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 Post subject: Bunavail and Pregnancy
PostPosted: Wed Jan 20, 2016 11:48 am 
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Hey guys,

I am aware this is a suboxone forum but I cant seem to find anything on Bunavail users and pregnancy. I have read that Subutex and suboxone don't pass the placenta wall therefore making it better for baby, but nothing regarding Bunavail. I am a Bunavail user, and then fell pregnant 24 weeks ago, in the time that I found out I was pregnant to now I have cut my dose from 2-4.2 mg films to 2-.525 mg doses spread out 8-10 hours apart. My main concern is the possibility for NAS when my baby is born in May, and the fear that I wont be able to breastfeed successfully due to Bunavail. I have been aiming to be completely off of it by April, but I don't know if I can..or if I should. My main question is, has anyone else who is taking Bunavail become pregnant? And how did your pregnancy turn out? Did your baby experience signs of withdrawal? Were you able to successfully breastfeed? Did everything turn out okay in the end? Ive asked my Dr, and she seems clueless..I rather get advice from people who have been thru it than my OB.
Thank you for your time :)


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PostPosted: Wed Jan 20, 2016 12:01 pm 
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Hi, I'm not sure what Bunavail is, but I know with subutex that it is safer than suboxone for babies while pregnant. I was on subutex and jus had my baby, 12 weeks ago. He was fine at birth. I had to have a c section, not due to the subutex or anything, but because he was breech.

Now my Dr's that handle my subutex warned me and made me so scared that #1 I was gonna possibly lose my baby to the state because of my subutex usage and #2 possibly because of the withdrawal, and then speaking of the withdrawal, they told me that he would have to stay in the hospital for a week to 2 depending on how he was. Etc etc. But my obgyn and I agreed that we would wait and see how he was when he was born and thn determine what care he needed. Thank God, he didn't need ANY withdrawal medication! He tapered off basically through me breastfeeding him. They don't get nearly the same amount through breastfeeding as they do while they are in the womb. Now every baby is different. Just because my son didn't need any help with withdrawals or medication, doesn't mean another mom's son won't. We only stayed one extra day just so they could watch him. He is now 12 weeks old and still perfect.

Now like I said in the beginning I'm not sure what Bunavail is, but if it anything like the subutex, then my advice to you is, continue to taper down as much as you can, but do not quit, because more times than most, that can be harmful to the baby than staying on the medication & having it regulated. I tapered down on the subutex, especially closer to birth, and was only doing a 1/4 of an 8mg subutex 2x daily, so a half. I'm not sure if that had any baring on how he was born or not. And then after he was born, everyone told I had to stay at the same dosage every day while breastfeeding. I couldn't take a 1/4 one day and a whole 8mg the next. Because like I said, they don't get nearly as much as when we are pregnant, so it's very important to stick with the same dosage.

And thank God, the state, children services, never got involved, probably because I was on them legally and had a Dr. I don't know what would have happened if I had stayed getting them illegally and didn't get into a subutex dr. And I sure as heck don't ever want to find out!

Goodluck to you & your baby! ♡


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PostPosted: Wed Jan 20, 2016 12:34 pm 
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Thank you for sharing your story.

Bunavail is said to be stronger due to the bioavailability and how it dissolves, so 8 mg sub is said to be the same as 4.2 Bunavail film. Not much is on the internet about Bunavail because it was just released last year while subs have been around for awhile. Im happy you didn't have any complications with your son's birth! I am desperately hopeful for a smooth birth. Ive taken my dose down to as low as I can go without feeling too much withdrawal symptoms. The yawning and watery eyes are the main ones I experience.

I need some advice from a Bunavail user because even though Bupe is the main ingredient, I think they all have different chemical makeups.


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PostPosted: Wed Jan 20, 2016 12:44 pm 
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I apologize. But I did look on Google for info for you which I'm sure you have as well. And the only thing I found (like you said info is very limited) was on drugs.com and maybe you have already read it, but if you scroll allllllll the way down to the pregnancy part, is does give some info. But if you're anything like me, you want someone who has had an actual real life experience with it.

I wish you the best and I will be praying for you and your baby for a safe and healthy delivery!

If you are interested here is the link I read.
http://www.drugs.com/pro/bunavail-buccal-film.html


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PostPosted: Thu Jan 21, 2016 1:31 am 
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Bunavail is equivalent to Suboxone, just different bio availabilities. Some women have delivered while on Suboxone and did fine. The preference is to be on plain buprenorphine (subutex) but probably splitting hairs. Given a choice I would much rather have my spouse, daughter etc taking Bunavail, Suboxone or other product than heroin or other opiate.
My colleague for years kept his patients on Suboxone and they did well.


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PostPosted: Fri Jan 22, 2016 9:44 pm 
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As docm2 said, Bunavail is the same drug. All of the 'premium' products--- i.e. Suboxone film, Zubsolv, and Bunavail--- have the same ratio of buprenorphine to naloxone (or are at least very close). They are all designed to deliver the same amount of buprenorphine into the bloodstream. Suboxone film's basic dose is 8 mg, and 25% of bupe is absorbed-- i.e. 2 mg of buprenorphine. With Zubsolv, about a third of the basic, 5.7 mg dose is absorbed-- i.e. about 2 mg. And with Bunavail, about 50% of the basic, 4.3 mg dose is absorbed-- again, about 2 mg.

In the case of all three medications, naloxone is NOT absorbed in any significant way as long as the drug is not injected.

So at least according to the science, each basic dose provides the same amount, of the same medication.

This gets a bit complicated.... but the amount of buprenorphine that ends up swallowed is greater in the case of Suboxone. Only 25% is absorbed in the mouth-- so the other 75%-- 6 mg-- is swallowed. That swallowed buprenorphine ends up being converted to a metabolite, norbuprenorphine, that causes constipation but does NOT cross into the brain. With Bunavail, only 50% of the drug ends up being swallowed and converted to norbuprenorphine. So with Suboxone Film, you get 6 mg of norbuprenorphine, and with Bunavail, you get 2 mg of norbuprenorphine... which is why Bunavail causes less constipation than Suboxone Film.

The fetus is exposed to the same level of buprenorphine with each medication. With Bunavail, there is less norbuprenorphine in the bloodstream. But norbuprenorphine doesn't cross the placenta, so it has little or no impact on the fetus, or on the incidence of neonatal withdrawal.

The short answer? They are all the same. Likewise generic 'Suboxone'-- the tabs that combine bupe and naloxone-- are exactly the same. And generic, plain buprenorphine? Also the same. They are all just buprenorphine-- and they all do the exact same thing, with the exact same side effects for both mommy and baby.


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PostPosted: Fri Jan 29, 2016 6:42 pm 
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Thank you for your informative reply.

Ive now dropped my dose to .5 mg a day. Do you have knowledge of the potential side effects that my baby may experience if any at all if I continue this dose small of a dose until delivery? I REALLY do not want my baby girl to experience NAS. I will do whatever it takes to prevent her from suffering. You stated all bupe medication is the same then why do most people say Subutex is better for pregnant women? I thought the chemical make up was different. Can you clarify?


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PostPosted: Tue Feb 02, 2016 8:28 am 
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After reading other responses, in differ threads I now completely understand that nalaxone is the ONLY reason that a pregnant woman would be switched to Subutex. But there is no proof that Nalaxone harms the fetus in utero but they just try to get the mom on just bupe. This didn't make sense at first because Nalaxone prevents over dose so I thought that this would be better than no nalaxone at all.

I am doing great on 1-.525 peice so I am going to stay at this dose until my body lets me go without taking anything at all. Im going to stop being so worrisome because that in itself can't be good for my little one.


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PostPosted: Tue Feb 02, 2016 1:48 pm 
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That is a common misunderstanding, that naloxone prevents overdose... it doesn't. All of the ceiling, and overdose protection, comes from buprenorphine alone. The ONLY thing naloxone MIGHT do is cause about 15 minutes of unpleasantness IF the drug is injected. I say 'might' because there is some evidence out there that the amount of naloxone in Suboxone and other similar meds is not enough to block buprenorphine-- which binds much more tightly than naloxone.

But again, that whole argument, whether naloxone works or not, ONLY applies to when it is injected. During any other use of Suboxone, Bunavail, Zubsolv, or generic Suboxone, the naloxone offers NO protection against overdose--- the protection comes from the ceiling effect of buprenorphine.

Understand that overdose is almost impossible with buprenorphine, no matter how it is taken, or with or without naloxone present. There are about 34000 overdoses in the US annually in people who have zero bupe in their bloodstream; there are about 40 overdoses each year in the US where the person has traces of buprenorphine. IN almost ALL of those 40 cases, the person would have lived if MORE buprenorphine was present.

There have been literally a few deaths from buprenorphine over the past few years in adults, and literally a few more in small children. In all of the deaths in adults, the person who died 1. had a very low, or no, tolerance to opioids, AND 2. took a second respiratory depressant that the person was also not tolerant to. The example is the 15 y o girl who died in Wisconsin 7 years ago--- she was not a heavy drug user, and did not use opioids at all. She used clonazepam all day, then took half a Suboxone tab and died in her sleep. I know of only one other death in Wisconsin in the past 10 years, and it was similar-- a young man who didn't use opioids, who combined Suboxone with a large amount of alcohol.

As for NAS, 50% of babies born to moms on buprenorphine show signs of NAS. In studies, the dose of buprenorphine didn't make a difference in the incidence--- but i have to believe that the risk is lower in someone like you, taking such a low dose of buprenorphine.

All of the safety data I wrote above can be found, in case people don't believe me. Look up 'deaths from buprenorphine' and go to the government sites, because all overdoses must be reported. People don't die from buprenorphine. It just doesn't happen... yet there is so much concern about the drug. Crazy.


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PostPosted: Thu Feb 04, 2016 11:26 am 
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Thank you !!

I definitely dont inject anything whatsoever. I think that nalaxone is commonly said to prevent overdose because thats what they give you in emergency situations if someone has OD'd on opiates. But this only refers to injecting it? I definitely believe you though, Thanks again for your time!!!


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