine-naloxone sublingual tablet.
However, because Zubsolv is more efficiently absorbed and utilized, Suboxone at higher doses can eventually become more expensive if you cover the expenses yourself without insurance.
On average, the cost of each out-of-pocket can be:
| Per 30 films/tablets | Suboxone | Zubsolv |
|---|---|---|
| Lowest Strength | From ~167.77 USD | From ~170.61 USD |
| Highest Strength | From ~576.86 USD | From ~654.36 USD |
Taste
The taste of any medication is a crucial part of tolerability and adherence. While taste is highly subjective, patients have reported that Zubsolv is more pleasant with its menthol flavor.
That’s a feature Suboxone can’t provide, as it is reported by patients to leave a bitter aftertaste.
In 2015, an experiment involving 60 men and women comparing the taste and after-feel of Zubsolv and the two formulations of Suboxone (the sublingual pill and the sublingual film) resulted in a staggering 77.4% and 88.9% preference for Zubsolv’s taste in comparison, respectively.
Final Verdict
OUD treatment is multifaceted, involving a combination of medical, social, and mental health services administration tailored to individual needs.
Each of these two medications has benefits and drawbacks. The ultimate decision depends on the patient’s needs and what their healthcare provider believes will achieve the best results and quality of life.
If you or a loved one need help managing opioid use disorder, book an appointment with Curednation to start your recovery journey today.
References
- Buprenorphine/Naloxone (Zubsolv®): A Review in Opioid Dependence
- New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone
- Buprenorphine and its formulations: a comprehensive review
- U.S. Food and Drug Administration – Highlights of Prescribing Information for ZUBSOLV (buprenorphine and naloxone) sublingual tablets for sublingual administration CIII
