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Subutex vs. Vivitrol

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Buprenorphine (Subutex) and naltrexone (Vivitrol) are both used to treat opioid use disorder, but they work in different ways and have different forms. Buprenorphine is a partial opioid agonist that helps ease cravings and withdrawal symptoms by attaching to opioid receptors in the brain, but it can still cause dependence and misuse. It is taken as a sublingual tablet that dissolves under your tongue. On the other hand, Vivitrol is an opioid antagonist that blocks opioid receptors, preventing the feel-good effects of opioids and alcohol. It is given as a monthly injection by a healthcare professional and does not have a risk of dependence or misuse. Buprenorphine is available as a lower-cost generic, while Vivitrol is only available as a brand-name medication. Common side effects of buprenorphine include headache and nausea, whereas Vivitrol can cause injection site reactions and nausea. Buprenorphine is a controlled substance, but Vivitrol is not.

Buprenorphine patch

(Butrans)

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Vivitrol

 

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Summary for Subutex

Prescription only

Buprenorphine patch, also known by its brand name Butrans, treats people with severe chronic (long-term) pain that isn't relieved with other treatment options. It works as an opioid partial agonist to help with pain. Buprenorphine patch (Butrans) is applied onto the skin once per week. This transdermal patch comes in many strengths. The pain specialist will decide on the dosage based on how severe your pain is and whether you were taking opioid pain medication before starting buprenorphine patch (Butrans). Side effects include nausea, dizziness, and headache.

Indications for Subutex

Pros and Cons for Subutex

Pros

  • Applied on the skin once per week
  • An option for people who can't swallow pills

Cons

Common Side Effects for Subutex

  • Nausea (21%)
  • Itching at the application site (15%)
  • Dizziness (15%)
  • Headache (14%)
  • Sleepiness (13%)
  • Constipation (13%)
  • Vomiting (9%)

Warnings for Subutex

  • Potential for addiction and misuse
  • Dangerously slow breathing (respiratory depression)
  • Risk for opioid overdose
  • Difficulty concentrating and extreme sleepiness
  • Harm to newborns when taken during pregnancy
  • Serious risks with patch exposure to high temperatures (e.g., heat, high fever)
  • Low adrenal hormone levels
  • Low blood pressure
  • Liver damage
  • Withdrawal symptoms
  • Seizures
  • Life-threatening heart rhythm problems (QT prolongation)

Summary for Vivitrol

Prescription only

Vivitrol is an extended-release naltrexone injection. It's an opioid antagonist that's used to treat opioid use disorder and alcohol use disorder in adults. Vivitrol is prescribed as part of a holistic treatment plan that also includes therapy and support groups. This medication is given as a deep gluteal injection into the muscle on the buttock, typically once a month by a healthcare professional. Some common side effects of Vivitrol include pain or tenderness at the injection site, nausea, and headache. Vivitrol is brand name only and not available as a generic medication.

Indications for Vivitrol

Pros and Cons for Vivitrol

Pros

  • Lowers opioid and alcohol cravings
  • Given once per month
  • Better option for people who don't want to take naltrexone tablets everyday

Cons

  • Need to go to clinic or HCP's office to receive the injections
  • Must be given by injection into the buttock muscle
  • Can cause bothersome injection site reactions, such as pain and swelling

Common Side Effects for Vivitrol

Alcohol use disorder

  • Tenderness, pain, swelling at injection site (up to 45%)
  • Nausea (33%)
  • Headache (25%)
  • Fatigue, tiredness (23%)
  • Low appetite (14%)
  • Trouble falling asleep (14%)
  • Vomiting (14%)
  • Diarrhea (13%)
  • Dizziness (13%)
  • Anxiety (12%)
  • Joint pain or stiffness (12%)
  • Stomach pain (11%)
  • Sore throat (11%)

Opioid use disorder

  • Higher liver enzymes (13%)
  • Common cold, flu (up to 7%)
  • Difficulty sleeping (6%)
  • High blood pressure (5%)
  • Injection site pain (5%)

Warnings for Vivitrol

  • More sensitive to opioids (risk of opioid overdose)
  • Opioid withdrawal
  • Liver injury
  • Risk of depression and suicidal thoughts
  • Injection site reactions
  • Severe allergic reactions

Prices with our coupons for Subutex vs. Vivitrol

Price Card Drug Icon
Buprenorphine90 sublingual tablets / 8mg
$55.26$464.85
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Price Card Drug Icon
Vivitrol1 carton / 1 vial of 380mg/vial
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