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PostPosted: Sat Dec 17, 2016 12:40 pm 
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Hi all —

So I haven't posted here in a long time.

So my doctor that I had since I started the program in late 2012 decided to leave for a different clinic due to some political issues. We had such a close relationship and she was so great. She had no plans on weening me down unless I wanted to and I always enjoyed going to this clinic because I just felt secure with her. She told me she was leaving a couple months ago and since then I had been calling the clinic back every couple weeks to see how a replacement for her was coming while also using treatment match and the internet to find other doctors that would accept my insurance. My insurance actually only works with a couple state-wide clinics so I'm very restricted.

So I've always wanted to try Subutex for a few reasons. Before I went to rehab, I was in a detox center where they had me on Subutex first. I remember feeling a really big difference when I got taken to the rehab side and put on Suboxone. I felt headaches and nausea at that point. When I started seeing the doctor in 2012 who just left, I asked her if I could try Subutex but of course like most doctors she said she can only prescribe that to women who are pregnant and nursing.

My entire treatment with Suboxone has been marked by every 1 - 3 months going into episodes of nausea coupled with a MAJOR headache. I seriously have never felt worse in my life during these episodes. I feel so ill you just want to be dead. If I can't make myself throw up during these episodes, I have to stick my thumb down my throat as this is the only way to stop this sickness. While I'm dry heaving, I feel like I'm tasting either naloxone or it could be stomache acid? Sticking your thumb down your throat can be dangerous and dealing with these episodes every 1 - 3 months is the reason I thought that now that my original Suboxone doctor is gone, I might as well try to find a doctor willing to prescribe Subutex to males instead of going with my doctors replacement.

So I used treatment match and I did end up finding a private doctor only 20-minutes away who said he would be willing to give me Subutex and for 3 years I was taking 16mgs of Suboxone which was elevated to 24mgs this summer. So during my first appointment, I asked the doctor if he would then have me on the equivalent of 24mgs of Suboxone if he were to prescribe Subutex and he said yes.

So a couple nights ago he wrote me a prescription for Subutex and I successfully had it filled at Walgreens. They had 90 tablets in stock. Here is the kind I got filled. The Activas brand which are orange with a moon on one side and 153 on the other. I want to make sure if I'm going to stick with Subutex, that I'm going to take the best formulation with the best absorption.

So when I got home I tried them out for the first time and they taste really bitter. Like more bitter then Suboxone films and the tablets. So what is everyones experience with these? It's kind of confusing what brands are available right now. From my understanding, the Roxane brand is to longer made?

Also, another question, does "Subutex" the brand name no longer exist? Do we just refer to the buprenorphine-only formulation as Subutex to avoid confusion? I read that Subutex was discontinued in 2011 but my doctor said there is still a drug called Subutex available. So what I'm asking, is there any drug on the market marketed or named as Subutex or is it just Buprenorphine now? Here is a picture from drugs.com of what is called "Subutex" https://www.drugs.com/imprints/b8-logo-10809.html is this what was disconintued?

So available on the market right now for 8mg "Subutex" aka Buprenorphine from my understanding are:

-Actavis Pharma, Inc. (Orange oval-shaped, moon on one side, 153 on the other)
https://www.drugs.com/imprints/logo-act ... 22875.html

-Ethypharm S.A. (White, round, arrow on one side, 8 on the other)
https://www.drugs.com/imprints/8-arrow-logo-16575.html

-Teva Pharmaceuticals USA (white, oval, b on one side, 799 on the other)
https://www.drugs.com/imprints/b-799-15937.html

-Mylan Pharmaceuticals Inc. (White, round, M 924 on one side)
https://www.drugs.com/imprints/m-924-22775.html

What else is there? I can't find any information or pics of a "hi-tech" brand that everyone was talking about?

So the reason I ask is because I have only seen this doctor who is prescribing me the Subutex once and after weeks of calling my old clinic to see if I can still get in, they couldn't even tell me if it was a for sure thing that the replacement would be able to see me. However, they called back after I started seeing this doctor and said they were ready to get me in. So I still have an appointment to see this doctor later in the month. I just want to go to it to get a "feel" for what this doctor is like and how long he will keep me on. I have no plans on getting off but last appointment with this new doctor, he said he would want to talk about weening me down in 6 months. I don't want to lose my spot at my old clinic if the new doctor at my clinic is okay with me staying on as long as I want. So if it turns out, I don't even like Subutex better and he has no idea for when to ween me down, maybe it would be best to go to my old clinic. I want to figure out what brands of Subutex works best for me before I make that decision. My insurance also works at my old clinic and this doctor I just saw is private so he doesn't accept insurance.

So mainly my question is what generic or brand of Subutex you think is the best so I can have Walgreens order it for me. I was talking with the pharmacist and she said the only other kind they had in stock, I think she said the name brand would have been like $1,400 for 90 pills. I don't think my insurance would cover that. Which formulation of Subutex would she have been referring to?

So what kind of Subutex do you take? Which one has worked the best for you?

Sorry this post is all cluttered. I had a lot to explain.


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PostPosted: Sat Dec 17, 2016 6:08 pm 
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I'm going to tell you what most doctors will think in response to your question, and to your approach to medication. You are anonymous, so I don't know you, nor does anyone else here-- so I'm not trying to start an argument. You should know what your doctor will likely say in response to these issues, if you bring them at your appointment.

I do not believe that Indivior (the company spun-off from Reckitt Benckiser that makes Suboxone) makes Subutex anymore. My understanding was that they stopped around the same time they came out with Suboxone Film, replacing the tablets.

Pharmacies in my part of the country will not order specific generic manufacturer's products. Maybe it is different in youra area-- but around here (Wisconsin) they decided on the manufacturer and then stock that product, changing every now and then based on prices.

From a physician standpoint, the goal is to have the patient pay less and less attention to the medication itself, and instead focus on living life free from substances. I worry sometimes that my own comments about dosing efficiency tilt people in the wrong direction, toward focusing on how they feel (or how they think they feel). If you are tapering or close to tapering, too much awareness on the type of medication, how you 'feel' on the medication, etc will work against you. Ideally a person starts to think of the medication as something that won't make him/her feel any different; they just take it withoutany focus on those details.

So... your doc might not react positively to your concerns. I'm just talking about averages, so maybe yours is different. At 24 mg you likely have much more buprenorphine in your system than you need in order to feel stable.

Finally, the 'hi-tech' manufacturer that you mentioned puts out a form of buprenorphine that people tend to complain about, saying that it feels too small and too weak to get people to a stable place.


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PostPosted: Thu Dec 22, 2016 4:15 pm 
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Thanks for your reply doctor.

I'm just grateful to no longer have to take Naloxone. After a few days, I have gotten used to the Subutex and I am okay with the taste so I don't think I will try to get some other generic.

Also, do you think the Naloxone was the reason for my pervasive horrendous vomit episodes with major head ache?


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PostPosted: Tue Jan 24, 2017 6:16 pm 
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I take the Hi Tech generic of subutex and didn't experience any changes, positive or negative. I was put on it when my insurance denied the suboxone films and had hoped some of the weird symptoms I had been experiencing would go away but no dice. On the flip side, I didn't feel any difference in strength so I'm happy to have the cost savings.


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