Vivitrol vs. Suboxone: What’s The Difference? Here’s What You Need To Know

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Dr. Po-Chang Hsu -

Medically Reviewed By:

Dr. Po-Chang Hsu

Last Medically Reviewed on December 4, 2023

  • Vivitrol is prescribed to prevent relapse to opioid dependence after opioid detoxification, while Suboxone is used to treat opioid dependence by reducing withdrawal symptoms and cravings.
  • The active ingredient of Vivitrol is Naltrexone, while Suboxone contains Buprenorphine and Naloxone.
  • A key difference between Vivitrol and Suboxone is their mechanism of action and administration; Vivitrol is an opioid antagonist administered as a monthly injection, while Suboxone combines an opioid agonist and antagonist and is typically taken daily under the tongue.
  • While both drugs are considered a low risk for addiction, they can still be misused if not taken under medical supervision.

When it comes to combating opioid addiction, two names frequently come up – Vivitrol and Suboxone. Both medications have received FDA approval, have advocates, and are considered life-saving treatments for opioid addiction. However, the choice between Vivitrol and Suboxone should be based on individual patient factors, the nature of their addiction, and medical considerations.

What is Vivitrol?

Vivitrol, also referred to as Naltrexone[1], is a medication prescribed primarily to prevent relapse into opioid dependence after opioid detoxification and also to treat alcohol dependence. What distinguishes it from other medications is its distinctive role as an antagonist, devoid of any opioid compounds. This exceptional characteristic makes it a valuable option in the fight against addiction.

How Does Vivitrol Work?

By blocking the opioid receptors in the brain, Vivitrol prevents the binding of opioids and their effects. This provides a highly effective remedy for mitigating the effects of opioids while ensuring enduring outcomes.

When someone ingests an opioid, whether it be a medically prescribed painkiller or an illicit substance like heroin, it enters the brain and binds to specific opioid receptors. This interaction is what triggers the effects associated with opioid consumption. This interaction sets off a series of reactions in the brain, ultimately leading to the euphoric sensation often associated with opioid use.

Vivitrol works by occupying opioid receptors, which stops opioids from binding to them. As a result, opioids are unable to produce their feelings of euphoria. This is why Vivitrol is known as an antagonist – it counteracts the effects of opioids.

Vivitrol[2] plays a role in the treatment of addiction by serving two important purposes. Firstly it effectively blocks the opioid effects. Secondly, it helps reduce cravings. These functions play a pivotal role in the recovery process since cravings often trigger relapses.

What are the Side Effects of Vivitrol?

As with any medication, Vivitrol may cause side effects[3]. Here is a list of potential side effects associated with Vivitrol:

  • Feeling nauseous
  • Experiencing headaches
  • Dizziness
  • Fatigue
  • Reactions at the site of injection include pain, swelling, and redness.

Although severe side effects are not common, they can still occur. These effects might include:

  • Stomach or abdominal pain
  • Feelings of sadness or low mood
  • Suicidal thoughts
  • Reduced appetite
  • Abdominal pain
  • Rash
  • Trouble breathing

It is important to use Vivitrol or any medication with the guidance of a healthcare professional who can oversee and manage any side effects. Before beginning any medication, it is always recommended to have a conversation with your healthcare provider about side effects.

What is Suboxone?

Suboxone is a prescribed medication specifically formulated to assist in the treatment of opioid dependence. It combines two active components – buprenorphine and naloxone.

How Does Suboxone Work?

Suboxone[4] is a potent blend of buprenorphine and naloxone, formulated to combat opioid addiction with efficacy. Each ingredient serves a crucial purpose in ensuring the medication’s optimal functionality.

Buprenorphine: Buprenorphine works as an agonist, which means it attaches to the same brain receptors as heroin or prescription painkillers. However, its activation of these receptors is much weaker.

This can be beneficial in reducing cravings and withdrawal symptoms for people dependent on opioids. As a partial agonist, buprenorphine’s activation of opioid receptors is weaker than full agonists like heroin, reducing the risk of intense euphoria and dangerous side effects commonly associated with stronger opioids.

Naloxone: Naloxone is an opioid antagonist included in Suboxone to counteract the effects of opioids, particularly to deter intravenous misuse of buprenorphine. When Suboxone is taken as prescribed, naloxone has minimal effect, but if injected, it can precipitate withdrawal symptoms in individuals with opioid dependence.

By combining these two ingredients, Suboxone helps prevent withdrawal symptoms, reduce cravings, and discourage medication misuse.

What are the Side Effects of Suboxone?

Like Vivitrol, Suboxone may cause a range of side effects. Common side effects include:

  • Nausea
  • Headache
  • Insomnia
  • Sweating
  • Constipation
  • Dizziness or lightheadedness
  • Weight loss or gain
  • Weakness or fatigue

In rare cases, Suboxone can cause more serious side effects such as:

  • Slowed breathing
  • Confusion
  • Fainting
  • Allergic reactions such as hives, rash, or itching

Are Vivitrol and Suboxone Addictive?

While Vivitrol and Suboxone are effective in treating opioid addiction, Vivitrol, containing Naltrexone, does not carry a risk of addiction. Suboxone, containing buprenorphine, has a lower potential for abuse compared to traditional opioid medications but still carries some risk of dependence.

Therefore, it’s crucial to exercise caution and carefully consider the potential for dependence when using these medications. It’s important for individuals to closely collaborate with their healthcare providers to ensure the appropriate and safe use of these medications as part of a comprehensive treatment plan.

Which Drug is More Effective?

Both Vivitrol and Suboxone have shown efficacy[5] in helping individuals manage their opioid use disorder. The effectiveness may vary based on needs and circumstances.

Doctors may choose to prescribe one medication over the other depending on other forms of treatment patients may be undergoing or any present side effects that one drug may have versus the other.

Frequently Asked Questions About Vivitrol vs. Suboxone

Is it safe to combine Vivitrol and Suboxone?

Taking both Vivitrol and Suboxone is generally discouraged due to how they interact. The Naltrexone in Vivitrol works against the partial opioid agonist effects of Buprenorphine in Suboxone. This could make Suboxone less effective and potentially initiate withdrawal symptoms.

Which medication, Vivitrol or Suboxone, has more pronounced side effects?

Although both medications can result in common side effects like nausea or headaches, Vivitrol may also have uncommon side effects, including depression and suicidal thoughts. This is important to discuss with your doctor before choosing an option that is right for you.

How do the costs of Vivitrol and Suboxone compare?

The cost of Vivitrol and Suboxone may differ depending on factors such as insurance coverage, geographical location, and other variables. Vivitrol generally has a higher price compared to Suboxone. It’s important to discuss costs with a healthcare professional before making any decisions to ensure an informed choice.

How long do the effects of Vivitrol and Suboxone last?

The duration of medication can vary. Typically, Vivitrol’s effects persist for up to four weeks, while Suboxone’s effects can span from twelve hours to several days.

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Sources


[1] National Library of Medicine. (n.d.). Naltrexone – StatPearls – NCBI Bookshelf. Naltrexone. https://www.ncbi.nlm.nih.gov/books/NBK534811/

[2] Naltrexone (vivitrol). NAMI. (n.d.). https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Naltrexone-(Vivitrol)

[3] U.S. National Library of Medicine. (n.d.). Naltrexone injection: Medlineplus Drug Information. MedlinePlus. https://medlineplus.gov/druginfo/meds/a609007.html

[4] Velander, J. R. (2018). Suboxone: Rationale, science, misconceptions. The Ochsner journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/

[5] Author links open overlay panelDr Joshua D Lee MD a, a, c, b, d, e, f, g, h, i, j, k, l, m, n, (XR-NTX), S. naltrexone, Krupitsky, E., Kelty, E., Lee, J., … Comer, S. (2017, November 14). Comparative effectiveness of extended-release naltrexone versus Buprenorphine-Naloxone for opioid relapse prevention (X:bot): A multicentre, open-label, Randomised Controlled Trial. The Lancet. https://www.sciencedirect.com/science/article/abs/pii/S014067361732812X

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