The Food and Drug Administration (FDA) has approved several different buprenorphine-based medications for opioid use disorder (MOUD). Suboxone is one of the most widely used options. Available as a sublingual film or tablet, Suboxone is popular because it contains naloxone. This keeps people from snorting or injecting it. Other approved forms include Bunavail, Cassipa, and Zubsolv. There are also FDA-approved extended-release brands that don’t contain naloxone. Sublocade and Brixadi are weekly or monthly injections.
The FDA is a government agency that reviews new medications to determine if they’re safe and effective. If the FDA approves a medication, it means that it helps people with a specific condition and the potential benefits outweigh the risks. The FDA continues to monitor data after approval. Individuals can report side effects, quality problems, use errors, and other issues directly.
In this blog post, we’ll talk about FDA-approved buprenorphine treatments that are available today.
What should I know about medications that contain buprenorphine?
Buprenorphine helps reduce cravings and withdrawal effects for people who have opioid use disorder (OUD). It’s also sometimes used to treat pain. It’s safe and effective for long periods. Many people choose to keep taking a maintenance dose. This allows them to avoid the tapering process and keeps them from using again.
Buprenorphine has some advantages compared to methadone, another commonly used MOUD. It has a ceiling effect, which means it doesn’t cause greater euphoria or respiratory depression at high doses. There’s a lower risk of death by overdose, and people who take opioids don’t feel intoxicated when they take it. To some degree, it blocks the effects of other opioids, which makes it harder to get “high” in general. It has fewer drug interactions than other opioids. It’s also generally considered safer for elderly people and those who have liver problems.
With any opioid, there’s always some risk of respiratory depression and other side effects. Combining opioids or taking them with certain medications can raise your risk of overdose. Buprenorphine is generally considered safer than other opioids, but that safety depends on individual factors. When you’re working closely with a provider, these risks are very low. Tell your prescriber about other medications you’re taking and past or current health conditions.
Buprenorphine-naloxone sublingual tablets and films
Suboxone was approved by the FDA in 2002. It’s available as a film or tablet, and it has all the same benefits as buprenorphine alone. Most prescribers prefer the combination of buprenorphine and naloxone. When snorted or injected, it can trigger sudden withdrawal symptoms. This discourages people from using it in excess. Taking other opioids while on Suboxone may also cause sudden, intense withdrawal symptoms or reduced effects.
With oral buprenorphine films and tablets, there is some risk of dental problems. It’s relatively rare. However, some people have experienced mouth sores, gum disease, tooth decay, and tooth loss. Only take your medication as directed, and follow instructions carefully. Take a sip of water and swish immediately after your strip or tablet dissolves. Wait until it’s fully dissolved before eating or drinking anything. Wait at least an hour before brushing your teeth.
Buprenorphine-naloxone is sold under different brand names, with varying delivery methods:
- Suboxone — Sublingual film or tablet
- Zubsolv — Tablets
- Bunavail — Buccal film
- Cassipa — Sublingual film with a higher dosage strength
Buprenorphine film without naloxone
Right now, there isn’t a daily buprenorphine-only medication under a major brand name that’s approved to treat OUD. However, there are generic versions available. These may be used off-label or in specific clinical scenarios such as pregnancy. There are also some extended-release medications that we’ll cover in the next section.
Without the naloxone, buprenorphine medications can be snorted or injected to achieve more of a “high.” Subutex, a buprenorphine tablet that was approved by the FDA in 2002, was discontinued for this reason. However, some people can’t take naloxone because of an allergy or other medical condition.
Some forms of buprenorphine are approved as pain treatments but can’t be prescribed for people with OUD. Belbuca and Buprenex are daily medications that are only approved to treat pain. It’s also available for pain treatment in a patch under the brand name Butrans.
Injectable buprenorphine
Extended-release injections make buprenorphine available to people who may not be a good fit for Suboxone. Besides those who have allergies, some people may experience unwanted side effects. These include nausea, headache, and anxiety. In these cases, Sublocade or Brixadi may be a better option. These are both injections that don’t contain naloxone. They were approved by the FDA for OUD treatment in 2017 and 2023, respectively. An implant called Probuphine was approved in 2016. It’s now discontinued because of restructuring at the manufacturer.
Before giving you an injection, your care provider should prescribe daily buprenorphine for at least a week. If you have an allergic reaction or side effects, you should avoid receiving an injection. Taking a smaller dose at first allows you to find out how you’ll react. If you have an allergy to naloxone, your prescriber will use their discretion to adjust your treatment.
Some people may prefer a longer-acting medication if they’re sensitive to the ups and downs of taking MOUD every day. For those who have achieved some stability in their recovery, weekly or monthly doses may be more convenient. Injections also don’t come with the same risk of dental problems as oral forms.
Which MOUD is right for you?
There are a few things to consider when weighing your options for MOUD. Your care provider should know about your medical history and other medications before making recommendations. Your insurance may also have some bearing on which medications are affordable. Your needs, your recovery goals, and your treatment experience are all important factors.
Different forms of buprenorphine come with unique sets of potential side effects. Daily forms can affect your energy level throughout the day. You may also notice some negative effects if you forget to take your medication.
Talk with your provider about the pros and cons of different delivery methods. They may give you some options to try out and guide you through the process of trying different medications to see what works best. Don’t take any MOUD without consulting a qualified prescriber. This helps ensure your safety and your success in recovery.
To summarize, keep the following considerations in mind when assessing different MOUD:
- Dosing frequency and delivery method
- Potential side effects
- Your experience and physical response
- Your medical history and health conditions
- Potential drug interactions
- Insurance coverage or cost
Get your buprenorphine prescription and support at Groups
MOUD and social support are both critical parts of the recovery process. Finding the right MOUD for you will help you feel your best mentally and physically. That way, you can fully engage with other aspects of treatment. Counseling and support groups help set you up for long-term success with your recovery goals, and working with care providers you trust can help ensure that you have the best experience.
Your provider can help you choose between the following MOUD and others, such as methadone. These contain buprenorphine-naloxone except for Subloxade and Brixadi, which don’t contain naloxone:
- Suboxone — Sublingual film or tablet
- Zubsolv — Tablets
- Bunavail — Buccal film
- Cassipa — Sublingual film with a higher dosage strength
- Sublocade — Injection
- Brixadi — Injection
At Groups, we help our members learn about their options so they can take part in their own treatment decisions. Our comprehensive treatment approach combines MOUD with counseling and support groups. We help you take care of your basic needs so you can start to envision the life you want and take steps toward making it a reality.
Are you looking for a treatment program right now? Contact us or Give our Recovery Support Specialists a call today. We provide treatment across the country—and we’re always expanding. See if we offer care in your state, either online or at one of our 130+ local offices. If Groups does not offer treatment in your area, you can locate other treatment options here.
