What is Subutex and how does it work?

Medications for opioid use disorder (MOUD) are an important tool for those who are addicted to opioids.

12/27/20224 min read

Medications for opioid use disorder (MOUD) are an important tool for those who are addicted to opioids. This pharmaceutical component's efficacy has been demonstrated in numerous studies. To date, the World Health Organization (WHO) has recommended and the US Food and Drug Administration (FDA) has approved three drugs to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. One or more of these three drugs are included in all brand-name MOUD prescriptions. Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolve are all common brand names. Each drug comes with its own set of qualities and adverse effects. This article is dedicated to the Subutex brand name.

What exactly is Subutex?
The brand name Subutex refers to a buprenorphine-monotherapy sublingual film or tablet. The route of administration of the medication is referred to as "sublingual film" or "sublingual tablet." Buccal film, sublingual film, sublingual tablet, injectable, and implant are some of the numerous forms of buprenorphine. Films and pills that are inserted beneath the tongue and dissolve in the mouth are known as sublingual. Subutex lasts approximately 31-35 hours after being taken sublingually. Some opioid use disorder (MOUD) treatments, such as Suboxone or Zubsolv, combine buprenorphine and naloxone. Subutex, on the other hand, is a buprenorphine monotherapy. Ingredients in buprenorphine monotherapies are not combined. Buprenorphine is the only ingredient in Subutex. To truly comprehend how Subutex works, we must first comprehend how buprenorphine functions.
What is Subutex's mechanism of action?

As previously stated, buprenorphine is one of three FDA-approved drugs for the treatment of opioid addiction. It's offered as a buccal film, sublingual film or tablet, injection, or implant, among other things. Buprenorphine is a partial agonist for opioids. In those with OUD, a partial opioid agonist can assist to lessen opioid cravings and withdrawal symptoms. It accomplishes this by interacting with the same opioid receptors that full opioid agonists activate. Oxycodone, heroin, fentanyl, and methadone are examples of complete opioid agonists. Buprenorphine, unlike a complete agonist, does not fully activate opioid receptors. Because it only partially activates opioid receptors, buprenorphine has a "ceiling effect." Buprenorphine makes it practically impossible for people with OUD to go "high" or experience euphoric effects. Buprenorphine is a maintenance drug that can be used as a short-term or long-term treatment for those who have OUD.

If you are allergic to this drug or have any other allergies, notify your doctor or pharmacist before taking it. Inactive chemicals may be included in this product, causing allergic reactions or other issues. For further information, speak with your pharmacist.

Tell your doctor or pharmacist about any previous medical conditions you've had, especially if you've had a brain injury, a tumor, or seizures; breathing problems (such as asthma, sleep apnea, or chronic obstructive pulmonary disease-COPD); liver disease; mental/mood disorders (such as confusion, depression); stomach/intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus); and difficulty urinating (such as due to enlarged prostate).

This medication may cause dizziness or drowsiness. You may become dizzy or sleepy if you consume alcohol or marijuana (cannabis). Do not drive, operate machinery, or engage in any other activity that requires attentiveness until you are sure you can do so safely. Alcoholic beverages should be avoided. If you use marijuana, talk to your doctor (cannabis). You're more likely to have breathing problems if you drink too much alcohol.

Buprenorphine has been linked to a heart rhythm disorder (QT prolongation). QT prolongation can cause dangerous (occasionally fatal) fast/irregular heartbeat and other symptoms (including severe dizziness and fainting) that require immediate medical intervention.

If you have certain medical problems or are taking other drugs that can cause QT prolongation, your risk of QT prolongation may be increased. Tell your doctor or pharmacist about all of your medications and if you have any of the following conditions before using buprenorphine: certain heart issues (heart failure, sluggish heartbeat, EKG QT prolongation), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

QT prolongation can also be exacerbated by low potassium or magnesium levels in the blood. If you use certain drugs (such as diuretics/"water pills") or have disorders like extreme sweating, diarrhea, or vomiting, your risk may increase. Consult your doctor about the safe use of buprenorphine.

Dental problems (such as tooth decay/loss, cavities, and infection) may occur in some patients who use this medication. Make an appointment with your dentist immediately after starting this medicine and inform them that you are taking it. Have frequent dental exams and learn how to keep your teeth and gums healthy to help prevent dental problems. Tell your doctor and dentist straight away if you suffer tooth or gum discomfort.

Tell your doctor or dentist about all the products you consume before surgery (including prescription drugs, nonprescription drugs, and herbal products).

The drug's adverse effects, particularly disorientation, dizziness, sleepiness, slow/shallow breathing, and QT prolongation, may be more severe in older persons (see above).

Women of childbearing age should discuss the risks and benefits of this drug with their doctor(s) before taking it. If you are pregnant or plan to become pregnant, tell your doctor. This drug should only be taken during pregnancy if absolutely necessary. If used during the first two months of pregnancy, it may modestly raise the chance of birth abnormalities. Also, using it for an extended period of time or in high doses close to the due date may harm the unborn child. Take the least effective dose for the shortest time possible to reduce the danger. If you observe any symptoms in your newborn baby, such as slow/shallow breathing, irritability, abnormal/consistent crying, vomiting, or diarrhea, call your doctor straight away.

This medication is excreted in breast milk and can have unfavorable effects on a nursing newborn. If your infant becomes unusually sleepy, has difficulties eating, or has trouble breathing, call your doctor immediately away. Before you start breastfeeding, talk to your doctor.