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OPIOID PARTIAL AGONIST/ANTAGONIST
Zubsolv (buprenorphine and naloxone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat opioid dependence in adults.
Zubsolv contains two medicines: buprenorphine and naloxone.
Buprenorphine partly activates a type of opioid receptor called the mu-opioid receptor. It also blocks another type called the kappa-opioid receptor. Naloxone blocks mu-opioid receptors.
These receptors are parts of the body that respond to opioids.
Doctors prescribe Zubsolv when an adult needs medication treatment for opioid dependence. Zubsolv should be used as part of a complete treatment plan that includes counseling and psychosocial support.
Zubsolv comes as a tablet that dissolves under the tongue.
Take the entire Zubsolv tablet. Do not cut, chew, or swallow it. Let the tablet dissolve completely under your tongue.
After the tablet has completely dissolved, take a sip of water. Gently swish the water around your teeth and gums, then swallow it. Wait at least one hour before brushing your teeth.
The dose of Zubsolv depends on the stage of medication treatment and how the person responds.
Zubsolv comes in six strengths:
When treatment first starts in people who are dependent on short-acting opioids, such as heroin, the first day’s dose is divided into smaller doses. Additional doses are usually given at intervals of one and a half to two hours, as directed by a healthcare provider.
After the starting phase of treatment, Zubsolv is taken once a day. This maintenance dose is used to help control opioid withdrawal symptoms and keep the person in treatment.
The maintenance dose generally ranges from 2.9 milligrams of buprenorphine with 0.71 milligrams of naloxone to 17.2 milligrams of buprenorphine with 4.2 milligrams of naloxone per day. A healthcare provider may adjust the dose based on how the person responds.
If a person switches between Zubsolv and other medicines containing buprenorphine and naloxone, the healthcare provider may need to adjust the dose. They may also check for signs that the dose is too high or too low.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
In clinical studies of Zubsolv and other buprenorphine formulations, common side effects were reported in about 5 percent to 37 percent of people, depending on the side effect and study. These included:
Zubsolv can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
The Zubsolv savings page describes a voucher card and a copay card. Eligible people may receive up to 30 free trial tablets with the voucher card. Those with commercial insurance may pay as little as $10 with the copay card.
The copay card can also reduce out-of-pocket costs, including copayments, coinsurance, and deductibles, with savings of up to $225 per prescription for eligible people paying cash or using insurance.
For more information, call 877-264-2440.
Before starting Zubsolv, your doctor will check your liver function with blood tests.
Tell your doctor if you have any allergies to buprenorphine, naloxone, or any ingredients in Zubsolv.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Do not take Zubsolv with certain medicines.
Some medicines and substances can be dangerous when taken with Zubsolv. These include other opioids, benzodiazepines, gabapentin, pregabalin, alcohol, and other medicines or drugs that slow down the central nervous system.
Using them together can cause severe sleepiness, breathing problems, coma, or death. Tell your doctor about everything you take so these risks can be managed safely.
Do not drive, use heavy machinery, or do other dangerous activities until you know how Zubsolv affects you. It can make you sleepy, dizzy, or lightheaded and may slow your reaction time.
Do not drink alcohol or take medicines that contain alcohol while taking Zubsolv. This can cause loss of consciousness or death.
Do not stop taking Zubsolv suddenly. Long-term use can cause physical dependence, which means the body becomes used to the medicine. Physical dependence is not the same as addiction.
A healthcare provider can gradually lower the dose to help reduce withdrawal symptoms.
If you miss a dose of Zubsolv, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Do not take two doses at the same time unless your healthcare provider tells you to. If you are unsure what to do, call your healthcare provider.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Zubsolv, talk with your doctor about the risks and benefits. Taking Zubsolv during pregnancy may cause withdrawal symptoms in your baby after birth. Zubsolv can also pass into breast milk and may harm your baby.
These answers are fact-checked by our editorial staff.
How effective is Zubsolv for opioid dependence?
Zubsolv was studied in two clinical trials involving people starting treatment for opioid dependence.
In the first study, 93 percent of people taking Zubsolv were still in treatment on day 3, compared with 92 percent of people taking generic buprenorphine. In the second study, 85 percent of people taking Zubsolv were still in treatment on day 3, compared with 95 percent of people taking generic buprenorphine.
These results show how many people stayed in treatment during the first three days. They do not show how well Zubsolv works for long-term recovery.
The studies also looked at side effects. During the first two days of treatment, 26 percent of the 538 people taking Zubsolv reported at least one side effect. The full safety group included 1,068 people who received either Zubsolv or generic buprenorphine.
How long does Zubsolv take to work for opioid recovery?
Zubsolv treatment begins when clear signs of opioid withdrawal are present.
For people who are dependent on short-acting opioids, such as heroin, the first dose should be taken when signs of moderate withdrawal appear, at least six hours after the last opioid use. Starting too early may cause sudden withdrawal symptoms.
Zubsolv tablets dissolve under the tongue. In clinical studies, the typical time for a tablet to dissolve was five minutes. However, this does not mean the medicine starts working in five minutes.
Does Zubsolv interact with other medicines?
Yes. Zubsolv can interact with several medicines and substances.
Some of the most serious interactions involve benzodiazepines, other opioids, alcohol, gabapentin, pregabalin, and other medicines that slow down the central nervous system. Taking these with Zubsolv can cause severe sleepiness, breathing problems, coma, or death.
Zubsolv can also interact with:
Tell your healthcare provider about all prescription medicines, over-the-counter medicines, vitamins, and herbal supplements you take. Do not start, stop, or change medicines without talking to your healthcare provider.
Your healthcare provider may need to adjust your treatment or monitor you more closely to help manage drug interactions.
On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.
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