Suboxone vs. methadone

Suboxone is a brand-name medication that contains two drugs: buprenorphine and naloxone. Methadone is a generic medication. It’s also available in a brand-name version called Dolophine.

Uses

Suboxone is FDA-approved to treat opioid dependence, including both the induction and maintenance treatment phases.

During the induction phase, the drug decreases withdrawal symptoms while you stop or reduce opioid use. During the maintenance phase, the drug keeps withdrawal symptoms and cravings in check as you complete your drug abuse treatment program.

Methadone is FDA-approved only for the maintenance phase of opioid dependence treatment. It’s used off-label for the induction phase of treatment. Methadone is also FDA-approved to treat moderate-to-severe pain.

In addition, methadone is approved for treatment during opioid detoxification. Detoxification programs are generally short-term, inpatient treatment plans used to wean people off of drugs such as opioids or alcohol. Opioid dependence treatment, on the other hand, is a longer-term approach to reducing dependence on opioids, with most of the treatment being done on an outpatient basis.

Forms and administration

Suboxone comes as an oral film that can be used under your tongue (sublingual) or between your gums and your cheek (buccal).

Methadone comes in several forms, including:

  • oral tablet
  • oral solution
  • tablet for oral suspension
  • solution for injection

Effectiveness

Suboxone and methadone have been compared in clinical studies evaluating their use for treating opioid dependence.

In a 2013 study, Suboxone and methadone were found to be equally effective for reducing the use of opioids and keeping users in their treatment program.

A 2014 study found that people taking Suboxone used opioids less compared to people taking methadone. However, the people taking methadone were more likely to stay in their treatment program.

An analysis of several studies found that overall, Suboxone was more effective for reducing the use of opioid drugs, but methadone was more effective for keeping users in their treatment program.

Side effects and risks

Suboxone and methadone have some similar side effects, and some that differ. Below are examples of these side effects.

Suboxone and methadoneSuboxoneMethadone
More common side effectsheadachenauseavomitingconstipationstomach pain or upsetanxietyinsomnia (trouble sleeping)dizzinessweakness or fatiguesweatingopioid withdrawal symptomsdepressionchillscoughfeverrunny nosesore throatdiarrheaback painloss of appetiteconfusionnervousnessdisorientation or confusiondry mouthblurred vision
Serious side effectsbreathing problems*comaabuse and dependence*hormone problems (adrenal insufficiency)severe allergic reactionliver damagesevere withdrawal symptomslife-threatening arrhythmia (QT-interval prolongation) *serotonin syndromesevere low blood pressureseizures

*Methadone has a boxed warning from the FDA. This is the strongest warning that the FDA requires. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Costs

Suboxone is a brand-name drug. It’s also available in a generic version. Generics are often less expensive than brand-name drugs.

Methadone is a generic drug. It’s also available as a brand-name version called Dolophine.

Methadone usually costs less than brand-name or generic Suboxone. However, the actual amount you pay will depend on your insurance.

Suboxone vs. Zubsolv

Both Suboxone and Zubsolv are brand-name medications that contain two drugs: buprenorphine and naloxone.

Uses

Both Suboxone and Zubsolv are FDA-approved to treat opioid dependence, including the induction and maintenance phases of treatment.

During the induction phase, the drug decreases withdrawal symptoms while you stop or reduce opioid use. During the maintenance phase, the drug keeps withdrawal symptoms and cravings in check as you complete your drug abuse treatment program.

Forms and administration

Suboxone comes as an oral film that can be used under your tongue (sublingual) or in your cheek (buccal).

Zubsolv comes as an oral tablet that’s used under your tongue.

Effectiveness

Suboxone and Zubsolv contain the same drugs and are used in the same way to treat opioid dependence. They’re expected to be equally effective. The decision to use Suboxone or Zubsolv is based on personal preference for use of the sublingual film or tablet.

Side effects and risks

Suboxone and Zubsolv contain the same drugs and cause similar common and serious side effects.

More common side effects

Examples of the more common side effects of Suboxone and Zubsolv include:

  • headache
  • opioid withdrawal symptoms, such as body aches, abdominal cramps, and rapid heart rate
  • nausea
  • vomiting
  • constipation
  • diarrhea
  • stomach pain or upset
  • anxiety
  • insomnia (trouble sleeping)
  • sweating
  • depression
  • chills
  • weakness or fatigue
  • dizziness
  • cough
  • fever
  • runny nose
  • sore throat
  • back pain

Serious side effects

Examples of serious side effects shared by Suboxone and Zubsolv include:

  • severe allergic reaction
  • abuse and dependence
  • breathing problems and coma
  • hormone problems (adrenal insufficiency)
  • liver damage
  • severe withdrawal symptoms

Costs

Suboxone and Zubsolv are brand-name drugs. There’s a generic version of Suboxone film. There’s no generic version of Zubsolv sublingual tablets.

Zubsolv usually costs less than brand-name or generic Suboxone. However, the actual amount you pay will depend on your insurance.

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