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

Both Vivitrol (naltrexone) and Suboxone (buprenorphine) are anti-craving medications used to treat substance use disorders. They are different medications,  but both interact with opioid receptors in the brain.

  In This Article

How is Suboxone different from Vivitrol?

Suboxone does not treat alcohol use disorder.

Suboxone must be taken every day.

Suboxone helps with withdrawals. 

Suboxone should be tapered prior to stopping. 

Suboxone is a partial opioid agonist.

Does Suboxone work better than Vivitrol?

Once patients with opioid use disorder start either medication, their success rates are similar between Suboxone and Vivitrol.

The challenge is that Vivitrol has to be given after withdrawal is over. Getting 7-10 days detoxed from opioids can be difficult without the help of medications like Suboxone. 

Therefore, Suboxone is generally cited as more successful. 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 Suboxone stronger than Vivitrol?

The answer isn’t straightforward. Because Suboxone partially activates the opioid receptor, Suboxone is stronger than Vivitrol in terms of opioid effect. Though, Vivitrol actually sticks to the receptor better than Suboxone but without activating it, so the opioid effect isn’t felt by patients.

Opioid receptor partly filled by buprenorphine

Suboxone

Partial Agonist

Opioid receptor blocked by naltrexone

Vivitrol

Antagonist

Is Suboxone safer than Vivitrol?

Both medications are very safe when used as prescribed. With either medication, interactions with opioids can be dangerous and may result in overdose.

Can Suboxone be used with Vivitrol?

No, you cannot take Suboxone and Vivitrol together since they have opposing mechanisms of action for the same opioid receptors. Taking both medications at the same time can cause significant withdrawal symptoms, including nausea, vomiting, sweating and severe pain.

How can I switch from Suboxone to Vivitrol?

When a patient decides to stop taking Suboxone, Vivitrol is sometimes started to provide a safety net against illicit opioid use and cravings.

The first step is to taper off of Suboxone. The patient must then wait for all the Suboxone to be completely out of their system, which typically takes about 7-10 days after their last dose.

How long it takes to taper off Suboxone depends on the dose. Patients coming off higher doses will typically need more time. Rushing the taper can lead to unnecessary withdrawal and/or cravings.

How can I switch from Vivitrol to Suboxone?

Transitioning from Vivitrol to Suboxone may be appropriate if cravings aren’t controlled with Vivitrol.

Ideally, the patient would wait around the time of their 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.

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Symetria doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the field.

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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