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What is the transition from Subutex (Bup-Mono) to Suboxone (Bup/Nal) like?

You should feel no difference when transitioning from buprenorphine-monotherapy (Subutex) to buprenorphine/naloxone (Suboxone). 

Buprenorphine/naloxone (Suboxone) is a combination of the active ingredient “buprenorphine” which helps prevent opioid withdrawal, craving, and overdose AND the inactive ingredient “naloxone,” which is not absorbed by the body and is added to the formulation to ensure that Buprenorphine/naloxone (Suboxone) is not misused. For example, if Buprenorphine/naloxone (Suboxone) were injected (not taken as it is supposed to), the naloxone would become active (absorbed by the body) and could cause opioid withdrawal symptoms.

If you are taking the medication as prescribed, buprenorphine-monotherapy (Subutex) to buprenorphine/naloxone (Suboxone) work the exact same way since the same active ingredient (buprenorphine) is being absorbed by the body.

So, if your medical provider transitions you from Subutex (just buprenorphine) to Suboxone (buprenorphine + non-absorbed naltrexone), your provider will simply replace one medication with another. As long as you are taking it as prescribed, your body should feel the same.

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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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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