Long-Acting Buprenorphine: Weekly and Monthly Options

Taking daily medication works well for many people in opioid use disorder treatment. For others, medication storage, privacy, travel, or remembering a daily dose can be difficult. Weekly or monthly extended-release buprenorphine may be worth discussing with a qualified provider.

Current injectable options include Sublocade and Brixadi. Both are administered by a healthcare professional and release buprenorphine over time. The former Probuphine implant was discontinued in the United States in 2020 and is not a current treatment option.

This guide breaks down how each long-acting option works, who's a good candidate, and how to discuss them with your provider. Whether you're just starting treatment or have been stable on daily Suboxone for months, understanding these alternatives helps you make informed decisions about your care.

What Is Long-Acting Buprenorphine?

Long-acting buprenorphine uses the same active medication found in daily buprenorphine products but delivers it through an injection that releases medication over weeks or months.

The active ingredient—buprenorphine—works identically to daily formulations. It's a partial opioid agonist that:

• Reduces cravings and withdrawal symptoms
• Can reduce the effects of other opioids, though it does not make opioid use safe or prevent every overdose
• Provides stable medication levels without the "peaks and valleys" of daily dosing

The difference lies in delivery. Long-acting formulations use specialized technology to create a depot (reservoir) of medication in your body that releases gradually. This means consistent blood levels without thinking about dosing every morning.

Why Consider Long-Acting Options?

Patients choose long-acting buprenorphine for several reasons:

• Eliminate daily dosing stress: No more setting alarms, packing medication for trips, or worrying about running out
• Increased privacy: No visible medication to take at home or work
• Better adherence: Can't forget a dose when it's already in your system
• Fewer diversion concerns: Nothing to store, secure, or potentially misuse
• Steady medication levels: Avoid fluctuations that can occur with daily dosing

Clinical trials support extended-release buprenorphine as one treatment option for opioid use disorder. Whether it is a better fit than daily medication depends on the individual, including treatment history, preferences, access, and insurance coverage.

Current Long-Acting Options

Two extended-release injectable buprenorphine brands are currently marketed in the United States. Product labeling and availability can change, so confirm current information with your provider and the FDA-approved medication guide.

Sublocade (Monthly Injection)

Sublocade is an extended-release subcutaneous injection (under the skin) given once monthly. Approved in 2017, it's the most widely available long-acting option.

How it works: A healthcare professional administers Sublocade under the skin. The medication forms a depot that releases buprenorphine over time. Review possible injection-site effects and when to seek help with your provider.

What to expect: Sublocade is given monthly by a healthcare professional. Injection-site reactions can occur. Its FDA-approved labeling includes important administration, eligibility, and safety requirements, so the dose and transition plan must be determined by the treating clinician.

Learn more in our complete Sublocade guide.

Brixadi (Weekly or Monthly Injection)

Brixadi, approved in 2023, offers the most flexible long-acting schedule with both weekly and monthly options. Like Sublocade, it's a subcutaneous injection, but it uses different depot technology.

How it works: Brixadi uses a liquid formulation that solidifies under the skin, creating a depot that releases buprenorphine over either a week or a month. Your provider injects it into your buttock, thigh, abdomen, or upper arm.

What to expect: Brixadi has weekly and monthly formulations administered by a healthcare professional. Injection-site reactions can occur. A clinician selects the formulation and dose using the approved labeling and the patient's current treatment.

What Happened to Probuphine?

Probuphine was a six-month buprenorphine implant, but its manufacturer discontinued it in the United States in 2020. It should not be presented as a currently available choice. People looking for a non-daily option can ask a clinician about currently marketed injectable products and other ways to make treatment more manageable.

Who Is a Good Candidate?

Long-acting buprenorphine isn't for everyone, and that's okay. The best formulation is the one you'll stick with. But certain situations make extended-release options especially appealing.

Ideal Candidates Include Patients Who:

• Meet the current eligibility requirements in the selected product's FDA-approved labeling
• Struggle with adherence to daily medication
• Want more privacy around treatment
• Have unpredictable schedules that make daily dosing difficult
• Are concerned about medication storage or diversion
• Experience stigma from visible daily medication use
• Want to discuss a longer-acting formulation as part of an ongoing treatment plan

Eligibility and transition requirements differ by product and patient. Do not convert a daily dose to an injectable dose without a qualified prescriber.

You Might Not Be Ready If:

• You're still in early treatment and need frequent dose adjustments
• You have active injection site infections or conditions affecting absorption
• You're not yet stable on any form of buprenorphine
• You prefer the control of daily dosing
• Cost or insurance coverage makes long-acting options inaccessible

A qualified addiction-medicine clinician can assess whether a long-acting option fits your treatment goals. Daily medication remains an appropriate choice for many people.

Transitioning From Daily Medication

Switching from daily Suboxone or generic buprenorphine to a long-acting formulation requires an individualized clinical plan.

Before Your First Injection

Your provider will review your current medication, recent opioid use, symptoms, medical history, and the product's current labeling. Requirements differ between products and can change as labels are updated.

What Happens at Your Appointment

Your provider will:

1. Confirm your current buprenorphine dose and review your treatment progress
2. Explain what to expect during and after the injection
3. Answer questions about side effects, activity restrictions, and follow-up care
4. Administer the injection
5. Observe you briefly to ensure no immediate reactions
6. Schedule the appropriate follow-up appointment

The Day of Transition

Follow the instructions your prescriber gives you for that specific day. Do not take, skip, or add medication based on a general online schedule; the safe plan depends on the product and your current treatment.

What to Expect in the First Few Weeks

Experiences vary after switching. Some people notice little change, while others need follow-up for symptoms or side effects.

Possible temporary effects:

• Injection-site tenderness or a visible lump
• Nausea or headache

Contact your provider if you experience withdrawal symptoms, concerning side effects, or worsening cravings after switching. Do not supplement or change medication without clinical instructions.

Insurance Coverage and Cost

Coverage and out-of-pocket cost vary by product, plan, pharmacy or medical benefit, provider network, and location. Verify current details before scheduling treatment.

Coverage Landscape

Medicaid: Coverage is state- and plan-specific. Review the current formulary and prior-authorization criteria for Ohio Medicaid, Pennsylvania Medicaid, or Virginia Medicaid, as applicable.

Commercial insurance: Formularies and medical-benefit policies differ among insurers and can change during the year. Call the member-services number on your card and ask about the exact product, network requirements, prior authorization, and expected cost.

Medicare: Coverage depends on how the medication is administered and billed, medical necessity, and the beneficiary's specific coverage. Confirm the benefit and participating provider before treatment.

Prior Authorization Requirements

An insurer may request:

• Documentation of opioid use disorder diagnosis
• Evidence of stability on daily buprenorphine (duration varies)
• Explanation of why daily medication is insufficient (adherence issues, patient preference)
• Prescriber credentials verification

Ask the prescribing office what assistance it can provide with authorization or an appeal and how long the plan estimates the review will take.

Out-of-Pocket Costs

Prices and assistance-program rules change. Ask the insurer and treatment site for a written estimate that separates the medication, administration visit, and any other services. Manufacturer programs may have eligibility restrictions; see our overview of copay assistance programs and confirm current terms with the program itself. If coverage is denied, ask about the plan's formal appeal process.

Before choosing a formulation, ask the prescribing provider and insurer to confirm whether it is available, clinically appropriate, and covered.

Comparing Your Options Side-by-Side

Choosing between Sublocade and Brixadi involves dosing frequency, eligibility, access, preferences, and treatment goals.

| Feature | Sublocade | Brixadi | |---------|-----------|---------| | Administration | Injection by a healthcare professional | Injection by a healthcare professional | | Frequency | Monthly | Weekly or monthly formulations | | Eligibility and dose | Determined from current labeling and clinical assessment | Determined from current labeling and clinical assessment | | Questions to ask | Injection-site effects, transition plan, follow-up, coverage | Weekly versus monthly formulation, transition plan, follow-up, coverage |

Neither option is universally better. A qualified clinician can explain the current labels and help weigh preferences against medical history and practical access.

Common Questions About Long-Acting Buprenorphine

Can I switch between long-acting formulations?

Switching may be possible, but timing and dose conversion require a prescriber familiar with both products. Do not assume the next scheduled appointment is automatically an appropriate transition date.

What if I want to stop treatment?

Do not use an extended-release formulation as a self-directed taper. Because medication can remain in the body after an injection and withdrawal experiences differ, stopping or switching should be planned with the prescriber and followed clinically.

Can I travel with long-acting buprenorphine?

Long-acting medication can reduce the need to carry daily doses, but plan travel around required appointments and keep your provider's contact information and medication list available for medical care.

What happens if I miss an injection appointment?

Contact the prescribing office promptly for individualized scheduling guidance. Do not add daily buprenorphine or change the next injection date on your own.

Questions to Bring to Your Provider

• Which currently available formulation, if any, fits my treatment history?
• What does the current FDA-approved label require before the first injection?
• What side effects require a routine call, an urgent call, or emergency care?
• How will follow-up work if I travel or move?
• How is the medication billed, and what will my plan require?
• What is the plan if I want to switch formulations or stop treatment later?

Long-acting buprenorphine can reduce the logistics of daily medication, but it is not a one-size-fits-all choice. Grata Health offers telehealth opioid use disorder treatment in Virginia, Ohio, and Pennsylvania. Ask which treatment services are currently available.