Buprenorphine
(Long-Acting Injectable)

What is long-acting injectable buprenorphine?

Long-acting injectable buprenorphine (LAI-B) delivers buprenorphine as a subcutaneous (under the skin) injection that releases medication slowly over one week or one month. It is an alternative to daily sublingual buprenorphine (Suboxone) for people with opioid use disorder, and one of the medicines used in opioid dependence treatment (ODT), also called opioid substitution therapy (OST).

Two formulations are available in Australia:

• Buvidal® (Camurus): available as a weekly (8 mg, 16 mg, 24 mg, 32 mg) or monthly (64 mg, 96 mg, 128 mg, 160 mg) injection, given under the skin of the abdomen, thigh, upper arm, or buttock.
• Sublocade® (Indivior): available as a monthly injection (100 mg or 300 mg), given only into the abdomen.

Why consider injectable buprenorphine?

LAI-B may particularly suit people who:

• Find daily sublingual dosing difficult to maintain
• Have concerns about keeping medication secure at home (e.g. with children, or in shared accommodation)
• Work irregular hours or travel frequently
• Want more privacy and fewer visits to the pharmacy
• Are stabilised on sublingual buprenorphine and ready for a simpler routine

Buvidal® vs Sublocade®: a comparison

Your doctor will help determine which formulation is most suitable for your circumstances.

How is the injection given?

The injection is given by a health professional trained to give it: a doctor, nurse practitioner, nurse or pharmacist. It is a small injection beneath the skin, not into a vein or muscle. A small lump (depot) may form at the injection site, which is expected and will gradually dissolve.

Injection sites are rotated to avoid skin reactions. The injection typically takes only a minute or two.

Starting injectable buprenorphine

To start Buvidal weekly, you will generally need to be in mild-to-moderate withdrawal from your current opioid (similar to starting sublingual buprenorphine). Some people transition directly from sublingual buprenorphine; your doctor will advise on timing and whether a transition dose is needed.

Sublocade is usually started after a period of stabilisation on sublingual buprenorphine.

Common side effects

• Injection site reactions: redness, itching, mild pain, or a lump under the skin. These are usually mild and resolve within days to weeks.
• Constipation: a common opioid-related effect; increase fluid and dietary fibre intake.
• Headache, nausea, sweating: often settle as your body adjusts.
• Sleep disturbance: may occur, especially early on.
• Fatigue or drowsiness: typically reduces after the first few weeks.

Important safety information

• Overdose risk from other opioids: Even with LAI-B on board, taking additional opioids can cause overdose. If someone overdoses, call 000 immediately and give naloxone (Nyxoid®) if available. Keep naloxone at home and show the people you live with how to use it; it is free in Victoria through the Take-Home Naloxone Program. Note: the depot formulation makes it harder to reverse buprenorphine itself with naloxone, but it still protects against other opioids.
• Driving: Avoid driving until you know how this medication affects you.
• Pregnancy: Discuss with your doctor immediately. LAI-B in pregnancy requires specialist guidance, though buprenorphine treatment is often continued and monitored.
• Do not attempt to cut or remove the depot under the skin. If you have concerns about the injection site, contact your doctor.

Where can I get the injection?

Injections can be arranged through your prescribing doctor's rooms or a participating community pharmacist. A list of pharmacies offering long-acting injectable buprenorphine in Victoria is available through the RACGP. Your doctor's rooms can assist with referral to a convenient location.

Missed injections and cost

• Missed injection: have the next injection as soon as you can; contact your doctor's rooms to arrange it. If too long passes (more than two weeks between weekly Buvidal® injections, or more than eight weeks between monthly injections), you may need to restart treatment.
• Cost: under the PBS you pay the usual PBS co-payment. If a pharmacy delivers your injection to your doctor's clinic, it may charge you the cost of delivery, but no more.

How long do I need treatment?

There is no fixed duration. Many people benefit from extended treatment, and the evidence strongly supports that staying on treatment reduces overdose risk and improves quality of life. Decisions about stopping or reducing should always be made with your doctor.

Questions?

Please raise any questions at your next appointment or call the rooms on 03 9834 3600. For urgent concerns or emergencies, call 000 or attend your nearest hospital emergency department.

For a problem with your pharmacy or prescriber that you cannot sort out together, PAMS (Pharmacotherapy Advocacy, Mediation and Support, run by Harm Reduction Victoria) is a free, confidential phone service on 1800 443 844. For alcohol and drug counselling or referral at any hour, call DirectLine on 1800 888 236 (24 hours, free and confidential).

Clinical content informed by: the Australian Government Department of Health, National Guidelines for Medication-Assisted Treatment of Opioid Dependence (2014); the Victorian Department of Health, Victorian Opioid Dependence Treatment Guidelines (2026) and Sublocade® discontinuation (2026); and the TGA approved product information for Buvidal® (Camurus) and Sublocade® (Indivior). These sources are publicly available at health.gov.au, health.vic.gov.au and tga.gov.au.