Both Vivitrol and Suboxone are anti-craving medications used to treat substance abuse issues. But, they are different medications and have different advantages and use cases.
- Vivitrol contains naltrexone
- Suboxone contains Buprenorphine with naloxone (Narcan) for safety
Category: Addiction Medicine > Vivitrol, Suboxone
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How is Suboxone different from Vivitrol?
Suboxone doesn’t treat alcohol issues.
- Vivitrol is FDA-approved to treat both alcohol and opioid addictions.
- Suboxone is FDA-approved for only opioid addictions.
Suboxone must be taken every day.
- Vivitrol is given as a monthly injection by a doctor.
- Suboxone is taken daily as a film under the tongue.
Suboxone helps with withdrawals.
- Vivitrol requires 7-10 days of sobriety from opioids to start and does not help with withdrawals.
- Suboxone helps relieve withdrawal symptoms.
Suboxone creates a medication dependence.
- Vivitrol is non-habit forming and can be stopped any time.
- Suboxone must be tapered down to avoid withdrawals.
Suboxone is a partial opioid.
- Vivitrol blocks opioid receptors in the brain and is not an opioid.
- Suboxone partially activates these receptors and is a partial opioid.
Does Vivitrol work better than Suboxone?
Once opioid patients get on a medication, the success rates are similar between Suboxone and Vivitrol.
The problem is that Vivitrol has to be given after withdrawal is over. Getting to 7-10 days detoxed from opioids can be difficult without the help of medications like Suboxone.
Therefore, Suboxone is generally cited as more successful in preventing relapse and total abstinent days. But, if a patient already has 7 days free of opioids (including Suboxone), then Vivitrol will be just as effective.
Both medications are great options to discuss with your doctor and both are most effective when combined with therapy like an Intensive Outpatient Program (IOP).
When is Vivitrol better than Suboxone?
One medication isn’t better than the other in general, but there are circumstances where Vivitrol might be the better option.
- For Alcohol: Vivitrol is the first-choice recommendation for alcohol issues, and can be a good recommendation for patients who struggle with both alcohol and opiates. Suboxone is not recommended for alcohol-only issues.
- When Detoxed from Opioids: If a patient has been off opiates for 7-10 days, Vivitrol would also be a great choice to help manage cravings. Since Vivitrol doesn’t cause any kind of dependence and Vivitrol side effects are mild to none.
- After Suboxone: Vivitrol can be an extra layer of security after tapering off of Suboxone to eliminate the dependence on taking medication daily.
Is Vivitrol stronger than Suboxone?
Because Suboxone actually partially activates the opioid receptor, you could say Suboxone is stronger. (Then, since methadone is a full-opioid, methadone is the strongest of the three medications — see also methadone vs. Suboxone).
Suboxone
Partial Agonist
Vivitrol
Antagonist
Is Vivitrol safer than Suboxone?
The biggest danger with either medication is the interactions with opioids. If opioids are used while on these medications, the risk of overdose is equally high.
In terms of non-life-threatening side effects, Suboxone can have more side effects and causes withdrawal symptoms if stopped cold-turkey.
Can Suboxone be used with Vivitrol?
No, you cannot take Suboxone and Vivitrol together. They both involve the same opioid receptors in the brain and taking both causes withdrawal symptoms and overdose is even possible.
The first step is to taper off of Suboxone. Then, a drug screen can help indicate the right time to start Vivitrol, typically at least 7 days after stopping Suboxone.
How long it takes to taper off Suboxone depends on the dosage. A patient on 10 mg of Suboxone might take 4-7 weeks to start Vivitrol. Rushing the taper leads to feeling sick unnecessarily.
Transitioning from Vivitrol to Suboxone isn’t common, but may be appropriate if cravings aren’t controlled with Vivitrol.
Ideally, the patient would wait until it’s time for the next Vivitrol shot (around 28 days) and start Suboxone instead. The change shouldn’t cause any side effects or sickness.
A Suboxone clinic will typically offer both medications. (See also — What is a Suboxone clinic?)
Are you looking to start Vivitrol or Suboxone treatment?
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