What is Brixadi?

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Brixadi is a form of buprenorphine, the same medicine that's in Suboxone, that you get as a shot instead of taking a film or tablet every day. You can choose a shot once a week or once a month, and its effects last longer than the film or tablet. The weekly and monthly shots each come in several strengths, depending on what dosage of buprenorphine you are stable on.

You may be able to switch to Brixadi once you've been taking buprenorphine as a film or tablet for at least 7 days. Talk to a clinician for more information.

How it helps

Buprenorphine works on the same parts of the brain as opioids like fentanyl, heroin, pain pills, kratom, and 7-OH. It attaches more strongly than most other opioids and can partly block their effects. Brixadi can:

Ease cravings and help you use fewer non-prescribed opioids
Lower your risk of overdose
Help you reach and keep working toward your recovery goals
Free you from taking medicine every day, with one shot a week or a month, whichever you prefer

How to get Brixadi through Boulder

Bring it up with your clinician at your next visit. They'll:

Walk through your options and answer your questions
Make sure regularly scheduled visits work for you
Find the nearest pharmacy that gives Brixadi shots
Send a prescription for your first shot, usually along with a 1 to 2 week prescription of your current buprenorphine to help with the switch

How often you'll get a shot

Weekly: You can get your next shot as early as 5 days and as late as 9 days after your last one.
Monthly: You can get your next shot as early as 21 days and as late as 35 days after your last one.

Getting your shots on schedule keeps the buprenorphine in your body at a steady level that works well.

How long it takes to feel steady

Brixadi starts working right after your first shot. For some people, that's enough. For others, it can take several weeks or months of shots to feel stable.

While your levels settle, your clinician might prescribe some of your current buprenorphine for up to a couple of months, in case you have withdrawal symptoms or cravings. Everyone's needs are different, and you'll work with your clinician to make sure yours are met. If people need extra medicine during this time, it's usually toward the end of the week (for weekly shots) or the end of the month (for monthly shots).

If you miss a shot

If it's been less than 9 days since your last weekly shot, or less than 5 weeks since your last monthly shot, contact your pharmacy to reschedule.
If it's been longer than that, message Boulder in the app for next steps and follow up with your clinician. We're here to support you. You can also ask for a bridge prescription of buprenorphine films or tablets until your next visit.

If you decide to stop

The buprenorphine from Brixadi can stay at working levels in your body for about 1 month after weekly shots, or about 4 months after monthly shots, depending on your dose and how long you've been getting them. Any withdrawal symptoms usually show up later and are milder than with other opioids, including sublingual buprenorphine. Talk with your clinician to make a plan to stop safely and get support for any symptoms or cravings.

Common side effects

Pain, itching, or bruising where you got the shot. This is common, and bruising usually fades in a few days. Try not to scratch. An ice pack can help with pain or itching.
Trouble sleeping. Buprenorphine can affect sleep. Let your care team know if sleep problems last 4 weeks or more after starting Brixadi.
Upset stomach or constipation. Drink plenty of water. Buprenorphine often causes constipation, so a stool softener can help. Ask your clinician about a prescription if you need one. If it doesn't get better in 2 to 3 days, talk with your care team or pharmacist.
Headache. This usually gets better over time. Talk with your care team or pharmacist if it keeps bothering you.

When to reach out

Contact your care team if you're still having cravings, if side effects are bothering you, or if you have any questions about Brixadi or your opioid use. If you develop any signs of skin ulcer, open wound, drainage, or fever, you should go to the hospital for evaluation.