What Is Zubsolv®?
- Approved for adult opioid disorder, Zubsolv® uses buprenorphine and naloxone to manage withdrawal under supervision.
- Zubsolv® combines partial opioid activation and naloxone for withdrawal, like Suboxone but with distinct doses.
- Zubsolv® tablets dissolve under the tongue, with varied shapes and doses based on buprenorphine and naloxone.
- Zubsolv® can cause mild and severe side effects, interacts with many drugs, needs careful medical review.
Opioid dependence is difficult to overcome on your own, and for many people, medication-assisted treatment provides a means to ease their journey toward recovery. Zubsolv® is an FDA-approved prescription drug for adults with opioid use disorder, but it should only be taken after a medical evaluation and under medical supervision.
Zubsolv® Drug Facts
Zubsolv®, the brand name of buprenorphine/naloxone as a sublingual tablet, is used to manage opioid withdrawal. The buprenorphine is a partial opioid agonist [1], meaning it only partially activates your brain’s opioid receptors. Naloxone is an opioid antagonist; it binds to the receptors and stops any opioid from activating the receptors.
Zubsolv® treatment works in two ways. First, buprenorphine, while an opioid, decreases your withdrawal symptoms. Then, the naloxone blocks the buprenorphine’s full effects to prevent misuse. It’s similar to Suboxone in that both medications have the same active ingredients but different doses of each.
What Drug Class Is Zubsolv®?
It belongs to the opioid antagonists, analgesics, and opioid partial agonist class.
What Does Zubsolv® Look Like?
It’s a small, white tablet that has a different shape for the different dosages, such as triangular, diamond, round, and oval. The specific milligram dosage is imprinted on one side of the tablet.
What Is Zubsolv® Used For?
When someone has an opioid use disorder, their body develops a physical dependence and acclimates to the amount of opioids and expects the amount to continue. Otherwise, they experience opioid withdrawal symptoms — cravings, restlessness, sweating, and vomiting — as their body clamors for opioid drugs.
Zubsolv® is prescribed to adults after a trained doctor or healthcare provider determines the medication will be safe and effective for them to use. When used correctly, it prevents opioid withdrawal symptoms as one part of a treatment program, and provides you or your loved one a significantly reduced opioid overdose risk. It’s frequently used as part of medication-assisted treatment which helps you or your loved one with medication, counseling, and therapy.
It’s commonly used as long-term treatment to help eliminate opioid dependence, with the dosage tapered over time with medical supervision.
How Does Zubsolv® Work?
The tablet is placed under your tongue and dissolves within 5 to 10 minutes — don’t chew, crush, or swallow the tablet. After the Zubsolv® enters the bloodstream through the mucus membranes inside your mouth, the buprenorphine partially triggers the opioid receptors in your brain. The partial activation provides enough of the euphoric or high sensation to prevent withdrawal symptoms. The naloxone blocks effects of other opioids and is added to Zubsolv® to discourage additional buprenorphine use.
How long does it take for Zubsolv® to take effect?
After the tablet has fully dissolved, it begins to work within 60 minutes.
How long does Zubsolv® last?
Depending on your prescribed dosage, Zubsolv® may stay in your bloodstream up to 11 days. No matter what your prescribed dosage is, one half of a single dose of buprenorphine leaves the body after 24 to 42 hours, its half life. Naloxone has a half life of 2 to 12 hours.
What Are Common Side Effects Of Zubsolv®?
While most people taking Zubsolv® experience mild side effects like belly pain; headache; constipation, nausea, or vomiting; runny nose; and sweating more than usual, serious side effects have been reported. The mild effects are usually temporary and easily managed, but it’s important to not cease taking Zubsolv® without first speaking with your doctor or healthcare provider.
Serious side effects, though rare, may include:
- Adrenal insufficiency;
- Allergic reaction;
- Breathing problems or respiratory depression;
- Central nervous system depression;
- Dental issues;
- Drowsiness;
- Increased blood pressure in your gallbladder or liver;
- Increased pressure in your head;
- Liver damage or hepatitis; and/or
- Orthostatic hypotension.
Contact your doctor or healthcare provider immediately if you or your loved one experience any of these side effects while taking Zubsolv® or believe you may have developed a dependence. An individualized treatment plan based on medical advice and behavioral therapy could be the help you need.
What Mg Do The Zubsolv® Pills Come In?
Your doctor or healthcare provider begins treatment with a low dose of Zubsolv® then adjusts the amount over time as necessary. The number imprinted on the tablet indicates the milligrams (mg) of buprenorphine in the Zubsolv® tablet.[2]
| Tablet Dosage | Ingredient Dosage |
|---|---|
| Zubsolv® 0.7 | 0.7 mg buprenorphine/0.18 mg naloxone |
| Zubsolv® 1.4 | 1.4 mg buprenorphine/0.36 mg naloxone |
| Zubsolv® 2.9 | 2.9 mg buprenorphine/0.71 mg naloxone |
| Zubsolv® 5.7 | 5.7 mg buprenorphine/1.4 mg naloxone |
| Zubsolv® 8.6 | 8.6 mg buprenorphine/2.1 mg naloxone |
| Zubsolv® 11.4 | 11.4 mg buprenorphine/2.9 mg naloxone |
The dosage prescribed by your doctor depends on several factors, including the severity of your OUD; opioids taken in the past; past frequency of use; withdrawal symptoms; and other medical conditions.
Zubsolv® and Other Drug Interactions
Zubsolv® has more than 600 known drug interactions, including common over-the-counter medications and supplements. If you take or use two or more medications or drugs at the same time, it’s called polysubstance use and can lead to serious drug interactions. Always consult with your healthcare provider before taking any other medications while on Zubsolv®, and share all medications or drugs you’re currently using before starting Zubsolv®.
Interactions may range from a mild allergic reaction to life-threatening conditions, such as low blood pressure. Known medications with moderate to major interactions with Zubsolv® include:
- Alprazolam
- Ativan (lorazepam)
- Bupropion
- Clonazepam
- Clonidine
- Cymbalta (duloxetine)
- Gabapentin
- Hydroxyzine
- Klonopin (clonazepam)
- Lexapro (escitalopram)
- Lisinopril
- Lyrica (pregabalin)
- Propranolol
- Seroquel (quetiapine)
- Trazodone
- Valium (diazepam)
- Xanax (alprazolam)
- Zoloft (sertraline)
Who Should Not Take Zubsolv®?
Your doctor or healthcare provider will give you a thorough evaluation to determine whether you’re healthy enough to take Zubsolv®. You shouldn’t take it you have or have had:
- A low seizure threshold;
- An inability to completely empty your bladder;
- Abnormal EKG with QT changes from birth;
- Abnormal liver function tests;
- Alcohol intoxication;
- Biliary and gallbladder problems;
- Breastfeeding, talk to your doctor about potential risks
- Chronic hepatitis B;
- Chronic hepatitis C;
- Cor pulmonale;
- Curvature of the spine with respiratory compromise;
- Decreased adrenal gland function;
- Decreased lung function;
- Enlarged prostate;
- High pressure within the skull;
- History of opioid overdose;
- Liver problems;
- Orthostatic hypotension;
- Overall weakened state;
- Psychosis caused by sudden alcohol withdrawal;
- Seizures;
- Sleep apnea;
- Toxic psychosis;
- Untreated decreased level of thyroid hormones; and/or
- Worsening chronic obstructive pulmonary disease
Start A Supportive Journey Toward a Healthier Lifestyle at Recovery Unplugged
Overcoming opioid dependence is possible, regardless of how long you or a loved one have had a use disorder. At Recovery Unplugged, we blend evidence-based methods with holistic healing so you return to the whole you. Contact us today.
What Happens If You Swallow Zubsolv®?
The medication won’t be as effective since it wasn’t dissolved before entering your bloodstream.
Is Zubsolv® a narcotic?
Yes. It’s a Schedule III controlled substance because it contains buprenorphine, a medication with misuse potential.
How does Zubsolv® make you feel?
Although the side effects may be different for each person taking Zubsolv®, they commonly include:
- Constipation;
- Difficulty sleeping;
- Headache;
- Nausea and vomiting;
- Pain; and/or
- Sweating.
What is the difference between Zubsolv® and Suboxone?
Zubsolv® is a tablet placed under the tongue where it dissolves and enters your bloodstream. Suboxone is generally used as a film placed on the inside of your cheek or under the tongue, but can also be a tablet.[3]
Will stopping Zubsolv® make me have withdrawal symptoms?
Yes, as your body is used to the medication and its effects. Your doctor or healthcare provider will help you stop using Zubsolv® in a way that minimizes or eliminates withdrawal symptoms.
Is Zubsolv® used to treat pain?
No. While buprenorphine, an active ingredient in Zubsolv®, can be prescribed off-label for pain relief, Zubsolv® itself isn’t. The medication isn’t a strong pain reliever and shouldn’t be used as one.
Does Zubsolv® cause weight gain?
Generally no, but it’s possible. Weight gain can happen with lifestyle changes you or your loved one make after starting OUD treatment, such as eating healthier. Speak with your doctor or healthcare provider if you notice changes in weight while taking Zubsolv®.
Can Zubsolv® cause vision problems?
Not directly, but it can cause central nervous system (CNS) depression which has blurred vision as a symptom. If you experience blurred vision, contact your doctor or healthcare provider immediately.
What happens if I take a benzo while taking Zubsolv®?
Contact your doctor or healthcare provider immediately. Overdose, coma, and death have been reported with concurrent buprenorphine and benzodiazepine use. Benzos, and other medications or drugs that act on the CNS, should be prescribed and used with extreme caution and under medical guidance.
What happens if I forget to take Zubsolv®?
If you miss a dose, take the dose when you remember. But if it’s almost time for the next dose, skip the missed dose and take the next on schedule. Don’t take two doses at once unless guided by your doctor or healthcare provider.
Can Zubsolv® be detected in a drug test?
It depends on the specific drug test. Many labs test for buprenorphine and norbuprenorphine, a metabolite, to make sure your body is metabolizing the drug through the liver.
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Sources
[1] Buprenorphine. SAMHSA. (2023, January 25). Retrieved February 2, 2023, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
[2] Orexo US, Inc. (n.d.). Dosage & Administration. Retrieved February 2, 2023, from https://www.zubsolv.com/zubsolv/dosage-administration/
[3] Center for Drug Evaluation and Research. (n.d.). DRUGS@FDA data files. U.S. Food and Drug Administration. Retrieved February 2, 2023, from https://www.fda.gov/drugs/drug-approvals-and-databases/drugsfda-data-files
