How long does it take to feel Brixadi?

October 8, 2025 •

4 min read

According to Brixadi’s official information, the medication begins to work after the very first dose, but patients should not expect to feel a typical opioid 'high'. This is because the medication is designed to provide a steady, continuous release of buprenorphine to manage opioid use disorder (OUD), not produce euphoria.

Quick Summary

Brixadi, an extended-release buprenorphine injection, starts working immediately after the first dose to manage withdrawal and cravings. However, patients don't feel a 'high' or immediate sensation because the medication is released slowly and steadily over a week or month, reaching stable levels over time.

Key Points

Immediate Onset: Brixadi begins to work right after the first injection to manage cravings and withdrawal symptoms.
Slow, Steady Release: The medication is slowly released from a gel depot under the skin over a week or month, providing stable buprenorphine levels.
No Euphoric 'High': As a partial opioid agonist, buprenorphine prevents withdrawal but does not produce the same 'high' as other opioids.
Time to Steady State: It takes approximately four weekly doses or four monthly doses to reach a consistent, stable therapeutic level in the body.
Monitoring Effectiveness: The medication's success is determined by a reduction in cravings and withdrawal symptoms, rather than a subjective 'feeling'.
Part of Comprehensive Treatment: Brixadi is a component of a larger treatment plan that includes counseling and therapy for opioid use disorder.

Understanding Brixadi's Unique Mechanism

Brixadi is an extended-release, subcutaneous (under the skin) injection of buprenorphine, a partial opioid agonist used to treat moderate to severe opioid use disorder (OUD). The unique aspect of Brixadi is its patented FluidCrystal® Injection Depot Technology. After a healthcare professional administers the injection, the liquid formulation turns into a biodegradable liquid crystalline gel, also known as a depot. This depot then slowly and continuously releases buprenorphine into the body over either one week or one month, depending on the prescribed schedule.

Unlike oral medications that can cause daily fluctuations in drug levels, the depot system maintains steady levels of buprenorphine. This stability is crucial for addiction treatment, as it helps to suppress cravings and reduce withdrawal symptoms without producing the rewarding 'high' associated with illicit opioids. For a patient, this means the medication is working in the background to stabilize their condition, and they are not meant to perceive its effects in a noticeable or dramatic way.

The Onset of Action vs. The 'Feeling' of Brixadi

The most important distinction for patients to understand is the difference between the medication 'working' and 'feeling' its effects. Brixadi starts working immediately by binding to opioid receptors in the brain, helping to alleviate cravings and withdrawal symptoms. However, the therapeutic effect is a subtle, background stabilization, not a conscious sensation.

For new patients, a period of stabilization on transmucosal (sublingual) buprenorphine is often required before switching to the extended-release injection to prevent precipitated withdrawal. For patients already on buprenorphine, the transition is more direct, and the steady release of medication from the depot helps maintain their stability without interruption.

Key aspects of the initial treatment phase include:

Initial dose: Brixadi starts working after the first injection to immediately begin managing withdrawal symptoms.
Stabilization: Healthcare providers will monitor a patient's initial response to ensure the dosage is effective and no withdrawal symptoms occur.
Gradual process: Unlike the rapid onset of a full opioid agonist, the onset of Brixadi is designed for sustained relief, aligning with the long-term nature of recovery.

Reaching a Steady State

While Brixadi starts working immediately, it takes time for the buprenorphine levels in the body to reach a stable, consistent therapeutic level known as "steady state". This is a normal part of the pharmacokinetics of an extended-release drug and is an expected part of the treatment journey.

For Brixadi Weekly, steady state is typically achieved after the fourth consecutive weekly dose.
For Brixadi Monthly, steady state is usually reached after the fourth consecutive monthly dose.

Once a patient reaches steady state, their buprenorphine levels remain consistently within the therapeutic range, helping to maintain treatment and reduce the risk of cravings and relapse.

Comparing Brixadi Dosing Schedules

The following table highlights the key differences between the weekly and monthly Brixadi options and how they compare to traditional daily sublingual buprenorphine.


Feature	Brixadi (Weekly)	Brixadi (Monthly)	Daily Sublingual Buprenorphine
Onset of Therapeutic Effect	Immediately begins controlling cravings and withdrawal after the first dose.	Immediately begins controlling cravings and withdrawal after the first dose.	Begins controlling cravings and withdrawal soon after administration.
Time to Steady State	Approximately 4 consecutive weekly doses.	Approximately 4 consecutive monthly doses.	Achieves steady state more quickly, but with daily peaks and troughs.
Dosing Frequency	Administered once every 7 days.	Administered once every 28 days.	Administered daily, typically as a film or tablet.
Administration	Subcutaneous injection by a healthcare professional.	Subcutaneous injection by a healthcare professional.	Dissolves under the tongue or in the cheek.
Flexibility	More frequent dosing allows for more frequent adjustment of treatment by a healthcare provider early in therapy.	Less frequent dosing requires a longer-term treatment plan and less frequent adjustments.	Daily adjustments can be made by the patient and provider in real-time.
Convenience	Eliminates the need for daily medication, reducing the risk of missed doses.	Offers maximum convenience with only 12 injections per year, reducing potential for forgetfulness.	Requires daily adherence and can be inconvenient for some patients.

What to Expect and How Effectiveness is Measured

Because Brixadi's goal is to provide stability, patients should not expect to have a specific 'feeling' of the medication working. Instead, effectiveness is monitored by the healthcare team through clinical observations, reduced illicit opioid use (confirmed by urine testing), and a reduction in cravings and withdrawal symptoms. This is part of a larger treatment plan that also includes counseling and behavioral therapy.

Patients may, however, experience physical sensations at the injection site. After the injection, a small bump or lump of the gel depot may be visible or felt under the skin, which should gradually decrease over time. Some injection site reactions, like pain, redness, or itching, are common and typically mild to moderate. Any persistent or severe reaction should be reported to a healthcare provider.

Conclusion

In conclusion, the question of 'How long does it take to feel Brixadi?' is answered by understanding its unique extended-release mechanism. The medication starts to work immediately after the first dose to manage withdrawal and cravings, but it is not intended to produce a euphoric 'feeling'. Instead, it provides a steady, continuous release of buprenorphine, with stable therapeutic levels reached over several weeks or months. This provides consistent support for patients with OUD, allowing them to focus on their counseling and behavioral therapy as part of their long-term recovery. For more detailed information on dosing and administration, refer to the official Brixadi website.

Frequently Asked Questions

Brixadi is not designed to produce a rapid onset or a euphoric feeling. The medication is an extended-release formulation intended to be released slowly and steadily over a week or month. The fastest way to start treatment is to get your initial dose from a healthcare professional, which will immediately begin the process of managing withdrawal and cravings.

No, you will not feel high or euphoric after a Brixadi injection. Buprenorphine is a partial opioid agonist, meaning it binds to opioid receptors to manage withdrawal and cravings but does not produce the same rewarding 'high' as other opioids.

You won't feel a distinct sensation of Brixadi 'starting to work' because its therapeutic effect is gradual and steady. The medication works in the background to stabilize your body and brain, with the primary indicators of success being a reduction in cravings and withdrawal symptoms over time.

It takes time for Brixadi to reach a stable therapeutic level, known as steady state. This is typically achieved after four consecutive weekly injections or four consecutive monthly injections.

You should contact your healthcare provider immediately if you experience withdrawal symptoms after a Brixadi injection. Your dose may need to be adjusted, as this indicates that the current dosage may be insufficient to fully manage your symptoms.

The main difference is the release profile. Sublingual buprenorphine is absorbed more quickly, leading to more pronounced daily peaks and troughs in blood levels. Brixadi's extended-release formulation provides a consistent, steady level of medication, which is less noticeable but more stable over the long term.

After your Brixadi injection, you may see or feel a small lump under your skin where the gel depot formed. This is normal and should decrease over several weeks. You might also experience mild injection site reactions like pain, redness, or itching, which should be reported to your provider if they are severe or persistent.

You should never stop Brixadi abruptly without consulting your healthcare provider. Stopping suddenly can lead to severe withdrawal symptoms. Because Brixadi is designed for sustained, steady relief, the absence of a noticeable 'feeling' is actually a sign that the medication is working correctly.