Sublocade injection: what to expect

Sublocade is buprenorphine in an extended-release form. After the injection, it forms a small deposit under the skin that releases medication steadily over the month.

It is a Schedule III controlled medication and is available only through a restricted safety program (REMS) to certified providers.

Adults with moderate to severe opioid use disorder who have started treatment with buprenorphine under the tongue. It suits people who would rather not take a daily dose.

A healthcare provider gives the injection under the skin of the abdomen, thigh, buttock or back of the upper arm. It is prepared and given only in a healthcare setting and is never self-injected.

• Do not rub or massage the injection site afterward.
• A small lump at the injection site is expected while the medication is released.

Once a month. The second 300 mg dose can be given as early as 1 week and up to 1 month after the first, then a monthly maintenance dose follows, with injections at least 26 days apart.

Sublocade follows at least one dose of buprenorphine under the tongue. A person new to buprenorphine takes a test dose (for example 4 mg) and is observed for an hour before the first injection. A person already taking 8 to 24 mg a day can switch directly.

• Insurance plans often require prior authorization before the first injection. Our front desk can check your insurance before your first visit.
• The first injection is given at an in-person visit in our West Ashley office.

Treatment typically begins with an in-person assessment, followed by weekly in-person or virtual visits before moving to a monthly schedule. Each plan is tailored to the patient and their situation.

If problems come up, visits become more frequent again until things are steady.

• A withdrawal check at every visit, using the Subjective Opiate Withdrawal Scale (SOWS).
• A urine drug test at every visit: a point-of-care test in our West Ashley office or a test at a local lab near you, with confirmatory lab testing when a result needs it.
• A urinalysis when needed. Some people have trouble urinating while taking buprenorphine, so we check for urinary retention or a urinary tract infection when symptoms point to it.
• Screening for depression and anxiety at every visit.
• Monthly counseling, alongside your medication visits.
• Each injection is given by a healthcare provider in our West Ashley office; it is never self-injected.
• A review of how you are doing, side effects and your goals.

• Serious harm or death could result if it were given into a vein, which is why only trained providers give it, under the skin.
• Do not drink alcohol, and tell your provider about every medicine you take, especially benzodiazepines or other sedatives.
• The medication can stay in your body for several months after the last injection.
• At a stable prescribed dose, buprenorphine does not cause a high, and its overdose risk is much lower than illicit opioids. It can still be dangerous with alcohol, benzodiazepines or other sedatives, and it must be locked away from children.