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Zubsolv
buprenorphine/ naloxone
Adult Dosing .
Dosage forms: SL TAB: 0.7 mg/0.18 mg, 1.4 mg/0.36 mg, 2.9 mg/0.71 mg, 5.7 mg/1.4 mg, 8.6 mg/2.1 mg, 11.4 mg/2.9 mg
Special Note
- [prescribing info]
- Info: strongly consider prescribing naloxone if risk of opioid overdose or accidental ingestion
- [formulation clarification]
- Info: not bioequivalent to other buprenorphine/naloxone products; comparable doses are:
- [Zubsolv 1.4 mg/0.36 mg SL tab]
- Info: equivalent to Suboxone or generic 2 mg/0.5 mg SL strip or generic 2 mg/0.5 mg SL tab
- [Zubsolv 2.9 mg/0.71 mg SL tab]
- Info: equivalent to Suboxone or generic 4 mg/1 mg SL strip
- [Zubsolv 5.7 mg/1.4 mg SL tab]
- Info: equivalent to Suboxone or generic 8 mg/2 mg SL strip or generic 8 mg/2 mg SL tab
- [Zubsolv 8.6 mg/2.1 mg SL tab]
- Info: equivalent to Suboxone or generic 12 mg/3 mg SL strip
opioid dependence
- [induction tx]
- Dose: 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL x1, may incr. by 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL q1-2h prn up to 5.7 mg/1.4 mg/day on day 1, then give equivalent total daily dose from day 1 on day 2, may incr. by 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL q1-2h prn up to 11.4 mg/2.9 mg/day on day 2, then may incr. by up to 2.9 mg/0.71 mg/day prn until sx stabilization; Start: when mild-moderate withdrawal sx present and >6h after last short-acting opioid use or >24h after last long-acting opioid use; Info: do not cut/crush/chew/swallow SL tab; consider single-ingredient buprenorphine product if long-acting opioid use
- [maintenance tx]
- Dose: 2.9 mg/0.71 mg-17.2 mg/4.2 mg SL qd; Start: equivalent total daily dose on last day of induction tx, then may adjust by up to 2.9 mg/0.71 mg/day prn; Info: do not cut/crush/chew/swallow SL tab; doses >17.2 mg/4.2 mg/day rarely more effective; taper dose gradually over several months to D/C
renal dosing
- [see below]
- renal impairment: no adjustment
- HD: no adjustment; no supplement; PD: not defined
hepatic dosing
- [induction tx]
- moderate-severe impairment: avoid use; Info: consider single-ingredient buprenorphine product
- [maintenance tx]
- mild impairment: no adjustment; moderate impairment: not defined, caution advised; severe impairment: avoid use
Peds Dosing .
- Dosage forms: SL TAB: 0.7 mg/0.18 mg, 1.4 mg/0.36 mg, 2.9 mg/0.71 mg, 5.7 mg/1.4 mg, 8.6 mg/2.1 mg, 11.4 mg/2.9 mg
Special Note
- [prescribing info]
- Info: strongly consider prescribing naloxone if risk of opioid overdose or accidental ingestion
- [formulation clarification]
- Info: not bioequivalent to other buprenorphine/naloxone products; comparable doses are:
- [Zubsolv 1.4 mg/0.36 mg SL tab]
- Info: equivalent to Suboxone or generic 2 mg/0.5 mg SL strip or generic 2 mg/0.5 mg SL tab
- [Zubsolv 2.9 mg/0.71 mg SL tab]
- Info: equivalent to Suboxone or generic 4 mg/1 mg SL strip
- [Zubsolv 5.7 mg/1.4 mg SL tab]
- Info: equivalent to Suboxone or generic 8 mg/2 mg SL strip or generic 8 mg/2 mg SL tab
- [Zubsolv 8.6 mg/2.1 mg SL tab]
- Info: equivalent to Suboxone or generic 12 mg/3 mg SL strip
opioid dependence (off-label)
- [induction tx, adolescents]
- Dose: 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL x1, may incr. by 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL q1-2h prn up to 5.7 mg/1.4 mg/day on day 1, then give equivalent total daily dose from day 1 on day 2, may incr. by 1.4 mg/0.36 mg-2.9 mg/0.71 mg SL q1-2h prn up to 11.4 mg/2.9 mg/day on day 2, then may incr. by up to 2.9 mg/0.71 mg/day prn until sx stabilization; Start: when mild-moderate withdrawal sx present and >6h after last short-acting opioid use or >24h after last long-acting opioid use; Info: do not cut/crush/chew/swallow SL tab; consider single-ingredient buprenorphine product if long-acting opioid use
- [maintenance tx, adolescents]
- Dose: 2.9 mg/0.71 mg-17.2 mg/4.2 mg SL qd; Start: equivalent total daily dose on last day of induction tx, then may adjust by up to 2.9 mg/0.71 mg/day prn; Info: do not cut/crush/chew/swallow SL tab; doses >17.2 mg/4.2 mg/day rarely more effective; taper dose gradually over several months to D/C
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
- hepatic impairment: consider adult hepatic dosing for guidance