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What to know about Brixadi for OUD

Find out more about Brixadi for opioid addiction treatment. Understand how it works, its benefits, side effects, and differences from Sublocade.

Ophelia team
Brixadi injectable buprenorphine medication packaging
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Fact checked by
Mena Soliman, NP

Patients who are eligible for medication for addiction treatment have a few options depending on their medical needs, including the severity of their opioid use disorder (OUD). Suboxone® is perhaps the most well-known treatment option currently (important safety information), while methadone is one of the oldest medications approved for the treatment of addiction, having been in use since the 1960s. Naltrexone may also be used to help manage and address opioid addiction.

But these are no longer the only options, especially for patients seeking buprenorphine treatment. In May of 2023, the U.S. Food and Drug Administration approved a new medication for opioid treatment, called Brixadi®. The drug’s FDA approval means patients with OUD now have another safe and effective option available.

What is Brixadi?

Brixadi uses buprenorphine as its active ingredient. Buprenorphine is a partial opioid agonist, meaning that it only partially activates the brain’s opioid receptors and can achieve the medical effects of an opioid without producing the high associated with other drugs. This makes it useful in curbing cravings and managing withdrawal without major risk. 

Buprenorphine is also used in Suboxone and Sublocade® and has proven to be effective in treating opioid use disorder. Brixadi is a special formulation of this drug that comes in a liquid form to be injected subcutaneously, or just underneath the skin, where it releases over an extended period. It is not approved for self-administration and is instead administered by a healthcare professional in a clinical setting.

The injectable formulation sets Brixadi apart from Suboxone, which is taken orally, usually as a sublingual tablet or a buccal film. Suboxone’s other active ingredient, naloxone, is absent in Brixadi.

How do Brixadi and Sublocade differ?

If this information makes you think Brixadi and Subloclade are similar drugs, you’re on the right track. They both have similar effects and methods of administration. They also use the very same active ingredient. The big differences between the two are the dosage and the frequency of administration.

Sublocade is only approved in two specific doses:

  • An initial dose of 300 mg monthly, which is typically used only for the first two months of treatment
  • A maintenance dose of 100 g monthly, which is used after the induction phase of treatment

Sublocade is also only administered once a month, with a minimum of 26 days required between doses.

On the other hand, Brixadi has several different approved dosages and can be applied on a monthly or weekly basis, depending on the patient’s needs and the recommendations of the patient’s physician. Weekly doses of Brixadi come in 8, 16, 24, and 32 mg formulations, while monthly doses come in 64, 96, and 128 mg formulations.

Another important difference between the two prescriptions is the area of injection. Sublocade is only approved for subcutaneous injection in the lower abdomen or upper buttock. Brixadi is also a subcutaneous injection that can be received in those two sites, and it’s approved for injection in the thigh and upper arm.

Who is Brixadi right for?

Brixadi is intended for the treatment of moderate to severe opioid use disorder. As long as a patient meets those criteria, Brixadi is a valid option. However, it may be particularly useful for patients who struggle with Suboxone. Because Suboxone comes in oral forms and must be taken more regularly, there is more room for error, whether forgetting to take doses or taking doses incorrectly.

As a weekly or monthly treatment given in a clinical setting, Brixadi may also be ideal for patients who need to travel to see a clinician or those who prefer professional oversight when taking medications. Due to the numerous dosages available, Brixadi can be helpful for patients who need to frequently adjust their dosage or who have struggled to find success via other treatment methods.

What are the side effects of Brixadi?

Brixadi’s active ingredient, buprenorphine, is an opioid. This means drug has many of the same side effects as other opioids, including:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Headaches
  • Insomnia
  • Increased likelihood of urinary tract infections (UTIs)
  • Joint pain

There are also more serious side effects, such as jaundice, dizziness when standing up, respiratory depression or significantly slowed breathing, listlessness, swelling in the face or throat, and symptoms of opioid withdrawal. If you experience any of these severe side effects, contact your doctor as soon as possible, and always call 911 if you believe you’re experiencing an emergency.

Some patients may also experience an allergic reaction to Brixadi. Consult with your doctor about what to do if this occurs. Since Brixadi is an injection, it’s also common to experience pain or swelling at the injection site. This isn’t usually cause for concern.

Gold-standard care with Ophelia

A thorough intake process is essential for understanding a patient’s care needs, which is why we offer a simple, accessible video call to get to know you. If our providers feel that a buprenorphine-naloxone medication is the right choice, we’ll send a prescription to your local pharmacy and set up a customized treatment plan.

Our clinicians stay on top of developments in the field to be sure we’re always providing the highest quality care backed by evidence. As more OUD  treatment options become available, we want to be sure our patients understand what’s new and what it could mean for their care plan.


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