Brixadi vs. Sublocade: Which Buprenorphine Injection is Right for You?

Brixadi and Sublocade are both extended-release buprenorphine injections used to treat moderate to severe opioid use disorder. Both are administered under the skin by a healthcare professional and are designed to maintain buprenorphine levels over an extended period, helping reduce opioid withdrawal symptoms and cravings without requiring daily medication. A major difference is that Brixadi is available in both weekly and monthly formulations, while Sublocade is primarily administered as a monthly treatment. 

The medications also have different available strengths and dosing approaches, which may influence which option is appropriate for a particular patient. Neither medication should automatically be considered better for everyone. At Ascension Solutions Treatment, our clinic considers a patient’s current buprenorphine treatment, symptoms, treatment stability, medical history, preferences, and recovery needs when discussing whether Brixadi or Sublocade may be appropriate.

Brixadi offers greater variation in dosing frequency because it is available as either a weekly or monthly injection. Weekly Brixadi is generally administered at seven-day intervals, while monthly Brixadi is administered at approximately four-week intervals. The available Brixadi strengths allow clinicians to select and adjust treatment according to the patient’s previous buprenorphine dose and clinical response. Patients can also transition between weekly and monthly Brixadi when clinically appropriate.

Sublocade follows a monthly maintenance schedule. Treatment generally begins with higher initial doses before transitioning to a monthly maintenance dose, although the exact regimen can be adjusted according to clinical response. The second Sublocade injection may sometimes be administered sooner than the usual monthly interval when clinically appropriate. At Ascension Solutions Treatment, our team evaluates each patient individually rather than selecting an injectable medication based only on convenience or dosing frequency.

Brixadi may be worth considering for patients who could benefit from having both weekly and monthly dosing options. A weekly formulation can give clinicians an opportunity to assess treatment response at shorter intervals and make dosing decisions based on symptoms and progress. Brixadi weekly can also be used in adults who have tolerated an appropriate test dose of transmucosal buprenorphine, while Brixadi monthly is intended for adults who are already receiving buprenorphine treatment. 

However, being eligible for Brixadi does not necessarily mean it is preferable to Sublocade. Factors such as previous buprenorphine treatment, withdrawal symptoms, cravings, medication response, liver health, other medications, lifestyle considerations, and preference for weekly versus monthly visits may influence the decision. At Ascension Solutions Treatment, our clinic evaluates these factors before recommending an extended-release buprenorphine option so treatment can be matched to the patient’s individual clinical needs.

Yes, insurance coverage can differ between Brixadi and Sublocade. Even though both medications contain extended-release buprenorphine and are used for opioid use disorder, insurance companies may place them under different formularies or coverage policies. One medication may be preferred by a particular health plan, while another may require prior authorization or additional clinical documentation. Patient copayments, deductibles, coinsurance, and pharmacy or medical benefit requirements can also differ.

Before beginning either medication, patients should verify coverage with their insurance plan and treatment clinic. Insurance approval may depend on diagnosis, previous buprenorphine treatment, medical necessity, plan requirements, and where the medication is administered. At Ascension Solutions Treatment, our team can discuss insurance information with patients considering Brixadi or Sublocade and help them understand which coverage questions they should address before starting treatment.

Choosing between Brixadi and Sublocade should begin with a clinical evaluation rather than simply comparing how often the injections are given. Important considerations can include the patient’s opioid use history, current or previous buprenorphine treatment, withdrawal symptoms, cravings, response to prior medications, other health conditions, medications, treatment preferences, and ability to attend scheduled appointments. Both medications are extended-release forms of buprenorphine, but their dosing flexibility and treatment pathways differ. 

Dr. Jonathan Hall, MD, and the team at Ascension Solutions Treatment help patients compare Brixadi and Sublocade based on their individual circumstances and recovery goals. Our clinic offers both Brixadi and Sublocade as treatment options for opioid use disorder and provides ongoing assessment to determine how well treatment is managing cravings, withdrawal symptoms, and overall stability. By reviewing the advantages, limitations, dosing schedules, and individual suitability of each option, our team can help patients make an informed decision about their medication-assisted treatment. For more information, contact us or request an appointment online. We are conveniently located at 3780 Holcomb Bridge Road Suite D2, Peachtree Corners, GA 30092. We serve patients from Peachtree Corners GA, Roswell GA, Johns Creek GA, Alpharetta GA, Dunwoody GA, Duluth GA, Norcross GA, and the surrounding Metro Atlanta areas.