The transition from Subutex to Suboxone is very easy. In most cases, you should feel no difference when transitioning from buprenorphine-monotherapy (Subutex) to buprenorphine/naloxone (Suboxone) or vice versa.
Subutex was approved by the FDA in 2002 for the treatment of opioid use disorder but was discontinued in 2011. However, generic forms of buprenorphine are still prescribed, and people often use the term Subutex to refer to any generic form of buprenorphine monotherapy. [1]
The Similarities Between Subutex and Suboxone
Subutex is a prescription medication for opioid use disorder (OUD) consisting of buprenorphine. Suboxone is a combination medication consisting of:
- Buprenorphine: A partial opioid agonist that helps prevent opioid withdrawal symptoms and cravings
- Naloxone: An opioid antagonist that remains inactive unless someone attempts to misuse Suboxone by injecting or snorting it. It sends the person into precipitated withdrawal, which can be very unpleasant.
If you are taking the medication as prescribed, however, buprenorphine-monotherapy (Subutex) and buprenorphine/naloxone (Suboxone) work exactly the same way, since buprenorphine is the only active ingredient for both.
So, if your medical provider transitions you from Subutex (just buprenorphine) to Suboxone (buprenorphine + non-absorbed naltrexone) or vice versa, they will simply replace one medication with another. As long as you are taking it as prescribed, your body should feel the same.
How to Switch from Subutex to Suboxone
The first thing you should do when switching from Subutex to Suboxone is consult your doctor. Both Subutex and Suboxone are prescription medications, so you must talk to a doctor to get them. Your doctor can determine the right dose for you and answer any questions about your treatment regimen.
Never switch medications without talking to a doctor or your addiction care team. It’s illegal to use these medications without a prescription, including buying them from dealers or using a friend’s drugs.
Determining the Right Dose
The Suboxone dose your doctor prescribes will likely be the same as the buprenorphine dose you were taking. One study examining the transition from buprenorphine to buprenorphine/naloxone revealed that over 90% of patients received the same dose when switching.[2]
However, the researchers concluded that when patients are transitioned from high buprenorphine doses to Suboxone, providers may need to make dose adjustments in the later phase of treatment in response to side effects. [2]
Do Subutex and Suboxone Have Different Side Effects?
The only difference between Subutex and Suboxone is the addition of naloxone in Suboxone. The naloxone, when taken orally, is not absorbed by the body and remains inactive. Therefore, the side effects of buprenorphine and buprenorphine/naloxone should be similar if not the same.
That said, sometimes people may feel side effects when switching from buprenorphine monotherapy to Suboxone. In one small study, about 50% of patients experienced adverse effects in the first 4 weeks after switching, such as: [2]
- Nausea
- Vomiting
- Stomach pain
- Indigestion
- Fatigue
- Headache
- Sweating
However, that percentage dropped to 26% during the 4-month follow-up period.[2] If you experience any Suboxone side effects when switching, make sure you let your doctor know—they may need to adjust your Suboxone dose. Be patient, it may take a while to find the perfect dose.
Additionally, very small amounts of naloxone might be absorbed when taking Suboxone. The side effects of naloxone are very minimal and rare, but occasionally allergic reactions do occur. If you have any intolerance to the naloxone in Suboxone, your doctor and you might consider switching from Suboxone to Subutex.
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
- Poliwoda S, Noor N, Jenkins JS, et al. Buprenorphine and its formulations: a comprehensive review. Health Psychol Res. 2022;10(3):37517. Published 2022 Aug 20. doi:10.52965/001c.37517
- Simojoki K, Vorma H, Alho H. A retrospective evaluation of patients switched from buprenorphine (Subutex) to the buprenorphine/naloxone combination (Suboxone). Subst Abuse Treat Prev Policy. 2008;3:16. Published 2008 Jun 17. doi:10.1186/1747-597X-3-16
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