Sublocade interactions: Alcohol, medications, and other factors

When to avoid Sublocade

Sometimes, factors or conditions could prevent your doctor from prescribing Sublocade due to the risk of harm. These are known as contraindications. The contraindications of Sublocade include:

Having had an allergic reaction to Sublocade or any of its ingredients

If you have had an allergic reaction to Sublocade or any of its ingredients, your doctor will likely not prescribe Sublocade. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Sublocade, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Sublocade.

Sublocade interaction with alcohol

It is not safe to consume alcohol while receiving Sublocade injections.

This is because drinking alcohol with Sublocade may increase the risk of certain side effects with Sublocade. Specifically, alcohol can increase the risk of respiratory depression and central nervous system (CNS) depression.

With respiratory depression, your breathing becomes weak, shallow, or slow. With CNS depression, the activity of your brain slows. This may cause symptoms such as sleepiness, confusion, or dizziness. In extreme cases, respiratory and CNS depression can lead to coma or death. For more information on the side effects of Sublocade, see this article.

Due to these risks, the manufacturer of Sublocade recommends that you avoid consuming alcohol with this drug.

If you have questions about alcohol and Sublocade, talk with your doctor.

Sublocade interactions with other medications

Before you start treatment with Sublocade, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Sublocade interacts with supplements, herbs, or vitamins, see the “Sublocade and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Sublocade. Keep in mind that this table does not include all drugs that may interact with Sublocade. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn more about Sublocade’s side effects, see this article.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Sublocade.

Other opioids

Opioids are medications prescribed to ease pain. Sublocade is also an opioid. However, the drug is prescribed for opioid use disorder (OUD) instead of pain. For more information about Sublocade and its uses, see this article.

Interaction result. Receiving Sublocade injections while taking another opioid can increase the risk of certain side effects from either drug. Specifically, taking these medications together can increase the risk of respiratory depression and central nervous system (CNS) depression.

With respiratory depression, your breathing becomes weak, shallow, or slow. With CNS depression, the activity of your brain slows. This may cause symptoms such as sleepiness, confusion, or dizziness. In extreme cases, respiratory and CNS depression can lead to coma or death.

Interaction explained. Both Sublocade and other opioids can cause respiratory and CNS depression when taken on their own. Receiving Sublocade injections in combination with another opioid can further increase the risk of these effects. (For more information on the side effects of Sublocade, see this article.)

Examples of opioid drugs. Below are a few examples of opioids that may interact with Sublocade:

• fentanyl (Actiq, Fentora)
• hydrocodone (Hysingla ER)
• morphine (Mitigo, MS Contin)
• oxycodone (Oxycontin, Roxicodone, Xtampza ER, others)
• tramadol (Conzip, Qdolo)

Steps you or your doctor may take. In most cases, doctors will not prescribe an opioid while you’re receiving Sublocade injections. This is because Sublocade is used to treat OUD. With OUD, a person feels unable to stop taking opioids even though the opioid may be causing harm.

In rare cases, a doctor may recommend the short-term use of an opioid while you’re receiving Sublocade. For example, they may prescribe an opioid for pain relief after surgery. In this case, your doctor may have you stay in the hospital while you’re taking the opioid. They’ll do this so they can watch you closely for symptoms of respiratory and CNS depression.

If you take Sublocade with an opioid, your doctor may also prescribe naloxone (Narcan, Kloxxado, Zimhi). This drug can help treat an opioid overdose, which may be caused by respiratory and CNS depression from Sublocade and the opioid. Naloxone may be available without a prescription at your local pharmacy. To learn more about this, talk with your doctor or pharmacist.

If you have more questions about what happens if you use other opioids while receiving Sublocade, talk with your doctor.

Benzodiazepines

Doctors can prescribe benzodiazepines to treat several conditions, including anxiety and seizures.

Interaction result. Receiving Sublocade injections while taking a benzodiazepine can increase the risk of certain side effects from either drug. Specifically, taking these medications together can increase the risk of central nervous system (CNS) depression and respiratory depression.

With CNS depression, your brain activity slows down. This may cause symptoms such as confusion, sleepiness, or dizziness. With respiratory depression, your breathing becomes weakened, shallow, or slow. In extreme cases, CNS and respiratory depression can lead to coma or death.

Interaction explained. Sublocade and benzodiazepines can cause CNS and respiratory depression when taken on their own. Receiving Sublocade in combination with a benzodiazepine can further increase these risks. (For more information on the side effects of Sublocade, see this article.)

Examples of benzodiazepine drugs. Here are some benzodiazepines that may interact with Sublocade:

• alprazolam (Xanax)
• clonazepam (Klonopin)
• diazepam (Valium)
• lorazepam (Ativan)
• temazepam (Restoril)

Steps you or your doctor may take. Before starting treatment with Sublocade, tell your doctor about all medications you’re taking.

If you’re taking a benzodiazepine, your doctor will advise you on the risks of taking the drug while receiving Sublocade injections. They may switch you from the benzodiazepine to a different treatment that doesn’t interact with Sublocade. Or they may lower your dosage of the benzodiazepine to help reduce these risks.

If you take Sublocade with a benzodiazepine, watch for symptoms of CNS and respiratory depression. If you have these symptoms, tell your doctor right away. They can advise you on whether it’s safe for you to keep receiving Sublocade with the benzodiazepine. If your symptoms seem severe or life threatening, call 911 or your local emergency number immediately.

If you take Sublocade with a benzodiazepine, your doctor may also prescribe naloxone (Narcan, Kloxxado, Zimhi). This drug can help treat an opioid overdose, which may be caused by respiratory and CNS depression from Sublocade. Naloxone may be available without a prescription at your local pharmacy. To learn more about this, talk with your doctor or pharmacist.

Diuretics

Diuretics are drugs prescribed to reduce levels of sodium and water in your body. Doctors often prescribe them to treat conditions such as high blood pressure and heart failure.

Interaction result. Receiving Sublocade injections while taking a diuretic can make the diuretic less effective.

Interaction explained. Sublocade may stimulate the release of a certain hormone that helps your body hold on to sodium and water. Specifically, Sublocade may stimulate the release of antidiuretic hormone. As a result, receiving Sublocade with a diuretic can reduce the effect of the diuretic.

Examples of diuretic drugs. Here are some diuretics that may interact with Sublocade:

• amiloride (Midamor)
• bumetanide (Bumex)
• furosemide (Furoscix, Lasix)
• spironolactone (Carospir, Aldactone)
• triamterene/hydrochlorothiazide (Maxzide)

Steps you or your doctor may take. Before starting treatment with Sublocade, tell your doctor if you’re taking a diuretic. They may increase the dosage of your diuretic. Doing so could make the drug more effective while you’re receiving Sublocade.

Sublocade and other interactions

Sublocade may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Sublocade.

Sublocade interactions with supplements

Before you start treatment with Sublocade, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Sublocade interactions with herbs

Sublocade may interact with a herbal supplement called St. John’s wort. Receiving Sublocade injections while taking this supplement may make Sublocade less effective.

Because of this, it’s important to check with your doctor or pharmacist before taking any herbal supplements during Sublocade treatment.

Sublocade and vitamins

There are no specific reports of vitamins interacting with Sublocade. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Sublocade.

Sublocade interactions with food

Eating grapefruit or drinking grapefruit juice while receiving Sublocade can increase your risk of side effects with the drug. (To learn more about Sublocade’s side effects, see this article.)

If you’d like to learn more about eating certain foods while receiving Sublocade injections, talk with your doctor.

Sublocade and vaccines

There are no specific reports of vaccines interacting with Sublocade. If you have questions about getting specific vaccines during Sublocade treatment, talk with your doctor or pharmacist.

Sublocade and lab tests

There are no specific reports of lab tests interacting with Sublocade. If you have questions about getting certain lab tests during Sublocade treatment, talk with your doctor or pharmacist.

UBLOCADE INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Sublocade.

Receiving Sublocade injections while taking cannabis or cannabis products may increase the risk of side effects from Sublocade, cannabis, or cannabis products. (For more information on the side effects of Sublocade, see this article.)

Before you start treatment with Sublocade, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Sublocade and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Sublocade. Before you take this drug, be sure to talk with your doctor about your health history. Sublocade may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Sublocade include:

• Gallbladder problems. Before starting Sublocade treatment, tell your doctor if you have a gallbladder problem. The drug may worsen this condition. Your doctor can tell you whether Sublocade is the right treatment option.
• Head injury or brain problem. If you have a head injury or brain problem, talk with your doctor before starting Sublocade treatment. The drug may increase the pressure inside your brain and spinal cord, which can cause extreme sleepiness. As a result, your doctor may not be able to safely monitor your head injury or brain problem. For this reason, your doctor may recommend a treatment other than Sublocade.
• Liver problems. Before starting Sublocade treatment, tell your doctor if you have a liver problem such as hepatitis. The drug may worsen liver problems in people who already have this condition. In addition, it is unknown whether Sublocade is a safe treatment option for people with moderate or severe liver problems such as liver failure. If you have a liver problem, your doctor can advise you on whether Sublocade is the right treatment.
• Lung conditions or breathing problems. Sublocade may cause respiratory depression as a side effect. Your risk for this side effect may be higher if you have a lung condition such as chronic obstructive pulmonary disease (COPD) or asthma. Your risk may also increase if you have a breathing problem such as sleep apnea. Before starting Sublocade treatment, talk with your doctor about any lung or breathing problems you have. They can tell you whether Sublocade is the right treatment.
• Abnormal heart rhythm or factors that increase your risk. Before receiving Sublocade injections, tell your doctor if you have an abnormal heart rhythm. Also tell them if you have any factors that increase your risk of this condition. Examples include low heart rate and low blood levels of potassium or magnesium. Sublocade may worsen abnormal heart rhythm in people who already have this condition or have a high risk for it. Your doctor can tell you whether Sublocade is the right treatment option for you.
• Pregnancy. Receiving Sublocade injections during pregnancy can cause neonatal opioid withdrawal syndrome in the infant after birth. This means the infant may have symptoms of opioid withdrawal. If you’re pregnant or planning a pregnancy, talk with your doctor. They can recommend the right treatment plan for you and the infant. For details about Sublocade and pregnancy, see this article.
• Breastfeeding. Sublocade can pass into breast milk, which may lead to side effects in a child who is breastfed. If you are considering breastfeeding while receiving Sublocade injections, talk with your doctor. To learn more about Sublocade’s use while breastfeeding, see this article.
• Allergic reaction. If you have had an allergic reaction to Sublocade or any of its ingredients, your doctor will likely not prescribe Sublocade. Receiving the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Preventing interactions

You can take certain steps to help prevent interactions with Sublocade. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It is also important to read the Sublocade label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Sublocade does not come with paperwork, you can ask your doctor to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Sublocade by receiving the injection exactly as your doctor prescribes.

Other resources

Besides learning about interactions, you may want to find out more about Sublocade. These resources might help:

• Overview of Sublocade. For a general overview of Sublocade, you can see this article.
• Side effects. If you’re interested in the side effects of Sublocade, see this article. Another option is to refer to the Sublocade prescribing information.
• Dosage specifics. To learn about the dosage of Sublocade, see this article.
• Drug comparison. For information about how Sublocade compares with Suboxone, read this article.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.