Buprenorphine w/out naloxone

Questions I've received about buprenorphine, Suboxone, Zubsolv, and addiction treatments... and my answers.
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AmeliaB
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Buprenorphine w/out naloxone

Post by AmeliaB »

So I’ve been on 8-2 buprenorphine naloxone for a year now and I just picked my Rx up for the month and it looked different and I read the label and it’s just straight buprenorphine. Any idea why my dr would do that? What’s the difference?
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rule62
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Re: Buprenorphine w/out naloxone

Post by rule62 »

That is actually surprising he did that. I've been trying to get my doctor to give me the straight generic buprenorphine for years but he refuses. The small amount of naloxone does nothing and won't hurt you. Most all doctors were told to prescribe the Suboxone because of the naloxone in it. The company claims that addicts won't shoot it up because the naloxone will make them sick. Wrong! Several members here have claimed to have injected it without any ill effects, so it does no good. The companies should either make it with more naloxone or take it out completely. It does no good the way it is.

My brother is prescribed the generic bupe and I'll ask my doctor once again if he'll give it to me. There really isn't any difference in the effects of buprenorphine in the body so have no worries. You are a fortunate one getting it w/o asking. If all I can get is Suboxone then that's fine.

Welcome to the forum. Not many members here anymore but feel free to post all you want.
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docm2
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Re: Buprenorphine w/out naloxone

Post by docm2 »

Any idea why my dr would do that? What’s the difference?

2nd question first: If taken properly no difference, except for some rare side effects from the Naloxone.

Unless you asked I suspect it was a oversight due to the electronic medical record. There are several steps to ordering medications but early in the process I type in Buprenorphine to the order selection and I will get 12+ options. Buprenorphine 8 mg is right above Buprenorphine/Naloxone 8/2 Films, which is right above Buprenorphine/Naloxone 8/2 tabs which is right above Suboxone 8/2 films. Total up all the dosages, name vs generic and I think there is 40 choices. Add in my 2 injections for Sublocade and there are a lot of options.

Normally, I wouldn't change dosage forms unless we have had a conversation. If you were on the films I would not intentionally change you to tabs unless we had the discussion it still goes under the tongue, 15 minutes, no swallowing, yada, yada yada.
I have met people prescribed 4 tabs a day, they take them like aspirin and get referred because they have ultra rapid metabolism. Their eyes light up when I have walk them through a detailed step by step, give them a 2 or 8 mg tab right there in the office and watch them. Withdrawals go away and they often get by with 16 mg a day now (or less).

Unlikely it was changed due to insurance. Ironically, insurance still insists on combo, and sometimes even name brand Suboxone. Funny, we could save them 2-3 thousand dollars a year using plain bup. I don't think anything neferious has occurred.

As Rule said: Welcome to the forum.
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