Zubsolv is a treatment for opioid addiction that is commonly used as a maintenance therapy. It can help a person with opioid dependence by reducing their cravings. It is used as part of a comprehensive treatment plan, which involves therapy and psychological treatments, to help individuals overcome addiction to opioids. What Is Zubsolv? Zubsolv is a combination of two drugs: buprenorphine and naloxone. It comes in tablet form, which is designed to be placed under the tongue until it dissolves. Zubsolv is used for the treatment of opioid use disorders. It can be used as an initial treatment to help someone stop using, as well as a maintenance treatment to help individuals stay sober. Zubsolv for Opioid Addiction Zubsolv works by helping a person to control the withdrawal symptoms of stopping opioid use while also managing withdrawal symptoms. When an individual who struggles with opioid addiction and dependence decides to stop using, painful and even dangerous withdrawal symptoms can emerge. These symptoms can be the first hurdle that is difficult to overcome. Even if someone is able to quit using opioids and get past the withdrawal phase, opioid cravings and other symptoms of addiction can result in a relapse. Drugs like Zubzolv can offer a medicinal treatment that can assist patients as they first quit using and set up a foundation for recovery. Zubsolv vs. Suboxone Similar to Zubsolv, Suboxone is also a combination of buprenorphine and naloxone that comes in a tablet or film that dissolves under the tongue. The difference between Zubsolv and Suboxone tablets is that Zubsolv has a better taste and a faster dissolve time. When the Zubsolv tablet dissolves, a greater amount of it is able to enter the bloodstream compared with Suboxone and, as a result, it has a 30% lower dosage rate than Suboxone while providing similar effects. Similar to the tablet, Zubsolv film has been shown to provide similar results compared to Suboxone film in initial and maintenance treatment. It is thought that patients prefer Zubsolv for its improved taste and faster dissolve time. Zubsolv vs. Subutex Subutex is similar to Zubsolv, but it only contains buprenorphine. Buprenorphine alone was used for many years as the leading medicinal treatment for opioid use disorder and is still considered the first-line treatment for opioid replacement therapy. Compared with Subutex, Zubsolv is less likely to cause abuse. Both are equally effective in treating opioid use disorder. How to Take Zubsolv Zubsolv tablets should be taken once daily. The tablet should be placed under the tongue and allowed to completely dissolve. It should not be chewed, cut, crushed, broken or swallowed. Do not eat or drink until the tablet is completely dissolved. The dosage of Zubsolv depends on what it is being used for. If more than one tablet is needed to achieve the prescribed dose, they should all be placed under the tongue to dissolve at the same time. During Inpatient TreatmentAs Maintenance MedicationIn Private Outpatient TreatmentDuring inpatient treatment, Zubsolv is usually used in the first, initial steps. When a person has decided to quit but is still using the drug, they can take Zubsolv to ease the withdrawal symptoms that would normally surface. Patients will usually get an induction dose, or first dose, and then the dosage will vary as it is gradually reduced. The dosing starts with 1.4 mg buprenorphine/0.36 mg naloxone for the initial dose. Following the initial dose, Zubsolv will be given every 1.5–2 hours at doses of 1.4 mg/0.36 mg or 2.8 mg/0.72 mg to control withdrawal symptoms. The total dose that can be given on the first day is 5.7 mg/ 1.4 mg. The second day, a dose of 11.4 mg/2.9 mg is given. Following initial treatment, Zubsolv is also used as a maintenance treatment, to help prevent the patient from relapsing. To achieve this, Zubsolv is usually given at a dose that maintains the person in treatment and prevents withdrawal symptoms. The dose is reduced to the lowest dose possible as quickly as possible, with the end goal being 11.4 mg/2.9 mg once a day or lower. The maximum daily dose is 17.2 mg/4.2 mg. Zubsolv works for as long as a patient needs in order to remain stable and not relapse. Zubsolv needs to be prescribed by a physician. If a person is stable enough to use Zubsolv, doctors may prescribe it for unsupervised use. They will consider the condition of the patient, their ability to control their cravings (e.g. not abuse Zubsolv) and the likelihood that they will give Zubsolv to another person who it is not prescribed to. If the doctor feels that they will be able to manage the prescription and stick to the dosing schedule on their own, they may prescribe it for outpatient use. How Does Zubsolv Work? Zubsolv works by interacting with opioid receptors. It contains buprenorphine, which binds to the opioid receptors, and naloxone, a drug that essentially inhibits the euphoria response. The combination of the two drugs prevents withdrawal symptoms from emerging but does not provide a high similar to a prescription opioid. The half-life of Zubsolv depends on that of buprenorphine, which is 24–48 hours. For that reason, Zubsolv is taken once a day to maintain levels of buprenorphine in the patient. How long Zubsolv blocks opiates, depends on the half-life of naloxone, which is only 30–60 minutes. Does Zubsolv Get You High? Because Zubsolv binds to the same receptors as opioids, you may be wondering, “Can you get high on Zubsolv?” Because it stimulates the same receptors as opioids, Zubsolv can cause feelings of euphoria, similar to opioids. However, the Zubsolv high is less intense than that of other opioids or illicit drugs because it only partially binds the receptor. Additionally, buprenorphine in Zubsolv has a “cap effect,” meaning that at a certain point it will reach a limit where no more can bind to the receptors and, therefore, there is no change in the reaction that a person feels. No matter how much more they take, no additional high will be achieved. This is part of the reason it works so well as a treatment for opioid addiction. Zubsolv Side Effects There are some side effects that can occur with Zubsolv treatment, including: Headache Nausea Constipation Diarrhea Vomiting Insomnia Excessive sweating Aches throughout the body Swelling of the arms and legs Painful sensations in the mouth or throat Loss of sensation in the mouth Zubsolv can also make you tired, causing sleepiness, dizziness or loss of coordination. For this reason, it is advised that patients taking the drug do not drive, operate heavy machinery or participate in other activities that might be dangerous until it is known how the medication affects you. Zubsolv treatment can also have more serious side effects, including: Difficulty breathing Jaundice Abdominal pain Symptoms of opioid withdrawal, such as tremors and flu-like symptoms If any of these effects are experienced, it is best to check with a doctor immediately. Zubsolv Withdrawal Since Zubsolv has a similar mechanism of action as opioid drugs themselves, Zubsolv withdrawal can occur. The symptoms are usually less intense than with opioid drugs and the onset may be delayed in comparison. It is advised to never stop taking Zubsolv without first speaking to a doctor. The duration of Zubsolv withdrawal will depend on how quickly the drug is stopped, but can take anywhere from a few days to a few months. In general, it is recommended to taper the drug, rather than suddenly stopping cold turkey. The tapering is usually done by decreasing the dose by 2 mg every 5–7 days. Zubsolv should not be used by people who are hypersensitive or allergic to buprenorphine or naloxone. It should also not be used in combination with many other types of drugs. It is best to speak with a physician before using it in combination with any other drug. If you swallow Zubsolv, it will not work as well. Dissolving it under the tongue allows for it to be absorbed directly into the bloodstream. If it is swallowed, it will not be absorbed as well through the digestive system and, therefore, there will be less of the drug available for use in the body. As with any drug, snorting Zubsolv is not recommended. Snorting can cause more of the drug to be absorbed than would be through dissolving it under the tongue and could lead to overdose issues. Zubsolv and Pregnancy The data on the risks of Zubsolv during pregnancy is limited, however, most conclude that there is not a risk of birth defects due to buprenorphine exposure. When a mother is taking opioids, whether illicit or prescribed, there is a risk that the baby will have neonatal opioid withdrawal syndrome after it is born, which can be dangerous if not treated properly. Can You Overdose on Zubsolv? Overdosing on Zubsolv is possible. Symptoms of a Zubsolv overdose include: Very small pupils Sedation Low blood pressure Troubled or slowed breathing. If an overdose is suspected, the person should get help immediately. Naloxone alone may be used as a treatment for overdose since it can bind to the opioid receptors and inhibit the effects of buprenorphine. Seeking Medication-Assisted Treatment for Opioid Abuse? Whether you're calling for yourself or a loved one, our Intake Coordinators are here to help. Your call is confidential, and there's no pressure to commit to treatment until you're ready. We are ready and waiting to answer your questions or concerns 24/7. 561-582-2030 How Long Is Opioid Addiction Treatment with Zubsolv? Zubsolv works for as long as a patient needs in order to remain stable and not relapse in their opioid dependence. There is not a recommended length of treatment for maintenance therapy. A person using Zubsolv for maintenance therapy may use it as long as it is beneficial to their treatment plan. It is recommended that physicians closely monitor the use of Zubsolv, including limiting the amount that is prescribed in order to avoid abuse. Benefits and Effectiveness Zubsolv has proven highly effective for treatment of opioid use disorders. Zubsolv effectively reduces opioid cravings and withdrawal symptoms, allowing people to successfully maintain treatment and avoid relapse. When compared to another opioid use disorder treatment such as methadone, people receiving buprenorphine/naloxone treatment were less likely to continue using illicit opioid drugs. Even though Zubsolv is effective for treating opioid use disorders, it should be used in combination with therapy and psychological support to provide a comprehensive treatment plan for individuals recovering from an opioid addiction. How Much Does Zubsolv Cost? Zubsolv costs $143.65 for a total of thirty 0.7 mg buprenorphine/0.18 mg naloxone tablets. The number of tablets that a person takes will depend on the dose prescribed by their doctor. The cost of Zubsolv vs. Suboxone is similar, with Suboxone costing $158.07 for thirty 2 mg/0.5 mg films. Suboxone can also be prescribed with higher doses in a single film, but the price increases significantly. Key Points: Understanding Zubsolv Treatment and Your Recovery Some key points to remember about Zubsolv and its use are: Zubsolv is a tablet the combines buprenorphine and naloxone for the treatment of opioid use disorders. Zubsolv is highly effective and can be used as induction or maintenance therapy. When used in combination with counseling and psychological support, Zubsolv can be a highly effective treatment for opioid use disorders. If you or a loved one are ready to address a substance use disorder, contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about starting professional addiction treatment. With individualized plans, each client receives the treatment that will be most beneficial for their unique situation. Take the first step toward a healthier future, call today. SourcesHeo, Y.A.; Scott, L.J. “Buprenorphine/Naloxone (Zubsolv®): A Review in Opioid Dependence.” CNS drugs. September, 2018. Accessed July 19, 2019. Gunderson, Erik W.; Sumner, Michael. “Efficacy of Buprenorphine/Naloxone Rapidly Dissolving Sublingual Tablets (BNX-RDT) After Switching From BNX Sublingual Film.” Journal of Addiction Medicine, March, 2016. Accessed July 19, 2019. Soyka, Michael. “New developments in the management of opioid dependence: focus on sublingual buprenorphine–naloxone.” Substance Abuse and Rehabilitation, January 6, 2015. Accessed July 19, 2019. Food and Drug Administration. “Zubsolv prescribing information.” September, 2018. Accessed July 19, 2019. Drugs.com. “Zubsolv.” March 11, 2019. Accessed July 19, 2019. Drugs.com. “Zubsolv Side Effects.” February 10, 2019. Accessed July 19, 2019. Food and Drug Administration. “Zubsolv medication guide.” July, 2013. Accessed July 19, 2019. Mauger, S.; Fraser, R.; Gill, K. “Utilizing buprenorphine-naloxone to treat illicit and prescription-opioid dependence.” Neuropsychiatric Disease and Treatment, April 7, 2014. Accessed July 19, 2019. Sutter, M.B.; Leeman, L.; Hsi, A. “Neonatal opioid withdrawal syndrome.” Obstetrics and Gynecology Clinics of North America, June, 2014. Accessed July 19, 2019. Hser, Yih-Ing; Saxon, Andrew J.; Huang, David; Hasson, Al; Thomas, Christie; Hillhouse, Maureen; Jacobs, Petra; Teruya, Cheryl; McLaughlin, Paul; Wiest, Katharina; Cohen, Allan; Ling,Walter. “Treatment Retention among Patients Randomized to Buprenorphine/Naloxone Compared to Methadone in A Multi-site Trial.” Addiction, January 2014. Accessed July 19, 2019. Drugs.com. “Zubsolv Prices, Coupons and Patient Assistance Programs.” Accessed July 19, 2019. Drugs.com. “Suboxone Prices, Coupons and Patient Assistance Programs.” Accessed July 19, 2019.