Can You Take Suboxone While Pregnant?

You can take buprenorphine/naloxone (Suboxone) while pregnant. It’s safer to use this drug and other forms of Medication for Addiction Treatment (MAT) therapies than to keep misusing opioids.

Researchers once thought the naloxone in Suboxone would cross the placenta and harm the baby. However, over time and with further studies, researchers have demonstrated that Suboxone is safe during pregnancy. But if you’re concerned, your doctor can help you transition to another medication that doesn’t include naloxone.

How Safe Is Suboxone During Pregnancy?

Suboxone contains two ingredients: buprenorphine and naloxone. Both of these ingredients are safe to use during pregnancy.

In studies conducted by Stanford Medicine and Harvard, researchers found that women taking buprenorphine alone during pregnancy had healthy babies, and their outcomes were better than those seen in women using methadone.[2]

In studies of women taking Suboxone (with both buprenorphine and naloxone), researchers found that women using the drug during pregnancy had healthy babies and stayed away from illicit drugs.[3]

All of this research demonstrates how safe Suboxone is during pregnancy.

Suboxone Dosage During Pregnancy 

Your Suboxone dose may need to be increased or decreased during pregnancy, especially in the third trimester, due to the following factors:

• Increased fluid in the body
• Faster metabolism
• Being metabolized by the placenta and fetus
• More excretion through the kidneys

If you need your dose increased or decreased as you progress through your pregnancy, talk to your doctor, who can help.

Suboxone Side Effects in Babies

Researchers say Suboxone is safe during pregnancy. In comparative studies, babies exposed to Suboxone in utero didn’t experience complications like stillbirth or congenital abnormalities.[1]

But the buprenorphine in Suboxone is a partial opioid agonist, and it can cross the placenta from a mother to her baby. Sometimes, babies are born with neonatal abstinence syndrome (NAS). Symptoms include the following:

• Irritability
• Hyperactivity
• Abnormal sleep patterns
• High-pitched crying
• Tremors
• Vomiting
• Diarrhea
• Failure to gain weight

The relationship between Suboxone and NAS can be managed.
Depending on the severity of symptoms, babies may simply be treated supportively (without medications) or may require small doses of methadone to ease withdrawal symptoms.

Alternatives to Suboxone During Pregnancy 

While Suboxone is safe during pregnancy, some pregnant people switch to a different medication. Several options are available, and this comparison table can help you understand how they stack up.

What Is Methadone?

Methadone is one of the oldest MAT options approved by the U.S. Food and Drug Administration. As an opioid agonist, it latches to brain receptors and triggers chemical changes that ease withdrawal symptoms and drug cravings.

Methadone is safe to use during pregnancy, per the Substance Abuse and Mental Health Services Administration.[4] It’s stronger than buprenorphine, so it might be the best choice if your OUD symptoms are severe.

But it does have some drawbacks when compared to Suboxone. They include the following:

• Hassle: You must go to a methadone clinic for your daily dose of medication.
• Misuse potential: Methadone doesn’t contain an ingredient like naloxone to help if you take too much.
• Taste: Methadone is typically delivered in an incredibly sweet drink. Some individuals can’t stand these flavors during pregnancy.

What Is Buprenorphine?

Pure buprenorphine products (sometimes called generic Subutex) are also considered safe during pregnancy.[4] These medications are partial opioid agonists, so they’re not as strong as methadone.

But buprenorphine has a ceiling effect, so it stops increasing in potency after a certain dose. This feature could keep you from misusing your drug.

Taking Subutex vs. Suboxone during pregnancy can come with some drawbacks, including the following:

• Easier to misuse: Buprenorphine’s ceiling effect offers some overdose protection. But without the naloxone component, you could misuse your prescription medication. 
• Mode of intake: Most pure buprenorphine products are delivered as dissolving pills. You may not like the taste or the gritty aftertaste.

Breastfeeding While Taking Suboxone

It is safe to continue Suboxone during breastfeeding. The medication you take may not pass through your milk to your baby.

Only a small amount of the buprenorphine in your Suboxone passes into your breast milk. That drug isn’t readily absorbed in your baby’s digestive tract.[4] The tiny amount of the medication your child might ingest during each feeding isn’t enough to cause harm.

Similarly, researchers say naloxone in your Suboxone isn’t readily absorbed through the digestive tract.[5] If your baby takes in some of the medication while feeding, it’s very unlikely to cause harm.

Suboxone and breastfeeding are very compatible. But your doctor will monitor both you and your baby for sedation or other difficulties. If they’re spotted, your dose may be adjusted.

Frequently Asked Questions

We’ve compiled some of the most frequently asked questions about Suboxone and pregnancy.