Belbuca is the brand name for buprenorphine delivered in a film format. Buprenorphine is one of the three medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD).
Belbuca films are designed for buccal (oral) administration. They dissolve when placed inside your cheek. When administered this way, Belbuca is effective for approximately 24 hours to prevent opioid withdrawal cravings. If it is being used as a pain medication, it may need to be dosed more frequently (twice or even three times a day).
Some Medication for Addiction Treatment (MAT) options, like Suboxone or Zubsolv, combine buprenorphine and naloxone.[3,4] In contrast, Belbuca is a buprenorphine monotherapy, which means it contains only buprenorphine.
What Is Belbuca Used For?
Belbuca is an evidence-based, safe, and effective medication for OUD, which can be used temporarily or as a long-term therapy.
Belbuca can help to do the following:
- Reduce cravings
- Mitigate withdrawal symptoms
- Minimize the chance of relapse
- Prevent overdose deaths
Buprenorphine, a partial opioid agonist, is a key Belbuca ingredient. A partial opioid agonist helps to reduce opioid cravings and withdrawal symptoms in individuals with OUD. It interacts with the same opioid receptors that full opioid agonists like oxycodone, heroin, fentanyl, and methadone activate.
Unlike a full agonist, buprenorphine does not fully activate the opioid receptors, providing enough opioid stimulation to prevent withdrawal but not enough to get “high” or cause respiratory depression to the same degree as full opioid agonists. 
It is, therefore, much harder to get “high” or experience euphoric effects with buprenorphine when taken as medically directed. It is also much harder to achieve a level of sedation that puts the individual at risk for respiratory suppression or overdose, making Suboxone much safer than other full opioid agonists.
Potential Belbuca Side Effects
Taking Belbuca properly, at the right dosage, and on time is important. Most potential side effects from Belbuca occur if the medication is not taken as directed.
The most common side effects are mild. They may include the following:
Again, when taken as medically directed, Belbuca is a safe and effective medication for treating opioid use disorder.
Things to Avoid While on Belbuca
While Belbuca is a safe medication, it’s powerful. You must respect your medication, and your body, and make good choices while you’re using it.
Take the following important precautions:
- Don’t mix: Belbuca may have side effects, particularly if taken with other sedative drugs or alcohol. Avoid taking Belbuca with other central nervous system depressants, such as benzodiazepines, as this can cause breathing problems and sedation.
- Don’t drive: Some people experience sedation on Belbuca, and it can make driving difficult. Until you know how your medications impact your attention levels, drive with caution. That being said, many individuals who take Belbuca are able to drive safely.
- Don’t misuse it: Take your doses as prescribed. Don’t take multiple amounts at once, take more than your doctor prescribed, or otherwise tamper with your treatment plan.
Where Can You Get Belbuca?
Belbuca is a prescription medication that can be prescribed to you by a treatment provider as part of an OUD treatment plan. The Drug Addiction Treatment Act of 2000 (DATA 2000) allows buprenorphine medications, including Belbuca, to be prescribed outside of an opioid treatment program.
Belbuca can be prescribed by a qualified physician and picked up from your local pharmacy. Often, Belbuca can be prescribed via telemedicine addiction treatment.
How Much Does Belbuca Cost?
Belbuca is a prescription medication eligible for insurance coverage, depending on your plan, carrier, and policy. Belbuca can be subject to a copay or deductible amount.
Belbuca typically costs around $400 out of pocket for a 60-day supply, which can be drastically reduced if you have insurance coverage or a pharmacy discount plan.
Belbuca also offers a Belbuca copay card that can provide you with significant savings and copay assistance. Savings are based on eligibility, but you may be able to get Belbuca for as low as $0 a month after activating your Belbuca copay card.
Talk to your provider about Belbuca and the potential payment options for this lifesaving OUD treatment medication.
How Belbuca Treatment Works
Your doctor should outline how to start taking your Belbuca when you first begin this treatment. Because everyone’s recovery is unique, your plan might look a little different than someone else’s. But most MAT programs are similar.
Belbuca treatment typically involves these steps:
- Abstinence: You will usually be counseled to avoid all opioids for 12 to 24 hours before starting Belbuca. The buprenorphine in your dose can render all opioids inactive, pushing you into withdrawal if you start too soon.
- Symptoms: Doctors look for moderate withdrawal symptoms (like sweating, shaking or nausea) as evidence that you’re ready for Belbuca. Your brain cells are adjusting, and you’re unlikely to experience severe withdrawal with your first dose.
- Induction: You take a small Belbuca dose as directed by your doctor and wait for withdrawal symptoms to fade. If they don’t, you use a little more. Your doctor guides this process and ensures you find a dose that doesn’t make you feel intoxicated but keeps your symptoms controlled.
- Maintenance: You use Belbuca on a schedule set by your doctor. You never miss a dose, and you work through counseling sessions, support group meetings, and other parts of your treatment plan.
- Assessment: Some people use MAT options like Belbuca indefinitely, as the medications keep symptoms in check and relapse risks low. Others consider quitting the drug. Regular conversations with your treatment team can help you make a smart choice.
- Taper: If you do choose to quit MAT, your doctor develops a schedule for a safe quit. Reducing your dose over time ensures you don’t experience severe withdrawal as you transition out of MAT.
- Substitution: Some people use another medication (such as naltrexone) to block opioids and prevent intoxication during a relapse. Your doctor can determine if this is the right approach for you.
Recovery takes time, and your program might look very different than the one we’ve outlined here. But these steps are common in MAT programs.
Alternatives to Belbuca
The FDA approved three types of medications to help people with OUD. Each one of these medications comes with different formulations (and names).
Your alternatives include medications containing these:
- Buprenorphine: Belbuca isn’t your only buprenorphine-based option. You could use combination medications (like Suboxone, which has buprenorphine and naloxone). You can also use Sublocade, a tablet version of buprenorphine.
- Methadone: One of the oldest OUD therapies available, methadone is delivered in special clinics, and it’s typically dosed every day.
- Naltrexone: Medications like ReVia and Vivitrol contain naltrexone, which blocks the euphoric action of opioid drugs and help some people to abstain from opioid use if they prefer NOT to use an opioid medication.
Your doctor can assess how severe your OUD is, your general health, and your preferences to determine which therapy is right for you.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Belbuca. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2019/207932Orig1s012ltr.pdf. 2019. Accessed February 2023.
- MAT Medications, Counseling, and Related Conditions. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions#medications-used-in-mat. November 2021. Accessed February 2023.
- Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. May 2021. Accessed February 2023.
- Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone. July 2021. Accessed February 2023.
- Clinical Pharmacology of Buprenorphine: Ceiling Effects at High Doses. Clinical Pharmacology and Therapeutics. https://pubmed.ncbi.nlm.nih.gov/8181201/. May 1994. Accessed February 2023.
- Statutes, Regulations, and Guidelines. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines#DATA-2000. December 2021. Accessed February 2023.
- Belbuca Savings and Copay Assistance. BioDelivery Sciences. https://www.belbuca.com/savings. 2022. Accessed February 2023.