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Subutex vs Suboxone: What’s the difference?

July 29, 2022

Table of Contents

Both Subutex and Suboxone are medications approved by the Food and Drug Administration (FDA) for treating opioid use disorders (OUD). Scientific research and patient feedback have shown Subutex and Suboxone to be equally effective in decreasing opioid cravings and overcoming withdrawal symptoms.

The main difference between Subutex and Suboxone is that Subutex contains only buprenorphine whereas Suboxone is the combination of buprenorphine with naloxone.

What's the Difference Between Subutex and Suboxone?

Subutex is primarily prescribed to patients who are pregnant, have severe liver disease, or have a documented naloxone allergy. Most other patients are prescribed Suboxone due to its reduced potential for misuse. 

Contrary to popular belief, Suboxone is also safe for pregnant patients. However, consult with a healthcare provider to determine whether Subutex or Suboxone will work best for you.

Subutex Strips

Subutex is the commonly known brand name for buprenorphine-monotherapy, meaning it only contains buprenorphine as its main ingredient. 

Buprenorphine acts as a partial opioid in the brain. It sits on the opioid receptors, thereby reducing cravings and preventing withdrawal symptoms. Since buprenorphine is a partial opioid, it has a ceiling effect. This means that there is no additional opioid effect after a certain dose, which ultimately decreases the risk of overdose

Suboxone is also a brand-name medication commonly prescribed to patients with OUD. As opposed to Subutex, Suboxone contains a combination of buprenorphine and naloxone.

Also known as Narcan, naloxone is an opioid antagonist that blocks opioids in the brain. The combination of buprenorphine with naloxone discourages misuse of the medication. Naloxone is not activated when taken sublingually or orally, but if Suboxone is injected or inhaled, the naloxone component precipitates an uncomfortable opioid withdrawal response.

Subutex vs. Suboxone Formulations

Subutex is available as a tablet in doses of 2 mg and 8 mg. 

Suboxone exists as a tablet and a film formulation (strips), both of which are equally effective and are available in 4 mg, 8 mg, and 12 mg dosage forms.

How to Take Subutex?

Subutex treatment for OUD is administered by placing films or tablets beneath the tongue. This process can take up to 15 minutes, during which patients are advised not to eat or drink.

Patients should not cut, chew, or swallow Subutex

How Long Does Subutex Block Opiates?

Subutex blocks opioid receptors in the brain for approximately 31 to 35 hours after sublingual administration. 

How to Transition from Subutex to Suboxone?

Switching any medication or altering its dosage without consulting a healthcare provider can lead to undesirable side effects. The transition from Subutex to Suboxone should be discussed and mapped out in detail with your provider, and this transition is safe and can be beneficial long term.

Learn About Bicycle Health Opioid Use Disorder Treatments

Learn more about the different options for treatment and how Bicycle Health can help you find the right solution for you. We have created a dozen articles where we cover all stages of the treatment process. Call us today or find a time to speak with one of our team members to hear more about just how effective our treatments are.

Subutex image by ZngZng under a Creative Commons Attribution 2.0 Generic license.

Bicycle Health provides Suboxone therapy for opioid use disorder. Bicycle offers educational resources on Belbuca, Subutex and Sublocade, but does not currently offer those therapies.

Rebekah L. Rollston, MD, MPH

Rebekah L. Rollston, MD, MPH, is a board-certified Family Medicine Physician and Head of Research at Bicycle Health. She earned her Medical Degree from East Tennessee State University Quillen College of Medicine (in the Rural Primary Care Track) and her Master of Public Health (MPH) from The George Washington University Milken Institute School of Public Health. Dr. Rollston completed her residency at Tufts University and Cambridge Health Alliance, a Harvard-affiliated community healthcare system in Greater Boston, with emphases in addiction medicine and sexual & reproductive health. Her professional interests focus on social determinants of health & health equity, addiction medicine, gender-based violence, sexual & reproductive health, rural health, homelessness & supportive housing, and immigrant health. Dr. Rollston has published on these topics in The Lancet, Journal of Health Care for the Poor and Underserved, American Journal of Health Promotion, Journal of Appalachian Health, and Medical Care.

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