Suboxone and other buprenorphine treatments
How does Suboxone treatment work?
What is buprenorphine and how does it work?
What is Suboxone?
Suboxone = Buprenorphine + Naloxone
Suboxone was the first opioid replacement therapy to be approved by the FDA since Methadone. Suboxone is a combination of Buprenorphine and Naloxone. Suboxone comes in film form (similar to Listerine strips) and is taken sub-lingually, or underneath the tongue.
There are other oral Buprenorphine based products. Many patients have strong opinions about what formulation they prefer. A brief description of each is listed below:
- Zubsolv contains both buprenorphine and naloxone. It comes in tablet form and is designed to dissolve under the tongue (sublingually). Zubsolv has a higher "bio-availability" than Suboxone, so the dosing is slightly different. For example, an 8mg Suboxone strip is equivalent to a 5.6mg Zubsolv tablet.
- Bunavail is also a combination of buprenorphine and naloxone, but it is administered in film form and dissolves in the cheek.
- Subutex (Buprenorphine only tablets) is administered in the same way as Zubsolv, via sublingual tablets. Subutex is generally prescribed for pregnant and breast feeding patients. Subutex, because it does not include Naloxone, can be abused.
- Generic "Suboxone" tablets are also available. Those are administered sublingually, similar to Zubsolv, but are dosed at the same level as Suboxone.
- Probuphine is a recently approved formulation of Buprenorphine that is implanted in the arm. Probuphine is indicated for the maintenance treatment of opioid dependence in patients who have achieved and sustained prolonged clinical stability on low-to-moderate doses of oral buprenorphine.
Vivitrol is a once month injection of Naltrexone which blocks opiate receptors in the brain. Unlike Suboxone, patients need to be completely free of any opioids in their system before starting treatment.
Indivior, the company that sells and markets Suboxone, received FDA approval in May 2016 to fast-track the development of a once-a-month injection of buprenorphine. As of now, there is no date for its introduction, but it appears that soon there will be a once-a-month injection that will be available for patients who have stabilized on their opioid medication assisted treatment.