Suboxone and Vivitrol are two medications approved to treat opioid use disorder. While Suboxone and Vivitrol are both effective for helping people with OUD manage withdrawal symptoms and cravings, there are several key differences between these two medications that will impact which will be most effective for your treatment. You should always consult with your provider to obtain a valid prescription for either medication if deemed necessary for your condition. 

If you think Suboxone may be able to help you overcome opioid use disorder, reach out to the professionals at Confidant Health’s online Suboxone clinic. We can conduct a virtual assessment to determine if Suboxone care may be right for you or direct you to a local provider if Vivitrol may be more suitable. As an online resource, Confidant Health is not able to administer Vivitrol.

What Is Vivitrol?

Vivitrol is an FDA-approved medication for the treatment of opioid use disorder and alcohol use disorder. It is a brand name for the drug naltrexone, an opioid antagonist that blocks the effects of opioids in your system. It is provided as a once-monthly injection and is intended to be used once you have abstained from opioid use for at least seven to 14 days.

Using opioids while receiving Vivitrol care for OUD can induce severe withdrawal symptoms. Since Vivitrol blocks the effects of opioids, it can also make you more sensitive to lower amounts of opioids, increasing the risk of overdose. Once you begin Vivitrol treatment, you should immediately reach out to your provider if you misuse opioids or are concerned you may relapse. 

What Is Vivitrol Used For?

Vivitrol is used to help reduce an individual's dependence on opioids or alcohol. As an opioid antagonist, Vivitrol blocks the effects of opioids, preventing them from providing the usual pain relief or euphoria. 

Vivitrol vs. Suboxone

Uses

Both medications support people recovering from opioid use disorder but do so differently. Suboxone is an opioid partial agonist, producing effects similar to but milder than other opioids. Vivitrol is an opioid antagonist, so it blocks the effects of opioids. Vivitrol is also used to help people manage alcohol dependence. 

Ingredients

Suboxone is a combination of buprenorphine and naloxone. Buprenorphine is an opioid partial agonist that produces mild euphoria and pain relief. Naloxone is an opioid antagonist added to Suboxone to help reduce the risk of misuse.

Vivitrol is composed solely of naltrexone, an opioid antagonist that blocks the effects of opioids and alcohol to reduce cravings. 

Side Effects

You may experience side effects when receiving Suboxone or Vivitrol care. Some potential side effects include:

  • Anxiety

  • Constipation

  • Diarrhea

  • Headache

  • Insomnia

  • Loss of appetite

  • Muscle or joint pain

  • Nausea and vomiting

Vivitrol may also result in the following side effects at the injection site:

  • Bruising

  • Itching

  • Pain

  • Swelling

If these side effects become too bothersome, consult with your provider right away for guidance. They can provide suggestions to alleviate the side effects or decide to switch your medication or change the dosage if applicable.

Vivitrol can also produce withdrawal symptoms if treatment starts while opioids are still in your system. These withdrawal symptoms may include:

  • Blurred vision

  • Disorientation

  • Hallucinations

  • Severe vomiting and diarrhea

If you experience any of the above symptoms while receiving Vivitrol treatment, reach out to your provider immediately. Excessive vomiting and diarrhea can lead to severe dehydration, which may require emergency care. 

Dosage and Forms

Although Suboxone and Vivitrol are both used to help people maintain recovery from opioid use disorder, the dosage and forms of each medication are quite different. 

Suboxone

Suboxone is administered as either a once-daily sublingual film or tablet dissolved under the tongue. The medication consists of a 4:1 ratio of buprenorphine to naloxone. It is available in the following strengths.

  • 2 mg/ 0.5 mg tablets and films

  • 4 mg/ 1 mg films

  • 8 mg/ 2 mg tablets and films

  • 12 mg/ 3 mg films

The recommended dosage varies based on your individual needs and whether you are in the induction or maintenance phase of treatment:

  • Day 1 of induction – up to 8 mg/ 2 mg daily

  • Day 2 of induction – up to 16 mg/ 4 mg daily 

  • Maintenance – between 4 mg/ 1 mg to 24 mg/ 6 mg daily

Vivitrol

Vivitrol is provided as a once-monthly injection, so you will need to schedule an appointment with a qualified provider each month to receive Vivitrol treatment. The medication is delivered as an injection into a muscle in your buttocks once every four weeks. The recommended dosage is 380 mg of Vivitrol in a single-dose vial. 

Switching from Vivitrol to Suboxone

Before deciding to switch from Vivitrol to Suboxone, you should speak with your provider. They can assess your condition and determine if Suboxone would be more appropriate for your needs. If your provider decides to switch you from Vivitrol to Suboxone, there are a few factors to consider during the transition:

  • Vivitrol is not addictive and does not contain opioids, but you should not stop your treatment abruptly. You should always consult with your provider before discontinuing your monthly injection. 

  • You will be more sensitive to smaller amounts of opioids after receiving Vivitrol treatment, so you must inform your provider of your last Vivitrol injection. This will help them determine an appropriate safe dosage of Suboxone. 

  • Suboxone is a once-daily medication, so you must be able to commit to taking your prescribed dosage at approximately the same time each day. 

Keep in mind that your increased sensitivity to opioids after Vivitrol treatment will also apply to cough, cold, or diarrhea medications that contain opioids. You should inform your primary care physician or any healthcare provider you see about your opioid medication-assisted treatment (MAT) regimen. 

Vivitrol vs. Suboxone FAQs

Is Vivitrol Similar or the Same as Suboxone?

Vivitrol is similar to Suboxone in that it helps manage opioid withdrawal symptoms and cravings to minimize the risk of relapse. However, it differs in that it can also be used for individuals with alcohol use disorder. Vivitrol also has different ingredients than Suboxone and is administered as a once-monthly injection, rather than a daily tablet or film like Suboxone.

Is Vivitrol Better Than Suboxone?

Vivitrol is not necessarily better or worse than Suboxone. Each individual responds to treatment differently, so some people may find that a once-monthly injection is more effective if they prefer the convenience. On the other hand, Vivitrol treatment cannot be administered until you have abstained from opioids for seven to 14 days. This may make Suboxone the better choice for some people. 

How Long After Suboxone Can You Take Vivitrol?

If your provider determines that you are a good candidate for Vivitrol treatment but are currently receiving Suboxone care, they will need to carefully wean you off the medication. You must discontinue Suboxone and other buprenorphine medications for at least seven to 14 days before beginning Vivitrol treatment. Receiving Vivitrol while you have opioids or opioid dependence medications in your system can induce severe withdrawal symptoms. If you experience adverse Vivitrol or Suboxone side effects or withdrawal symptoms, you should reach out to your provider right away or seek emergency medical care. 

Is Suboxone or Vivitrol Treatment Right for You? Ask the Experts at Confidant Health

If you need support for opioid use disorder, you can trust the professionals at Confidant Health’s online Suboxone clinic. We are here to answer your questions about Suboxone care through our virtual treatment clinic and can provide you with a referral if we feel Vivitrol may be appropriate for you. Get started by scheduling an intake assessment with our team today.