Sublocade and Dosage: Form, Strengths, Administration, and More

Medical content notice: This article is for general educationnot personal medical advice. Sublocade (buprenorphine extended-release) is a prescription medication that must be administered by a trained healthcare provider in a certified setting. If you have questions about treatment, dosing, side effects, or costs, talk with a licensed clinician.

What is Sublocade?

Sublocade is a long-acting form of buprenorphine, a medication used to treat moderate to severe opioid use disorder (OUD) in adults. Instead of taking a daily tablet or film, Sublocade is given as a once-monthly injection that releases buprenorphine steadily over time. Think of it as “set it and (mostly) forget it”with one important catch: you don’t set it. Your healthcare provider does.

Medication treatment for OUD is widely recognized as evidence-based care. Buprenorphine helps reduce withdrawal symptoms and cravings and can lower overdose risk when used as prescribed as part of a complete treatment plan (often including counseling and other supports).

Why Sublocade is different from daily buprenorphine products

Daily buprenorphine products (like sublingual tablets or buccal films) can work very well, but they require consistent daily dosing. Sublocade takes a different approach: a depot (a small “medication reservoir” under the skin) forms after injection and releases buprenorphine gradually. That steady delivery can help some people:

• Reduce day-to-day ups and downs related to dosing schedules
• Lower the burden of remembering (or worrying about) daily medication
• Decrease risks related to lost medication, diversion, or running out early
• Make adherence simplerone appointment a month instead of a daily routine

That said, a monthly shot is still a commitment. Your calendar becomes part of your treatment team.

Form and strengths: what Sublocade comes in

Sublocade is supplied as a sterile solution in a single-dose, prefilled syringe. It comes in two dosage strengths:

• 100 mg/0.5 mL
• 300 mg/1.5 mL

Those numbers matter because Sublocade dosing is typically described in milligrams (mg) per monthly injection, and your clinician chooses the strength based on where you are in treatment (starting vs. maintenance) and how you’re responding.

How Sublocade is administered (and why you can’t do it yourself)

Sublocade is administered by subcutaneous injection (under the skin) by a healthcare provider. It is available only through a restricted distribution program called the Sublocade REMS (Risk Evaluation and Mitigation Strategy). The goal is safety: there is a boxed warning about the risk of serious harm or death if Sublocade is administered intravenously. Because of that risk, Sublocade is not dispensed directly to patients for at-home use.

Injection sites

Healthcare providers administer Sublocade subcutaneously. Approved injection sites include the abdomen, and labeling updates have also allowed additional sites such as the thigh, buttock, or back of the upper arm. Sites should be rotated between doses to reduce local irritation.

Standard dosing schedule: initiation and maintenance

Sublocade dosing is typically divided into two phases:

1) Initiation doses

The recommended initiation schedule is:

• 300 mg for the first injection
• 300 mg for the second injection

The second injection may be given as early as 1 week after the first injection, depending on clinical need, and is generally given within the first month.

2) Maintenance doses

After the first two injections, the recommended maintenance dose is:

• 100 mg once monthly

If a patient tolerates 100 mg but does not have an adequate clinical response (for example, persistent cravings or ongoing opioid use), a clinician may consider increasing maintenance to 300 mg monthly when the benefits outweigh the risks.

Dosing interval: “monthly” has a minimum spacing

Maintenance injections are administered at least 26 days apart. In real life, schedules get messyweather happens, rides fall through, life does its thingbut clinicians generally try to keep dosing consistent to maintain steady medication levels.

Starting Sublocade: who it’s for and what “stabilized first” means

Sublocade is indicated for adults with OUD who have started treatment with transmucosal buprenorphine (like a sublingual tablet or buccal film) or who are already receiving buprenorphine. Many clinicians want to confirm that a person can tolerate buprenorphine before giving a long-acting injection.

Rapid initiation (what it means in plain English)

Labeling updates have described a rapid initiation approach where Sublocade can be started after a single dose of transmucosal buprenorphine, followed by observation to confirm tolerability before the first injection. Your clinician will decide the safest initiation plan based on factors like recent opioid use (including fentanyl exposure), withdrawal status, and medical history.

Important: Do not try to “self-initiate” buprenorphine or change your medication plan without a clinician. Starting buprenorphine at the wrong time can cause intense withdrawal symptoms in some situations, and Sublocade is designed to be delivered only under medical supervision.

Dosage adjustments: when might the dose change?

There’s no single “perfect” dose for everyone. Clinicians adjust treatment based on response and safety. Reasons a provider might consider dose adjustments include:

• Symptoms not well controlled: cravings, withdrawal symptoms, or ongoing opioid use
• Tolerability: side effects such as sedation, nausea, constipation, or injection-site issues
• Medical factors: liver function concerns or medication interactions
• Clinical goals: stability, recovery supports, and overall progress

One common pathway is starting with the standard initiation schedule and then continuing at 100 mg monthly. Some patients remain on 300 mg maintenance if clinically appropriate.

Missed dose guidance: what happens if you’re late?

If a maintenance dose is missed, the next dose should be administered as soon as possible, and the following dose should be given at least 26 days later. Occasional delays of up to about 2 weeks are not expected to have a clinically significant impact for many patients, but your clinician will still want to assess symptoms and risk.

Special scenario: a planned two-month interval

For some patients who are stable on 100 mg monthly, there may be situations (for example, extended travel) where a clinician may administer a single 300 mg dose to cover a two-month period, then resume 100 mg monthly afterward. Because higher doses can lead to higher peak levels, clinicians typically counsel patients about possible increased sedation or other buprenorphine-related effects.

What to expect at appointments: practical “day-of” reality

Most Sublocade visits follow a predictable rhythm:

• Check-in and quick assessment (how you’ve been feeling, cravings, use, stressors, sleep)
• Medication and safety review (especially other sedating meds)
• Injection by a trained provider in a clinic/healthcare setting
• Site check and instructions about what’s normal vs. what needs attention

Some clinics observe patients briefly after injectionsparticularly during initiationto ensure symptoms are stable or improving and to watch for sedation or worsening withdrawal.

Side effects and safety considerations

Like any medication, Sublocade has potential side effects. Many are manageable, but some can be serious. Commonly reported issues can include:

• Injection-site pain, itching, redness, swelling, or a lump under the skin
• Constipation
• Nausea or vomiting
• Headache
• Fatigue or sleepiness

Serious safety topics (the ones clinicians take very seriously)

• Respiratory depression risk is higher when buprenorphine is combined with other sedating substances or medications. Always tell your clinician what you take.
• Liver concerns: buprenorphine has been associated with liver enzyme changes in some cases; clinicians may monitor liver function before and during treatment.
• Allergic reactions are possible, including to components of the delivery system.
• Long duration: because Sublocade is extended-release, medication can remain in the body for a prolonged period after stopping; clinicians consider this when planning transitions.

How long do people stay on Sublocade?

There is no single maximum recommended duration for maintenance treatment. OUD is often chronic, and continuing medication can be appropriate long-term. Clinicians typically reevaluate periodically based on stability, risks, recovery supports, and patient preference.

If stopping Sublocade is being considered, clinicians plan carefully because the medication’s extended-release nature can mean lingering effects for months. A “quick stop” is rarely the goalmore like a thoughtful off-ramp.

Cost, access, and logistics: the unglamorous but real part of dosing

Sublocade can require prior authorization or specific insurance steps, and the REMS program means it’s delivered to certified healthcare settings rather than handed to a patient at a pharmacy counter. Clinics often have staff who coordinate:

• Insurance approval and documentation
• Medication shipping and storage
• Appointment timing (remember: at least 26 days between maintenance injections)

If you’re considering Sublocade, it’s reasonable to ask the clinic, “How does your office handle approvals and scheduling?” This is one of those times where being politely persistent is a health skill.

Examples: what dosing timelines can look like

Example 1: Standard initiation to maintenance

Alex starts treatment after confirming buprenorphine tolerability with a clinician. Alex receives:

• Month 1: 300 mg
• Month 1–2 window: second 300 mg injection (sometimes as early as 1 week based on need)
• Month 3 and onward: 100 mg monthly (at least 26 days between doses)

Alex reports fewer cravings and likes not having daily medication reminders, so the clinician continues 100 mg monthly.

Example 2: Maintenance dose increase

Jordan completes the two 300 mg initiation doses and moves to 100 mg monthly. After a few months, cravings return during high-stress periods. The clinician assesses triggers, supports, and safety factors, then considers whether 300 mg monthly maintenance is appropriate. The plan includes close follow-up and ongoing counseling supports.

Bottom line

Sublocade is a once-monthly, healthcare-provider–administered buprenorphine injection used for adults with opioid use disorder. It comes in 100 mg and 300 mg strengths, commonly starts with two 300 mg initiation injections, and continues with 100 mg monthly maintenance (with 300 mg maintenance considered in some cases). Because of safety risks, including the boxed warning about intravenous administration, Sublocade is available only through a REMS program and must be administered in certified healthcare settings.

If you’re evaluating Sublocade, the most important “dosage detail” is this: the right dose is the one chosen and monitored by a clinician who knows your history, your risks, and your goalsbecause recovery isn’t one-size-fits-all, and neither is pharmacology.

Real-World Experiences With Sublocade: What People Commonly Notice (About )

Clinical guidelines and prescribing information tell you what should happen. Real lifeever the overachieveradds extra chapters. Here are common experiences that patients and clinicians often report around Sublocade dosing and administration, shared in a general, non-identifying way.

The “quiet brain” effect

Many people describe a subtle shift after stabilization: fewer “background cravings” and less mental math about timing doses. With daily products, some folks feel their day is divided into “before dose” and “after dose.” A monthly injection can remove that daily marker. Not everyone experiences this, but when it happens, people often describe it as getting back a little cognitive bandwidthlike closing 27 browser tabs you didn’t realize were open.

Appointments become the new routine

Swapping daily dosing for monthly visits sounds like a trade-up (and it can be), but it replaces one routine with another. People often say the best success comes when the injection appointment is treated like a non-negotiable meetingsame way you’d treat a final exam or a flight. Clinics may book the next visit before you leave, and that little “future you” favor can prevent late doses.

Injection-site sensations: normal vs. annoying

It’s common to feel tenderness, firmness, or a small lump at the injection site. Some people are surprised that the area can feel “present” for a while, especially early on. The experience varies: for some it’s a mild soreness; for others it’s more noticeable for a few days. People tend to do best when they know ahead of time what’s expected and what needs a call to the clinic (like signs of infection or unusual worsening pain).

The dose conversation is often about life, not just milligrams

When a clinician considers maintaining 100 mg versus using 300 mg maintenance, the decision often includes practical factors: high-stress work environments, unstable housing, co-occurring anxiety, or recent relapse risk. Patients often report that the best dosing decisions happen when they feel safe being honest about cravings, slip-ups, or triggerswithout fear of judgment. In other words, dose optimization is frequently a relationship skill as much as a medical one.

Travel and scheduling: surprisingly emotional

People sometimes feel a strong sense of relief the first time they travel without packing daily medication or worrying about pharmacy logistics. That relief can be empoweringand also emotionalbecause it highlights how much daily planning used to revolve around OUD. For those using a planned two-month interval (when clinically appropriate), it can feel like getting a little more freedom, with the important reminder that the plan is still guided by a clinician.

Overall, lived experience tends to echo the same theme: Sublocade isn’t “magic,” but it can be a powerful tool. When dosing, scheduling, and support line up, many people describe it as making recovery feel more manageableand a bit more like regular life again.