Medication Information:
Buprenorphine (generic) ~ Subutex (brand)
Buprenorphine/Naloxone (generic) ~ Suboxone (brand) Classification: Buprenorphine is a partial opioid agonist. Naloxone is
an opioid antagonist.
Common Usage: Subutex and Suboxone are indicated for the treatment of
opioid dependence. When taken as prescribed Subutex and Suboxone are
clinically interchangeable. Subutex is recommended to start treatment.
Suboxone, due to the presence of naloxone, is recommended for continuing
treatment, especially when dose administration is unsupervised. Naloxone
blocks the effects of opioids and is likely to cause intense withdrawal symptoms
if misused intravenously, but has no effect if administered as prescribed. CommonDosages: Both Subutex and Suboxone must be taken sublingually: the
tablets should be placed beneath the tongue until they are dissolved. The
administration of Subutex for starting treatment varies according to the type of
opioid dependence: long- or short-acting opioid, time since last use and level
of opioid dependence. The starting dose should be titrated to clinical
effectiveness as quickly as possible to prevent undue symptoms of opioid
withdrawal. See drug labeling for more information. The recommended dose of
Suboxone for continuation treatment of opioid dependence is 16 mg/day. The
dose is required to keep the patient in treatment and suppress withdrawal
symptoms may vary from 4 to 24 mg/day. CommonMajor Side Effects: Respiratory depression has been associated with the
use of buprenorphine and death has resulted from intravenous misuse of
buprenorphine by opioid-dependent individuals, especially with co-administration
with benzodiazepines. Buprenorphine produces
opioid dependence is characterized by withdrawal upon abrupt discontinuation or
rapid reduction of the dose. The most common side
effects associated with buprenorphine include: weakness, chills, headache,
infection, pain, abdominal pain, withdrawal syndrome, vasodilation,
constipation, nausea, insomnia, sweating, anxiety, depression and nervousness. This is not a complete
list of all known or potential adverse effects. Notify your prescriber or
pharmacist of any symptoms that have started since you began taking this
medication, changing its dose, or adding or changing other medication or diet.
Take care when performing any tasks (for example, driving or operating
machinery) that requires your attention until you have experience with this drug
and are confident you can perform the task safely. Interactions with Other Medications: Certain drugs may increase the
levels of buprenorphine in the blood. Thus, the dosage of buprenorphine
may need to be reduced if administered with azole antifungals such as
ketaconazole (Nizoral), macrolide antibiotics such as erythromycin (E-Mycin), or
HIV pretease inhibitors such as ritonavir (Norvir), indinavir (Crixivan) and
saquinavir (Invirase). There is potential for
interaction between buprenorphine and benzodiazepines, such as alprazolam
(Xanax), diazepam (Valium), clonazepam (Klonopin) and others. Caution
should be used when administering buprenorphine with any other medication which
depresses the central nervous system. This is not a
complete list of all known or potential drug interactions. To help prevent
avoidable problems, always make sure your pharmacist and all prescribers know
all of the medications you are taking. This includes over-the-counter
drugs and any dietary or herbal supplements or medications. Identification: Buprenorphine is available as Subutex in oval, white
tablets in strengths of 2 and 8 mg. Suboxone tablets are
hexagonal and orange. Suboxone is available in tablets with 2 mg
buprenorphine with 0.5 mg naloxone in tablets with 8 mg buprenorphine with 2 mg
naloxone. Storage: Store this medication at normal room temperature (59° F to 86°
F) in a tightly closed, light- and moisture-resistant container. If you
have difficulty opening child-resistant containers, your pharmacist can provide
a container that is easier to open. Keep the medication out of direct
sunlight and avoid storing it in a warm or humid area - such as the bathroom or
kitchen - to prevent deterioration. To prevent accidental poisoning, keep
all medications out of the reach of children. Do not take an expired
medication. Do not transfer medication from one container to another.
Carefully discard discontinued medication where children cannot find it. Edited by Lawrence H.
Price, M.D. ASERVICE OF…. Psychopharmacology Update
Note: These guidelines are for general information only.For more specific information, consult your physician orpharmacist. | 
