What is Subutex?
The Subutex brand was discontinued in 2011, but the word is used to describe buprenorphine-only medication, as opposed to Suboxone which also contains naloxone for a safeguard.
Both Subutex and Suboxone treat opioid addiction by keeping cravings and withdrawal symptoms manageable.
Subutex vs. Suboxone | Discontinued | Subutex Tablets | Subutex Side Effects | FAQ | Getting Subutex | Ask a Question
Subutex vs Suboxone
Both Subutex and Suboxone have the same active ingredient — buprenorphine. But, Suboxone has an additional medication called naloxone that isn’t found in Subutex.
Naloxone doesn’t impact the function of Suboxone unless it is abused. If Suboxone is taken in excess or injected, the Naloxone can send a person into withdrawal instead of giving off a high and protects against overdose death. Subutex doesn’t have this safeguard.
Suboxone is safer than Subutex (buprenorphine-only).
| Compare | Suboxone | Subutex |
| Ingredients | Buprenorphine + Naloxone | Buprenorphine |
| Includes Safeguard Against Abuse | Yes | No |
| Delivery | Sublingual film under tongue | Sublingual tablet under tongue or monthly injection |
| Brand Names | Suboxone, Zubsolv, generic | Subutex (discontinued), Sublocade (monthly injection), Belbuca, generic |
| Most Common Uses | Outpatient treatment / at-home prescription For opioid detox & ongoing maintenance | Inpatient treatment For opioid detox & maintenance usually only if pregnant or Naloxone allergies |
Subutex for Detox
Some addiction treatment providers prescribe Subutex (buprenorphine only) for the first days of opioid detox, then switch patients to Suboxone (buprenorphine + naloxone).
The idea is to reduce the risk of precipitated withdrawal by not including naloxone. However, both Subutex and Suboxone cause precipitated withdrawals when induction dosages are not timed correctly. Working with a doctor experienced in opioid detox is the best way to avoid precipitated withdrawals. Suboxone is the safer medication for outpatient use. ⓘ
Why Was Subutex Brand Discontinued?
Subutex was developed by the same manufacturer as Suboxone, now known as Indivior. Indivior cited safer alternatives as the reason for the discontinuation of Subutex in 2011.
Generic buprenorphine-only medications are still used in specific situations like inpatient settings or during pregnancy. But, Suboxone is safer and therefore a better option for most patients, especially for at-home use.
What Does Subutex Look Like?
Subutex brand tablets don’t exist anymore, but several manufacturers make buprenorphine-only tablets in 2mg and 8mg doses. These are probably what someone is referring to when they say “Subutex pill”.
Buprenorphine-Only Tablets
While they may look like pills, all are actually taken as tablets that dissolve under your tongue.
Subutex Side Effects
The medication in Subutex (buprenorphine) is well-tolerated.
The most common side effect reported by Symetria patients is constipation. Over-the-counter laxatives, fiber supplements or diet changes can help.
Less Common Side Effects of Subutex
- Drowsiness (shouldn't occur when stabilized on the right dose)
- Nausea / Vomiting
- Headache
- Sleep issues (including insomnia)
- Dental issues (including tooth decay and infections) ⓘ
Precipitated Withdrawal
Precipitated withdrawals are opioid withdrawal symptoms that hit patients suddenly after taking an anti-craving medication like Subutex too soon.
Symptoms of precipitated withdrawals can be severe and include diarrhea, headache, vomiting, anxiety, runny nose, body aches and chills.
If your initial dose of Subutex (buprenorphine) is taken at a clinic that’s experienced with opioid withdrawal, the risk of precipitated withdrawal is low and can be treated. Subutex should only be started when already in a state of withdrawal.
Subutex Abuse
Subutex (buprenorphine) has a ceiling effect that limits the euphoria and risk of overdose compared to full opioids like heroin or morphine. Patients with an opioid tolerance aren’t likely to feel “high” with Subutex and taking more Subutex does not give more euphoria.
That said, Subutex still carries a higher potential for abuse than Suboxone, which contains the Naloxone safeguard. And, to stop taking Subutex, a buprenorphine taper should be used instead of quitting cold turkey.
Subutex FAQs
Subutex (buprenorphine) partially activates opioid receptors in the brain.
Because buprenorphine satisfies these opioid receptors, they don’t send signals triggering withdrawal symptoms or cravings.
Only partially activating the opioid receptors makes buprenorphine safer than full opioids like heroin, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), etc. and prevents the same “high”.
Suboxone and Subutex contain the same active ingredient, so switching between the medications is simple. Most patients taking Subutex make the switch to Suboxone, whether it’s after a few days of detox or after pregnancy. There are not many situations where a doctor would agree to switch a patient from Suboxone to Subutex.
Subutex (buprenorphine) is used to treat Opioid Use Disorder but is not a first-choice medication.
Subutex is usually only used if a patient is:
- Pregnant
- Allergic to naloxone
Subutex (buprenorphine) is a safer medication than methadone, but methadone has more regulations around prescription and dispensing to help with safety issues. That means both medications are safe treatment options when taken as directed.
See also buprenorphine vs. methadone.
In response to COVID-19, restrictions were temporarily altered to allow online prescription of buprenorphine. (Though, states like Alabama have rolled back these measures).
However, there are limited situations where a doctor would prescribe Subutex — whether in person or online. Suboxone is the default medication choice because it is safer, which would be even more important in an online setting without having vitals or confirmed drug screen data.
Subutex Doctors Near Me
Subutex brand is no longer available, but buprenorphine-only medication is still used in specific circumstances. And, all patients can get relief from opioid withdrawal symptoms and stop cravings with buprenorphine-based medications.
Subutex Doctors Near Illinois & Texas
Illinois Buprenorphine Clinics
16 Comments
I haven’t used in two full days, but I am starting to have a full on withdrawal symptoms now. I have Subtext but I am scared to take it because before I have taken Suboxone to early, and it put me in withdrawal badly.
It is best to see a professional and have your withdrawal symptoms evaluated prior to starting buprenorphine (i.e. Subutex). Standard practice is to perform a Clinical Opioid Withdrawal Scale (COWS) assessment which scores the level of opioid withdrawal you are in. Using that score as a guideline, we can make a determination if it is too early or not to start buprenorphine treatment. The more distress you are in and the longer you have gone since last opioid use, the better the chances of avoiding precipitated withdrawals. For most people, 2 days is enough time unless the opioid you have a physical dependence on is a long-acting opioid like oxycodone or methadone. Short-acting opioids like hydrocodone or heroin usually need less time comparatively, but everybody is different.
So any doctor can now prescribe Subutex?
Yes, technically any MD or DO can prescribe it (no longer need a DEA-X license or buprenorphine waiver), but some physicians may not prescribe it because they don’t feel comfortable doing so or because it is outside of their specialty (i.e. Cardiology). It is best to have it prescribed by a medical provider with whom you will have ongoing routine medical follow-up for your opioid use disorder, such as a primary care provider, psychiatrist, or addiction medicine specialist.
Requirements to get subscribed subutex
A diagnosis of moderate or severe opioid use disorder is required. Your medical provider will be able to assess you for a diagnosis of opioid use disorder.
What if buprenorphine does not work
If buprenorphine doesn’t work in terms of either controlling your opioid cravings and reducing your illicit opioid use, then methadone is an alternative option. Methadone is usually stronger at managing cravings, and can be increased to higher therapeutic amounts, whereas increasing a Buprenorphine dose past 24mg daily rarely gives more benefit. A third option is extended release injectable Naltrexone (Vivitrol) which will block the euphoric effect of illicit opioids and can help deter people returning to illicit opioid use, but is not very helpful for opioid cravings.
Suboxone gives me a horrible migraine. I’m in bed for at least 4 hrs a day after taking it. Ive been dealing with it for about 3 years now. It’s getting really unbearable. Any advice on how to make suboxone work for me?
Headache is definitely a potential side effect of Suboxone. I would recommend you discuss it with your provider to develop some alternative options. Splitting/dividing the dose to be taken twice or even three times per day, instead of just once daily can help. If headaches still persist, then your provider may want to discuss a trial of decreasing the Suboxone dosage. Another option is switching from buprenoprhine-naloxone (Suboxone) to a buprenorphine-only formulation (no naloxone, aka buprenorphine mono), since the naloxone component can cause headaches for some patients.