Vivitrol vs. Suboxone: Are they the same? Which is better?

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Lee, J. D., Nunes, E. V., Novo, P., Bachrach, K., Bailey, G. L., Bhatt, S., … & King, J. (2017). Comparative effectiveness of extended-release
naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X: BOT): a multicentre, open-label, randomized controlled trial.
The Lancet.

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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.

Table of Contents

How is Suboxone different from Vivitrol?

Suboxone doesn’t treat alcohol issues.

Suboxone must be taken every day.

Suboxone helps with withdrawals. 

Suboxone creates a medication dependence. 

Suboxone 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.

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).

Opioid receptor partly filled by buprenorphine

Suboxone

Partial Agonist

Opioid receptor blocked by naltrexone

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?

Still Have Questions?

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Symetria has addiction treatment clinics across Illinois and Texas. You can likely get scheduled TODAY — medications or therapy.