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Suboxone vs. Vivitrol: Which One is Right for You?

Struggling with opioid addiction can be an incredibly challenging and life-altering experience. While the path to recovery is different for everyone, it often involves a comprehensive approach known as medication-assisted treatment (MAT).

Suboxone and Vivitrol are two medications that are commonly used in MAT.

What is Suboxone?

Suboxone is a prescription medication that contains buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, which means it can activate the same receptors in the brain as opioids but to a lesser extent. This helps reduce opioid cravings and withdrawal symptoms, making it a valuable medication in opioid addiction treatment. 

Naloxone, on the other hand, is an opioid antagonist that is included in Suboxone to deter misuse. If Suboxone is taken as prescribed (sublingually or buccally), the naloxone is typically not absorbed well and doesn’t produce significant effects. However, if someone tries to misuse Suboxone by injecting it, the naloxone can precipitate opioid withdrawal symptoms.

Suboxone may be given to individuals who are detoxing from opioids, however, it must be given at least 12-24 hours after the last dose of opioids. Taking Suboxone too soon can cause interactions with the opioids in your body, resulting in sudden and severe withdrawal symptoms.  It should only be used under the supervision and guidance of a healthcare professional with expertise in addiction medicine.

Suboxone Side Effects

Suboxone may cause side effects. Common side effects of Suboxone include:

  • Nausea
  • Vomiting
  • Constipation
  • Headache
  • Sweating
  • Insomnia
  • Numbness or tingling in the mouth
  • Drowsiness
  • Dizziness
  • Lightheadedness
  • Weakness

Less common but more severe side effects are:

  • Respiratory depression (slow or shallow breathing)
  • Allergic reactions, including hives, itching, rash, and swelling of the face, lips, tongue, or throat
  • Adrenal insufficiency, which can cause symptoms like nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or low blood pressure
  • Liver problems, with symptoms such as dark urine, yellowing of the skin or eyes (jaundice), and upper abdominal pain
  • Worsening opioid withdrawal symptoms if taken too soon after the last use of opioids

Most withdrawal symptoms will subside within a few days, however, if you experience severe or concerning side effects, speak with your doctor or seek medical care immediately.

What is Vivitrol?

Vivitrol is a monthly injection that contains naltrexone, an opioid receptor antagonist. Naltrexone works by binding to and blocking the opioid receptors in the brain, which prevents opioids from attaching to these receptors. This action effectively blocks the pleasurable effects of opioids, such as pain relief and feelings of euphoria, thereby reducing the risk of opioid misuse.

Vivitrol is different from medications like buprenorphine or methadone, which are partial opioid agonists, as it does not activate opioid receptors but rather inhibits their activation. This makes Vivitrol a non-addictive option for those in recovery from opioid addiction.

Vivitrol injections are administered intramuscularly, usually in the buttocks. They must be administered every 28-30 days.

It’s important to note that individuals must be opioid-free for a minimum of 7-10 days before starting Vivitrol to avoid precipitating opioid withdrawal symptoms.

Vivitrol Side Effects

Vivitrol rarely causes significant side effects. The most common side effect is injection site reactions, including pain, itching, swelling, redness, or irritation at the injection site. These reactions are normal and typically subside after a few days.

Other side effects of Vivitrol include:

  • Nausea
  • Vomiting
  • Headache
  • Dizziness
  • Fatigue
  • Decreased appetite
  • Insomnia
  • Anxiety
  • Muscle cramps
  • Joint pain
  • Diarrhea
  • Constipation
  • Chills
  • Increased blood pressure

Most side effects are self-limiting and resolve as your body gets used to the medication.

How are Suboxone and Vivitrol Similar?

Suboxone and Vivitrol are two very different medications, however, they do share some similarities. The first similarity is their intended use. Both Suboxone and Vivitrol are approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder as a part of medication-assisted treatment (MAT). When taken as directed, both medications can help alleviate opioid cravings and support individuals on their recovery journey. Finally, both medications are most effective when combined with a comprehensive approach involving behavioral therapy and counseling.

What are the Differences Between Suboxone and Vivitrol?

There are many differences between Suboxone and Vivitrol. First, it’s important to note that, unlike Suboxone, Vivitrol can be used to treat both opioid and alcohol use disorders. Suboxone is only approved for use in opioid dependence and treatment.

One of the biggest differences between Suboxone and Vivitrol is that they contain two different medications. Suboxone contains buprenorphine and naloxone, while Vivitrol contains naltrexone. These medications work differently in the brain and have varying side effects.

Another difference is the method of use. While Vivitrol is a monthly injection, Suboxone is a daily oral medication. Skipping a dose of Suboxone can lead to buprenorphine withdrawal, causing fluctuations in mood, cravings, and other symptoms. However, with Vivitrol, individuals don’t have to worry about taking a daily medication and their naltrexone levels remain steady throughout the month. As a result, Vivitrol is a preferred choice for people who struggle with taking medications as prescribed.

As an injection, Vivitrol is only administered in a doctor’s office. Additionally, naltrexone can’t get you high. The buprenorphine in Suboxone, on the other hand, may be abused by some individuals. This is the reason that Vivitrol has a lower risk for abuse and dependence than Suboxone. In fact, abruptly stopping the use of Vivitrol (naltrexone) will not result in withdrawal symptoms because Vivitrol is not habit-forming.

Another way Suboxone and Vivitrol are different is that Suboxone can treat opioid withdrawal, but Vivitrol is used after a period of detoxification to alleviate cravings and regulate brain chemistry.

As always, it’s best to discuss your questions and concerns with your doctor before starting a new medication. An addiction specialist can evaluate your situation and help you determine which medication is right for you.

Find Out if Suboxone or Vivitrol are Right For You

If you or a loved one are struggling with addiction, medication-assisted treatment (MAT) may be the right choice for you. To learn about our treatment programs or begin your recovery with a confidential assessment, please contact our team at Mandala Healing Center today.


  1. Substance Abuse and Mental Health Services Administration (SAMHSA): Buprenorphine, Retrieved November 2023 from
  2. Food and Drug Administration (FDA): Suboxone, Retrieved November 2023 from
  3. Substance Abuse and Mental Health Services Administration (SAMHSA): Naltrexone, Retrieved November 2023 from
  4. Food and Drug Administration (FDA): Vivitrol, Retrieved November 2023 from