Understanding the Equivalents: What is the equivalent of brixadi 96 mg?

October 9, 2025 •

4 min read

While there is no single, identical drug that functions exactly like Brixadi 96 mg, this monthly extended-release buprenorphine injection has distinct dosing patterns that can be compared to other forms of Medication-Assisted Treatment (MAT). Understanding what is the equivalent of brixadi 96 mg requires examining different administration routes, dosing schedules, and buprenorphine plasma concentration levels provided by other medications like Sublocade or daily sublingual products.

Quick Summary

There is no direct single-medication equivalent to Brixadi 96 mg due to its unique extended-release monthly injection delivery. Similar treatment alternatives include weekly Brixadi injections (24 mg), monthly Sublocade injections (100 mg or 300 mg), and daily sublingual buprenorphine products like Suboxone (12-16 mg daily based on stabilization).

Key Points

No Single Equivalent: There is no direct, single-dose medication equivalent to Brixadi 96 mg monthly injection due to its unique extended-release formulation.
Internal Brixadi Equivalent: A Brixadi 96 mg monthly dose corresponds to a 24 mg weekly Brixadi dose for patients transitioning between dosing schedules.
Sublingual Equivalent: Patients typically start on 12-16 mg daily sublingual buprenorphine before transitioning to a 96 mg monthly Brixadi dose.
Sublocade Comparison: Sublocade is another monthly buprenorphine injection but is not a direct dose-for-dose equivalent to Brixadi 96 mg and uses different dose strengths and injection sites.
Administration Matters: The primary difference from daily medications like Suboxone is the convenience of a once-monthly injection versus daily self-administration.
Not a Straight Swap: Converting between different buprenorphine products is a clinical decision based on patient stabilization, not a simple milligram-for-milligram exchange.
Other OUD Treatments: Methadone (full agonist) and Vivitrol (antagonist) are also used for OUD but are not buprenorphine equivalents.

The search for a medication equivalent to Brixadi 96 mg is complex because it is an extended-release, once-monthly subcutaneous injection administered by a healthcare professional. The therapeutic goal is to maintain a steady plasma concentration of buprenorphine to treat opioid use disorder (OUD). Other buprenorphine products, including different Brixadi doses, other long-acting injections, and daily sublingual films or tablets, offer varying absorption rates and dosing intervals. Patients and providers considering switching treatments or exploring options must focus on achieving a stable, therapeutic level of buprenorphine rather than a simple milligram-for-milligram conversion.

Brixadi Dosing and Internal Conversions

Within the Brixadi product line itself, a patient on the 96 mg monthly injection is receiving a total buprenorphine dose equivalent to a patient on a 24 mg weekly injection. For example, a patient transitioning from weekly to monthly Brixadi who was stable on 24 mg weekly would be converted to the 96 mg monthly dose. This internal conversion illustrates how the same medication is delivered over different timeframes, making the administration schedule a key consideration.

Comparison with Sublocade: Another Monthly Injection

Sublocade is another long-acting buprenorphine injection administered monthly, but its dosing schedule is different from Brixadi's. Sublocade comes in 100 mg and 300 mg monthly doses, often beginning with a higher dose. While both provide consistent buprenorphine levels, they are not direct dosage equivalents. A patient on Brixadi 96 mg monthly would need a careful assessment by their provider to determine if they could switch to a Sublocade dose and which one would be most appropriate.

Key Differences Between Brixadi and Sublocade

Dosing Flexibility: Brixadi offers both weekly and monthly options with more dosage strengths (64 mg, 96 mg, 128 mg monthly). Sublocade offers only monthly dosing in 100 mg and 300 mg strengths.
Injection Sites: Brixadi can be injected into the buttock, thigh, abdomen, or upper arm. Sublocade is only injected into the abdomen.
Formulation Differences: Though both contain buprenorphine, the specific formulations and release profiles differ, requiring a prescriber to carefully manage any transition between the two medications.

Comparison with Daily Sublingual Medications

Daily, self-administered sublingual products, such as Suboxone (buprenorphine/naloxone) films or tablets and Zubsolv (buprenorphine/naloxone) tablets, offer a different approach to OUD treatment. Unlike the steady release from a monthly Brixadi injection, these medications provide a daily dose of buprenorphine.

Based on clinical conversion guidelines, patients who were stabilized on a daily sublingual buprenorphine dose of 12-16 mg are candidates for the monthly 96 mg Brixadi injection. This demonstrates that the equivalent daily oral dose is not a simple calculation but is determined by a patient's stable response to treatment before transitioning to the long-acting injectable.

Key Differences Between Brixadi and Daily Sublinguals

Administration: Brixadi is a monthly injection administered by a healthcare provider, while sublingual films or tablets are self-administered daily.
Adherence: The once-monthly injection reduces the risk of non-adherence compared to daily medication.
Abuse Potential: The long-acting injectable format significantly reduces the potential for misuse and diversion associated with daily take-home medication.

Other Alternatives for Opioid Use Disorder

Beyond buprenorphine-based treatments, other medication-assisted treatments for OUD exist, though they are not considered equivalents of buprenorphine.

Vivitrol (Naltrexone): This is an opioid antagonist, meaning it blocks opioid receptors entirely. Vivitrol is a once-monthly injection for patients who are fully detoxified from opioids, as buprenorphine cannot be in their system when they start.
Methadone: A full opioid agonist, methadone is typically administered daily in a clinic setting under strict supervision. It functions differently than buprenorphine by fully activating opioid receptors to suppress withdrawal and cravings without causing the same high.

Comparing Key Buprenorphine-Based OUD Medications


Feature	Brixadi (Monthly)	Sublocade (Monthly)	Suboxone (Daily)
Dose	96 mg	100 mg or 300 mg	12-16 mg daily*
Active Ingredient	Buprenorphine	Buprenorphine	Buprenorphine/Naloxone
Route of Administration	Subcutaneous (under the skin) injection	Subcutaneous (under the skin) injection	Sublingual film or tablet
Administration Frequency	Once every 28 days	Once per month	Once per day
Who Administers?	Healthcare Provider	Healthcare Provider	Patient (self-administered)
Injection Sites	Buttock, thigh, abdomen, or upper arm	Abdomen	N/A
Ideal Candidate	Patients stable on 12-16 mg/day sublingual buprenorphine	Patients stable on 8-24 mg/day sublingual buprenorphine	Individuals who can reliably adhere to daily medication
Primary Benefit	Consistent dose, less risk of diversion	Consistent dose, less risk of diversion	Patient control over daily dosing, flexible to start	*Equivalent daily dose for stabilization prior to monthly injection

Conclusion

In conclusion, there is no single, simple medication that is a direct equivalent to Brixadi 96 mg. This extended-release monthly injection is part of a broader family of buprenorphine-based treatments for OUD, including weekly Brixadi injections, monthly Sublocade injections, and daily sublingual products like Suboxone. A patient stabilized on a 96 mg monthly Brixadi dose would likely have been previously stable on a daily sublingual buprenorphine dose of 12-16 mg, but this is a conversion, not an exact equivalent substitute. Choosing the best medication-assisted treatment depends on individual patient needs, treatment history, and clinical factors, and should always be determined by a qualified healthcare provider. The significant differences in administration frequency, site, and dosage flexibility are critical factors to consider when comparing these treatment options.

Further Information: For comprehensive prescribing information, refer to the official FDA documents for Brixadi: https://www.brixadihcp.com/pdfs/brixadi-prescribing-information.pdf.

Frequently Asked Questions

Yes, based on clinical guidelines, a patient stabilized on 12 mg to 16 mg of daily sublingual buprenorphine would typically transition to a 96 mg monthly Brixadi injection. A healthcare provider must manage this transition.

Both are monthly injectable buprenorphine treatments, but they are not exact dose equivalents. Sublocade is available in 100 mg and 300 mg doses and is injected only in the abdomen. Brixadi offers more flexible dosing options and injection sites.

The term 'stronger' is misleading because of the different delivery methods. Brixadi 96 mg provides a consistent, extended release of buprenorphine over a month, whereas Suboxone provides a daily dose. The goal is a steady therapeutic level for OUD treatment, achieved differently by each medication.

The equivalent weekly Brixadi dose for a patient receiving the 96 mg monthly injection is 24 mg per week.

No, you cannot combine weekly Brixadi doses to create a monthly dose. The weekly and monthly formulations are different and have distinct concentrations.

Monthly injections like Brixadi offer improved adherence and privacy, as they are administered by a healthcare provider once a month. This reduces the need for daily dosing and minimizes the risk of misuse or diversion associated with take-home oral medication.

Yes, but this is a significant change in treatment that must be managed by a doctor. Methadone is a full agonist requiring daily clinic visits, while Vivitrol is an antagonist requiring complete opioid detoxification before use. These are different classes of drugs and are not buprenorphine equivalents.