Suboxone vs. Subutex: What Is the Difference?

Suboxone contains two medicines, buprenorphine and naloxone. Subutex contained buprenorphine alone. The Subutex brand is discontinued in the United States, but generic buprenorphine-only tablets remain available, and many people still call them Subutex.

Both are used in medication treatment for opioid use disorder. If you are planning to take one of these medications, it helps to know how they differ.

What Is Subutex?

Subutex was the brand name for sublingual tablets that contain buprenorphine. The Food and Drug Administration approved it for the treatment of opioid dependence. FDA later determined that the brand was not withdrawn from sale for reasons of safety or effectiveness. FDA's determination

Buprenorphine is a partial opioid agonist. It binds to the body's opioid receptors and activates them less fully than drugs such as heroin, oxycodone or morphine.

Because of that, buprenorphine has a ceiling: beyond a certain point, a larger dose does not keep increasing its effects in the same way.

At the right dose, buprenorphine can reduce withdrawal symptoms and cravings. That, in turn, helps lower the risk of returning to opioid use. CDC: Treating opioid use disorder

How to Take Subutex

Buprenorphine tablets are placed under the tongue and left to dissolve. They are not swallowed.

Starting buprenorphine too soon after other opioids can cause precipitated withdrawal. Your clinician decides when you take the first dose, based on your symptoms and the opioids you have been using. A fixed waiting time does not suit every patient. FDA Suboxone prescribing information

After you stabilize, your clinician adjusts the dose. You then keep taking the medication and have regular check-ups.

What Is Suboxone?

Suboxone is another brand-name medication used to treat opioid use disorder. Like Subutex, it contains buprenorphine.

What is different is that Suboxone also contains naloxone.

Naloxone is an opioid antagonist. On its own, as a nasal spray or injection, it is used to reverse an opioid overdose. Most people know that product by the name Narcan.

In Suboxone, naloxone is added to discourage certain forms of misuse. When Suboxone is taken as directed, buprenorphine provides the main effect. The naloxone in Suboxone is not a substitute for rescue naloxone during an overdose. FDA Suboxone prescribing information

How to Take Suboxone

Suboxone film or tablets are placed in the mouth as directed and left to dissolve completely. Do not chew or swallow them.

After the medicine dissolves, gently rinse your mouth with water and swallow. Wait at least one hour before brushing your teeth. FDA: Dental care with buprenorphine

As with buprenorphine-only tablets, you will have regular check-ups. Some people take this medicine for years and others for a shorter time. There is no mandatory short course.

Subutex vs. Suboxone: The Differences

Now that you know what both medicines are, here are the things that make them different.

Misuse

The main difference is the naloxone. It is included in Suboxone to discourage injecting or snorting the medicine. It does not guarantee that the medicine cannot be misused.

Buprenorphine-only tablets do not contain that deterrent. Both products are opioids, both can cause physical dependence and both can be misused.

Neither product should be chosen because of a claim that one is always safer, stronger or less addictive. The choice depends on your treatment history, how you tolerate each medicine, pregnancy and other health factors, and it belongs to you and your clinician.

Access To Care

Suboxone can be prescribed online through a video visit with a licensed provider, which removes travel to a clinic for many patients. Whether a buprenorphine-only tablet is appropriate instead is a decision for your provider.

Can You Substitute Subutex and Suboxone?

Many people assume they can switch between the two because the medicines are similar. Be careful.

Always follow your prescriber's instructions. Do not change your dose, borrow someone else's tablets or film, or swap one product for the other on your own. A change in product may need attention to how the medicine is absorbed and taken.

If you want to switch from one medicine to the other, speak to your doctor. He or she can advise whether the change is right for you.

Similarities Between Subutex and Suboxone

Even though the products are different, they have a lot in common.

The Ceiling Effect

Both contain buprenorphine, so both have the ceiling described above. That ceiling lowers, but does not remove, the risk of slowed breathing. The risk rises when buprenorphine is combined with alcohol, benzodiazepines or other sedatives.

The Role

Both medicines have the same purpose. They can reduce opioid withdrawal and cravings and support ongoing treatment for opioid use disorder.

The Side Effects

The two medicines also have similar side effects, which are usually mild or moderate.

They include:

• Constipation
• Headache
• Tongue pain
• Back pain
• A numb mouth
• Sleeping problems
• Blurred vision
• Stomach pain

Keep naloxone available, and call 911 for slow or abnormal breathing or if someone cannot be woken. CDC: Responding to an overdose

Understand The Difference Between Suboxone vs. Subutex

Suboxone is buprenorphine with naloxone. Subutex was buprenorphine alone, and its generic is still prescribed. Which one fits is a clinical decision, and effective treatment that you can take consistently matters more than the brand.

Start Suboxone treatment online. You can see one of our Suboxone doctors online, by video. The first visit is $89. Follow-up visits are $50 weekly, $75 every two weeks or $89 monthly. Visits are cash pay, and medication is priced separately.