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PostPosted: Tue May 02, 2017 7:56 pm 
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Recently I've been holding a light behind my subs and have noticed what looks like a bacteria growth on the film - which I assume is the medication. Sometimes it looks like there is more medication on one strip than another. I've had some strips that looked as if they hardly had anything on them at all... But I have not really noticed a difference in effect. I take one 8mg strip twice a day. More often than not the film seems to be consistent in the amount of what it's covered with. Rarely do I see one that is almost completely bare of this covering. Is this any indication of the amount of medication per strip? How is the amount of medication per strip regulated? Would anyone else like to comment on this? Thank you.


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PostPosted: Wed May 03, 2017 6:28 am 
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I used to buy fentanyll off vendors on the dark net markets in blotter form and the dose for the most part was the same every time. The technique is either done with a dropper on to the sheet of blotting paper or the entire sheet dipped in a liquid both techniques are open to some variance of dose but i was happy over quite a number of purchases and going by the feedback score of the vendor so were most of the other buyers.
I feel pretty confident that the people running the multinational pharma that gives us suboxone is pretty focused on extreme profits with the least possible public liability and if a bunch of student chemist come mafia can do fentanyl blotters well then the well heeled well protected can do it a whole lot weller.
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PostPosted: Wed May 03, 2017 8:17 pm 
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The citizen's petition and FDA response, back in about 2011, discussed problems with the production of tablets in blister-packes. My impression after reading those documents, that mentioned the production of the film, was that the the medication is not added to a 'blotter', but rather mixed in a substance tha tis extruded and dried, to make the film. If that's the case, and I don't have any inside knowledge beyond those reports, then the darker areas likely come from thicker portions of the film.

Over the years, patients have brought to my attention small changes in Suboxone film, ranging from the slit in the package--- which has been moved a bit further down on the package-- to the thickness of the strip, clearly becoming thinner over time. Patients often keep a couple extra doses hiddent away for an emergency, which is an understandable thing to do given that doctors occasionally just drop out of practice. But the differences are notable when strips from 2-3 years ago are compared to the current product.

I suspect that the total amount of buprenorphine per strip is constant, or varies by an inconsistent amount, because FDA approval demands consistency. But there are no FDA-approved uses for pieces of film, so it would not surprise me if some parts of a strip are a bit thicker than others.


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PostPosted: Thu May 04, 2017 7:29 am 
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Dr Junig mentioned the slit for ease of opening...I've often wandered about that allowing air into the foil sleeve... And eventually allowing it to lose it's potency over time.

Sometimes when the air is more humid, and you are handling a strip, the moisture from your hands will cause it to become 'sticky'...
I've had that happen and while trying to fold an 8mg strip into halves, wound up having it stick to itself...and after some frustration and a few choice adjectives, just eventually took the entire 8mg because trying to fold and tear it evenly was no longer an option.

I would think they could change the formula to be a menthol flavor, since menthol has an effect that feels ...I guess like a better option. Cough drops come to mind...menthol flavored can generally have your nasal passages clearing up within a couple of seconds...so obviously it causes some reaction in the mouth. Just wish that orange flavor wasn't the only option they have. Obviously for the addictive tendency, we don't want candy flavored meds with Suboxone, as people would begin to enjoy it way more than they already do, but we should have some small choices, like variation between orange and menthol, maybe even a mini-8mg strip that is half the size of what we get now ...

Most of what I would like to see is just petty...a few thoughts tho.

Anyone else got anything about the slit opening on the packs? Since it's not on a sealed section of the packaging, surely it could allow air in...?

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PostPosted: Thu May 04, 2017 6:11 pm 
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i just got switched to the 2mg strips. the dr. explained since i was only taking a 1/4 of a strip that it would be better to take a whole 2mg strip for a more consistent dose. it was my 1st visit to that dr. but i have heard mention of that here. yes, there may be 8mg per strip, but where is it on the strip?

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PostPosted: Thu May 04, 2017 8:39 pm 
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SSG: From reading, it appears the soluble films are manufactured as follows: each dosage in a suspension of buprenorphine hydrochloride in an aqueous solution of the excipients (polyethylene oxide, hydroxypropyl methylcellulose, maltitol, acesulfame potassium, lime flavor, citric acid, sodium citrate, FD&C yellow #6) and naloxone hydrochloride is evenly spray coated onto large wide polyester sheets then heat oven-dried. The resulting soluble film on the sheet is printed with white ink, marking the dose N2, N8 etc. then separated from the polyester sheet, cut into the required sizing and heat sealed within pouches.
The 2/0.5 and 8/2 soluble films are identical in size but the 8/2 soluble film is 25% heavier.
I also read Naloxone is prone to oxidative degradation. In the sublingual tablets, degradation has been minimised, however, the same stabilization approach is not possible for the soluble films and naloxone can degrade rapidly whereas naloxone is relatively stable in the sublingual tablet.

The weird medicine info Per FDA, is that a 12mg strip has higher bioavailability than one 8mg + (2) 2mg strips. Also, some films strengths had higher bioavailability over the same dose of suboxone tablet. systemic exposures of buprenorphine and naloxone may be different when patients are switched from tablets to strips or vice-versa and dosage adjustments may be necessary when switching between products.

Dr J: Imo, Indivior's claim that packaging Suboxone tablets in blister paks - was too difficult - was part of the ruse to stop tablets here in the US - bc blister paks are alive and well across the EU, likely bc the patent for Suboxone tablet is still valid there. As of today, the European Medicines Agency lists only one Suboxone product - the SL tablet manufactured in 7 or 28 tablet blister packs of 2mg, 8mg or 16mg. Indivior plans to expand Suboxone blister paks to China in 2018.

jonathan, IDK on air entering thru the slit but there is a 2015 experiment on patient's claiming they mistakenly washed/laundered their films and so needed more. It shows Suboxone, Bunavail in foil and Zubzolv in blister pack -- came out A OK.
https://www.ncbi.nlm.nih.gov/pubmed/25811238

Also, last summer docm2 asked 'We are under severe heat conditions (unusual for our area). Has anyone ever had their strips melt in the foil if left in a closed vehicle?'
I decided to check and my response: 'I placed a 5yr old well kept sealed 8mg suboxone film in foil on the dashboard of my car. 95 degree day, full sun, black car, facing west, 11am - 5pm -- 6 hrs, 162 degrees inside per gauge. I opened the metal foil and sub film looks fine. One side stuck a bit on the foil. When I picked it up, it was maybe a bit softer, not as stiff as I remember the room temperature ones to be but its been 5 yrs since I last took bup. NO melting at all. Fully usable SL film, imo'. I dissolved it under running water so have no idea of its effectiveness/potency.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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