Sublocade, a long-acting injectable form of buprenorphine, is a highly effective treatment for opioid use disorder. In a previous issue (CATR Jan/Feb/Mar 2023), we discussed the strict prescribing guidelines set by its manufacturer, Indivior. Recently, however, the FDA announced three key changes:

• Rapid Induction—Previously, patients had to take sublingual buprenorphine for seven days before receiving Sublocade. Under the new guidelines, an injection can be given just one hour after a single sublingual dose—enough to confirm the patient won’t experience precipitated withdrawal.
• Loading Dose Option—Instead of waiting four weeks for a second dose, patients can now receive a second 300 mg injection just one week after the first, helping patients reach therapeutic buprenorphine levels more quickly.
• Expanded Injection Sites—In addition to the abdomen, providers can now administer Sublocade in the thigh, buttock, and back of the upper arm.

These changes aim to make Sublocade more flexible to use and also more competitive with Brixadi, the other long-acting injectable buprenorphine, which has more dosing and administration options.

—Noah Capurso, MD, MHS
    noah.capurso@yale.edu