Heather L. Roe, DO
What is the difference between Subutex and Suboxone?
Subutex and Suboxone are two similar medications that are commonly confused with each other. This article will give the description of both and why/when one would be used over the other.
What are they?
Subutex is the brand name of a buprenorphine tablet that does not contain naloxone. The brand Subutex has been discontinued, but the term is still used to describe generic buprenorphine pills.
Suboxone is the brand name of a film that contains both buprenorphine and naloxone. The name Suboxone is commonly used to describe any medication, whether brand name or generic, that contains this combination of medication. Generic buprenorphine/naloxone comes in both films and tablets.
How are they similar?
The active ingredient is the same in both medications. Buprenorphine is the generic name of the medication that is used for opioid dependence. An individual that is on Suboxone could switch to an equivalent dose of Subutex without meaningful change in the symptom control.
Both medications come in pill form. Only the buprenorphine + naloxone combination comes in a film.
Individuals would take the medication sublingually regardless of which formulation they are on. This is true for both the films and tablets. It’s a common misunderstanding that switching to the tablet form would allow people to swallow the medication like most other pills.
Neither medication has a very pleasant flavor. Although this can sometimes be undesirable for the patient, it is ideal to discourage children and pets from consuming in the unfortunate instance they have access to the medication.
How are they different?
Naloxone was added to buprenorphine as a deterrent to medication misuse. The doses of naloxone added to this product are not active when swallowed or taken sublingually. However, if the medication were to be injected into the bloodstream, the dose takes an opioid blocking effect and can cause precipitation of withdrawal symptoms. Physicians are encouraged to prescribe Suboxone (buprenorphine/naloxone) to most patients unless a contraindication exists.
What reasons would a patient need to be on Subutex instead of Suboxone?
Historically, the Subutex formulation has been used for pregnant women. This is no longer necessary as it has been used long enough that the naloxone appears to be safe during pregnancy.
The Subutex formulation is also commonly recommended for initial therapy when a patient is transitioning off methadone onto a buprenorphine product. This is generally only needed for the first few days of dosing and then the patient is switched to a Suboxone product.
The other indication for the buprenorphine monotherapy is in the rare instance of naloxone allergy.
As always, we encourage you to talk to your doctor about your specific situation to determine which is the best option for you.