Zubsolv vs. Suboxone for Opioid Use Disorder: Similarities and Differences
Medically reviewed by Femi Aremu, PharmDMedically reviewed by Femi Aremu, PharmD
Zubsolv and Suboxone are medications containing the same active ingredients–buprenorphine (a partial opioid agonist) and naloxone (an opioid antagonist)–to treat opioid use disorder.
Opioid use disorder is characterized as having a problematic pattern of opioid use, leading to problems or distress. Opioid drugs can include heroin, as well as prescription pain drugs such as oxycodone and morphine.
At first glance, Zubsolv and Suboxone might seem identical because they contain the same active ingredients and have the same uses. However, a few key differences set them apart.
This article will discuss the similarities and differences between Zubsolv and Suboxone, including how they work, dosage methods, side effects, costs, and more.
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Zubsolv and Suboxone: How Are They the Same?
Zubsolv and Suboxone are both formulations of the ingredients buprenorphine and naloxone. They are used to treat individuals with opioid dependence.
Zubsolv is available as a sublingual (applied under the tongue), orally dissolving tablet. Suboxone is available as an orally dissolving film.
These medications should used as a part of a treatment plan that includes psychosocial support and counseling. Zubsolv and Suboxone are both considered Schedule III controlled substances, which means they have a low to moderate potential for dependence.
Can Zubsolv and Suboxone Be Used for Pain Relief?
In the past few years, healthcare providers may have prescribed these medications off-label for pain relief. Present information does suggest that buprenorphine and naloxone may provide pain relief in people with chronic pain who are also dealing with opioid dependence or addiction.
How These Medications Work
Both buprenorphine and naloxone work to treat opioid addiction in different ways in the body.
Buprenorphine controls the mu-opioid and kappa receptors. These receptors are responsible for the pain signals in the body.
Buprenorphine partially activates the mu-opioid receptor while blocking kappa-opioid receptor activation. As a partial agonist, buprenorphine works just enough to stop cravings and withdrawal without producing side effects like euphoria.
Buprenorphine also has an opioid agonist ceiling effect, which means that taking higher doses won't produce a greater effect.
Naloxone works by binding to the opioid receptors in the body without activating them. By preventing the activation of these opioid receptors, it provides an anti-overdose effect. This alleviates withdrawal symptoms, helping you feel more comfortable after stopping the use of opioids.
Related: Buprenorphine vs. Suboxone: Similarities & Differences
Side Effects
Zubsolv and Suboxone both share the same common side effects. Side effects that one may experience while on either medication include:
Headache
Nausea or vomiting
Constipation
Increased sweating
Insomnia
Are Zubsolv and Suboxone Addictive?
Zubsolv and Suboxone both contain buprenorphine. Buprenorphine has the potential risk of misuse and dependence, which can lead to addiction. This is because buprenorphine can produce moderate withdrawal symptoms upon abruptly stopping it.
Still, developing an addiction to these medications is unlikely due to the "ceiling effect" achieved by Zubsolv and Suboxone. This ceiling effect prevents you from feeling any added effects from taking higher doses.
Onset and Duration of Action
Orally disintegrating dosage forms work relatively fast because they rapidly disintegrate in the saliva, releasing the drug promptly and dispersing it in the bloodstream.
Since Zubsolv is an orally disintegrating tablet, it works fairly quickly. It should take effect within 60 minutes of first taking the dose and may even take effect earlier.
It can take 24 to 42 hours for half of a single dose of buprenorphine to leave the body, also known as the half-life of the drug. This means it can take five to nine days for the buprenorphine to be completely cleared from the body.
Similar to Zubsolv, Suboxone is orally disintegrating and works fairly quickly. Suboxone begins to work within 20 to 60 minutes of the first dose. Since it also contains buprenorphine, it has the same half-life of 24 to 42 hours.
What Does "Half-Life" Mean?
A drug's half-life refers to the amount of time it takes for the active substance to be reduced by half in the body. Drugs can have different half-lives, with some ranging from a few hours to days.
How Are They Different?
There are certain characteristics of each medication that set them apart from each other.
For example, Zubsolv is available as an orally disintegrating tablet, while Suboxone is available as an oral film. In addition, more dosage strengths of Zubsolv are available.
Other differences include the drugs' bioavailability and cost considerations.
Dosage and Delivery
Zubsolv is only given as an orally disintegrating tablet. It was developed with sucralose and menthol, which are used as sweeteners to mask the taste of the bitter ingredients. People may find it more pleasant to take the Zubsolv tablet than Suboxone film or tablets, as it tastes less bitter.
Zubsolv comes in six different dosage strengths:
Buprenorphine 0.7 mg/naloxone 0.18 milligrams (mg)
Buprenorphine 1.4 mg/naloxone 0.36 mg
Buprenorphine 2.9 mg/naloxone 0.71 mg
Buprenorphine 5.7 mg/naloxone 1.4 mg
Buprenorphine 8.6 mg/naloxone 2.1 mg
Buprenorphine 11.4 mg/naloxone 2.9 mg
Suboxone differentiates from Zubsolv in that it is available as an orally disintegrating film. It is available in four different dosage strengths:
Buprenorphine 2 mg/naloxone 0.5 mg
Buprenorphine 4 mg/naloxone 1 mg
Buprenorphine 8 mg/naloxone 2 mg
Buprenorphine 12 mg/naloxone 3 mg
Even though the dosage forms differ, they are taken similarly. You place the tablet or film inside one side of the cheek or under the tongue, allowing it to completely dissolve in the mouth. It is also important to note that the film and tablet should be administered whole and not cut, chewed, or swallowed. Both the film and tablet should not be moved after the initial placement.
Bioavailability
Zubsolv and Suboxone also differ in their bioavailability, which means that the body absorbs Zubsolv and Suboxone at different rates.
As the tablet/film dissolves in the mouth, the medication slowly enters the body’s bloodstream by the mucous membranes. The bioavailability of each drug can explain how much is entering the body. Because both medications are orally disintegrating, they work faster than a traditional tablet that you would swallow.
Zubsolv and Suboxone both have different levels of bioavailability. They contain a 4:1 ratio of buprenorphine and naloxone, meaning buprenorphine (80%) will have a greater effect than naloxone (20%).
Due to its formulation, Zubsolv has a significantly greater bioavailability than Suboxone. Therefore, you would need a higher dose of Suboxone to equal the same dose of Zubsolv.
Cost and Coverage
Zubsolv is currently only available as a brand name, with no generic option. Being a newer drug, Zubsolv tends to be more expensive than Suboxone. The price for a one-month supply of the lowest strength of Zubsolv is around $170 or more, depending on your pharmacy.
Suboxone is similarly priced, though, around $168 for a one-month supply of the lowest dose.
However, Suboxone has a generic option available on the market, buprenorphine/naloxone, which is much cheaper at $57 or more. The prices increase with higher strengths of the medication. Although insurance coverage varies, individuals who do not have insurance coverage may find it more affordable to choose generic Suboxone.
Which One Should I Take?
Zubsolv and Suboxone contain the same ingredients, buprenorphine and naloxone, both proving to be effective treatment options for opioid use disorder.
The main difference between these two is that Zubsolv has greater bioavailability and less bitter taste due to its tablet formulation. However, Zubsolv does not have a generic alternative available. Suboxone film is available in a generic version. If cost concerns you, a generic can be a more affordable option.
Ultimately, it is up to you and your provider to determine which suits you better.
MAT for Opioid Use Disorder
Zubsolv and Suboxone decrease the risk of overdose and treat opioid addiction in adults. While they play an important role in treatment, they are part of a complete treatment program. This program includes counseling and behavioral therapy.
Medication for Addiction Treatment (MAT) programs are the use of medications, along with the use of psychosocial therapy and support, to provide a whole-person approach to the treatment of substance use disorders. While medication for opioid use disorder is first-line treatment, individuals can benefit from additional psychosocial therapy and support.
The duration of MAT programs can range from several months to years, and it is determined on a case-by-case basis. In some cases, MAT can be long-term. The decision regarding the duration of MAT is made collaboratively between the patient and their healthcare provider.
While medication for MAT is a commonly used approach, other examples of MAT include cognitive behavioral therapy and peer support groups.
SAMHSA Helpline
If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Summary
In the journey towards recovery from opioid use disorder, medications like Zubsolv and Suboxone have pivotal roles in addiction treatment. Understanding the differences and benefits of these medications is essential when navigating treatment and recovery.
Overall, Zubsolv and Suboxone are both effective options. They contain the same active ingredients and work in the same way. However, Zubsolv has higher bioavailability than Suboxone, which means you need less of it to achieve the same results. Also, because of its formulation, it tastes less bitter.
The author would like to recognize and thank Sakina Yasmin Naqvi for contributing to this article.
Read the original article on Verywell Health.
