What is Zubsolv, and how is it different from Suboxone?
Zubsolv is a prescription tablet that dissolves under the tongue. It contains two medications, buprenorphine and naloxone, and it is used to treat opioid dependence and opioid use disorder, the medical name for opioid addiction.
If you are familiar with buprenorphine treatment with Suboxone, then you will easily understand what Zubsolv is and how it works. In fact, Zubsolv is very similar to Suboxone. They have the same two active ingredients, and they do the same job.
I am an osteopathic physician with over two decades of experience in treating medication and drug dependence and addiction, and I have prescribed both. The differences between them are practical, not pharmacological. Zubsolv and Suboxone are the same medicine in different clothes.
Yet, patients ask about the differences all the time. Is the tablet just a generic form of the film? And, why is the number on the Zubsolv box lower?
Zubsolv vs Suboxone, which one is better?
As is true in many cases, there is not a clear winner between these two medications. Each has advantages, and patients have their own preferences. The differences are the taste, the time that the medication takes to dissolve, a confusing dose scale, and a brand name that fewer people recognize.
What is the Suboxone film?
Suboxone is the old brand in the world of opioid dependence treatment. The U.S. Food and Drug Administration (FDA) first approved it in 2002, and the name has become synonymous with buprenorphine treatment.
While Suboxone was originally a sublingual tablet, the company eventually came out with the film, or strip, form of the medication. Suboxone has always been a combination of two drugs. Buprenorphine does the job of treating opioid dependence, and naloxone is included mainly to discourage misuse.
The film dissolves under the tongue within a few minutes, and many patients complain that it leaves a bad aftertaste. The most commonly used strengths are 8 mg/2 mg and 2 mg/0.5 mg, where the first number refers to buprenorphine and the second to naloxone.
What about Zubsolv?
Zubsolv is a more recent brand. The FDA approved it in 2013, and it has never had the same public recognition as the Suboxone film. It is a small, white tablet that comes in six strengths.
Taste is an advantage of Zubsolv.
Zubsolv has a minty taste with no bad aftertaste. That may not seem like a big deal, but when you have to take a medication every day, taste is important.
Does Zubsolv dissolve faster than Suboxone?
For some patients, it may. Many describe the tablet as dissolving very fast, which means less waiting around with your mouth closed.
The Zubsolv prescribing information, also known as the label, is more modest. It states that the dissolve time varies from person to person, and that the median time observed was 5 minutes.
According to the label, the tablet must be taken whole, it must not be cut, chewed, or swallowed, and you should not eat or drink anything until it has completely dissolved. Because dental problems have been reported with buprenorphine medications that dissolve in the mouth, it also advises waiting at least one hour before you brush your teeth.
Fewer people know the name, so there may be less diversion.
Buprenorphine is a controlled opioid, so diversion, meaning the sale or sharing of a prescribed medication, is an important issue.
I have found that, because Zubsolv is the lesser known brand, there is less of a problem with diversion. When people on the streets do not know a brand, they will not buy it as readily from drug dealers. This is a form of “security through obscurity.”
While this is an observation, and not something that I can prove with numbers, it is hard to sell a product that nobody is asking for.
Why are the Zubsolv doses so confusing?
A disadvantage of Zubsolv is the numbers on the box. While Zubsolv is available in a wider variety of strengths, they do not line up with the more commonly known Suboxone strengths of 8 mg and 2 mg. For example, Zubsolv 5.7 mg/1.4 mg is equivalent to Suboxone 8 mg/2 mg.
Why are the Zubsolv numbers lower? The answer is bioavailability, or the share of a medication that actually gets into your system. Zubsolv is a differently engineered tablet, and more of its buprenorphine is absorbed while it sits under your tongue.
So, a patient who is moved from Suboxone 8 mg to Zubsolv 5.7 mg has not had the dose cut. Only the scale has changed. Do not compare milligrams across brands, and ask your doctor or pharmacist what your dose corresponds to.
What are the Zubsolv strengths, and how do they compare to Suboxone?
According to the prescribing information, Zubsolv comes in six strengths, and the label gives the corresponding Suboxone tablet dose for five of them.
The smallest tablet is Zubsolv 0.7 mg/0.18 mg, at half the strength of the next size up, and the label’s conversion list does not include it. Zubsolv 1.4 mg/0.36 mg corresponds to Suboxone 2 mg/0.5 mg, and Zubsolv 2.9 mg/0.71 mg corresponds to Suboxone 4 mg/1 mg.
Zubsolv 5.7 mg/1.4 mg corresponds to Suboxone 8 mg/2 mg. The two largest tablets, Zubsolv 8.6 mg/2.1 mg and Zubsolv 11.4 mg/2.9 mg, correspond to Suboxone 12 mg/3 mg and 16 mg/4 mg.
How is Zubsolv started? For a patient coming from heroin or another short-acting opioid, the label describes a first day that begins with a single 1.4 mg/0.36 mg tablet and may reach a total of 5.7 mg/1.4 mg. On the second day, it describes a single dose of up to 11.4 mg/2.9 mg.
After that, the label describes a maintenance dose that is generally in the range of 2.9 mg/0.71 mg to 17.2 mg/4.2 mg per day. These numbers are not a schedule for you to follow from an article. Your dose is found by working with your prescriber.
Is Zubsolv generic for Suboxone?
No, not at all. Zubsolv is not a generic medication. It is a brand of its own, with its own formulation, and that formulation is the reason that the milligrams do not match.
So, is there a generic Zubsolv? As of this writing in 2026, there is not. No generic version of Zubsolv is sold in the United States.
The real generics are the buprenorphine and naloxone tablets and films that pharmacies dispense every day. They are generics of Suboxone. While they contain the same two ingredients as Zubsolv, they are not interchangeable with it milligram for milligram, so a switch takes a new prescription written for the corresponding strength.
The generics work. Yet, a generic tablet may not dissolve as fast or taste as pleasant as Zubsolv, and waiting ten minutes for a tablet to dissolve can be tedious.
Which brand should you ask for?
I recommend that you do not request a particular brand of medication from your doctor. Tell your doctor about your concerns, and about your history of taking medication in the past.
If you could not tolerate the taste of the film, or a tablet took too long to dissolve, say so. That is not shopping for a brand. It is your history, and your doctor needs it. Then, let your doctor make an informed decision based on that information.
Your insurance company will often decide.
Health plans often prefer one brand or the other, and a plan’s list of covered drugs can change from year to year. So, check your own plan, and if you are looking for a savings program, check the manufacturer’s site.
In some cases, an insurance change may necessitate changing the brand. Usually, this does not turn out to be a problem, since these medications are essentially the same in the way they work. A careful explanation and reassurance from the doctor can make all the difference.
Who can prescribe Zubsolv?
When this article was first written in 2019, a doctor needed a special federal certification, known as the X-waiver, to prescribe buprenorphine for opioid dependence. Congress eliminated the X-waiver in the Consolidated Appropriations Act, 2023, which was signed on December 29, 2022.
Today, any prescriber with a standard Drug Enforcement Administration (DEA) registration that covers Schedule III medications may prescribe buprenorphine, where state law allows. Any doctor who can prescribe Suboxone can also prescribe Zubsolv.
Unfortunately, there are some doctors who prescribe buprenorphine medications, yet they choose not to write prescriptions for Zubsolv. I do not know why a doctor would single out this particular FDA-approved medication, but they are out there. So, if you have a reason to prefer Zubsolv, it is not a bad idea to call and ask before you make an appointment.
Does Zubsolv cause withdrawal symptoms?
When it is taken properly, Zubsolv will stop withdrawal symptoms and keep them from coming back. However, if a patient takes Zubsolv too soon after taking another opioid, such as heroin, fentanyl, or pain pills, it can cause precipitated withdrawal.
This form of opioid withdrawal happens when the opioid receptors are still occupied by the other opioid. Buprenorphine pushes the other opioid off and takes its place with a weaker signal, which causes a sudden, relative withdrawal state. While precipitated withdrawal is typically not dangerous, it can be severe.
For short-acting opioids, the label says that the first dose should be given when objective signs of moderate opioid withdrawal appear, and not less than six hours after the last use. When fentanyl is involved, the wait is often longer and less predictable.
So, the timing of the first dose is a decision for your prescriber, and it is not something to guess at. If you become very sick, cannot keep fluids down, or something feels seriously wrong, call your doctor, and call 911 in an emergency.
What are the side effects of Zubsolv?
The side effects of Zubsolv are the side effects of buprenorphine. According to the label, the common ones are headache, nausea, vomiting, sweating, constipation, insomnia, pain, swelling in the feet and ankles, and signs and symptoms of withdrawal. The article on Suboxone constipation applies to Zubsolv as well.
The most serious warning on the label is about breathing. Combining buprenorphine with benzodiazepines, alcohol, or other sedating drugs increases the risk of slowed breathing, overdose, and death. So, tell your doctor about everything that you take, and if someone is hard to wake or is breathing slowly, call 911.
The same label says that treatment should not be categorically denied to patients who take these medications. If you are prescribed a benzodiazepine, do not stop it suddenly on your own, because stopping abruptly can trigger seizures.
Tapering off Zubsolv is hardest at the last milligram.
Not everyone who takes Zubsolv will want to stop, and no one should be pushed to. According to the label, there is no maximum recommended duration of maintenance treatment, and for the patient who does decide to come off of it, the instruction is to taper gradually.
Buprenorphine produces physical dependence, which means that the body has adjusted to the medication and will react if it is taken away too quickly. Physical dependence is not addiction.
Many patients report that the last milligram is the hardest part. They describe coming down from a full dose over many months with little trouble. Then, somewhere below a milligram, they hit a wall, where every cut feels worse than the cut before it.
Why would the bottom be harder than the top? The likely explanation is receptor occupancy. At the usual treatment doses, buprenorphine may already occupy most of the opioid receptors, so a reduction near the top is hardly noticed. Near the bottom, a reduction of the same size removes a far larger share of what is left.
So, the reductions should get smaller as the dose gets smaller, with time at each step for the body to settle. The Maudsley Deprescribing Guidelines describe this pattern, known as hyperbolic tapering, for other medications that cause physical dependence. The same principle can be applied to buprenorphine.
Why do the 0.7 mg and 1.4 mg tablets matter in a taper?
Fortunately, this is where Zubsolv has a practical advantage. The smallest Suboxone film holds 2 mg of buprenorphine, and so does the smallest generic tablet. Zubsolv comes in a 1.4 mg tablet, which corresponds to that 2 mg strength, and in a 0.7 mg tablet at half of it.
Patients on the films often end up cutting them into smaller and smaller pieces, and a sliver of film is not a precise dose.
Even so, going from the smallest tablet to nothing is still, in proportion, the largest cut of the entire taper. There are ways, worked out with a prescriber, to take smaller doses, and they are covered in the article on how to taper off of Suboxone.
If the taper is too fast, the doctor must slow it down, and if you are doing well, you and your doctor may agree to go a bit faster, as tolerated.
There is a risk of relapse after the medication is stopped, and the label says so. So, stay in touch with your doctor after the last dose. And, if the low end of a taper ever leaves you feeling hopeless, or thinking about suicide, call or text 988, the Suicide and Crisis Lifeline, at any hour.
How does Zubsolv compare to methadone?
Zubsolv is used for medication-assisted treatment (MAT) of opioid dependence and opioid use disorder. Methadone is used for the same purpose, and there is a full comparison in the article on Suboxone vs methadone.
Sublingual buprenorphine works very well for many people. However, there are people who will not do well with it, and some who have difficulty getting started on it at all. For those patients, methadone maintenance is a well-established option, and there is no shame in needing a different medication.
More treatment options is a good thing.
It is always good to have more choices when it comes to medications that contain buprenorphine. Patients are different, and when a doctor has several medications with different advantages, the doctor can address the needs of the individual patient.
There is also a buprenorphine tablet without naloxone, once sold as Subutex, which is covered in the article on Suboxone vs Subutex. It is mainly used when a patient is pregnant or has had an adverse reaction to naloxone.
Whether it is a tablet or a film, a brand or a generic, it is the same medicine doing the same job. What matters is that it works for you.
How do I prescribe Zubsolv and Suboxone?
I provide buprenorphine treatment, with Zubsolv, Suboxone, and the generic films and tablets, to new patients throughout Florida by telemedicine, with in-office visits available in Fort Lauderdale. Patients start at home with phone support, and when fentanyl is involved, I use a low-dose start when needed. My practice is concierge and not insurance-based, and visits are monthly, and weekly when needed. The patient decides whether the goal is long-term maintenance or a gradual taper.
To ask about buprenorphine treatment, or about tapering off of it, you can reach my office through the contact form.
This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.
