New Form of Suboxone: Dissolving Film

Yesterday the FDA approved a new delivery system for the medication buprenorphine. Reckitt Benckiser, the drug company that makes the brands Suboxone (a combination pill of buprenorphine and naloxone) and Subutex (containing only buprenorphine), is now approved to manufacture and sell Suboxone in the form of a thin film that is placed under the tongue to be absorbed. According to early studies, patients think the film tastes better, dissolves more quickly, and is easier to use. I don’t yet have any information on the relative cost of this new film.

Since it was just approved, it’s not likely that a generic form of the film will be available for many years.

 This film of buprenorphine, the active ingredient, can’t be obtained as a generic, and it may be a few weeks before it appears in retail pharmacies.

 I’m hoping the sublingual (under the tongue) film will be harder to snort or inject, because there are reports of addicts misusing the Suboxone and Subutex tablets. And every addict misusing the name brands or the generic of buprenorphine who comes to the attention of law enforcement endangers the existence of the buprenorphine program.

 In the past I worried about prescribing Subutex, the form of the drug that doesn’t contain naloxone, or the newer generic buprenorphine, which also doesn’t contain naloxone. But apparently, some addicts are able to inject Suboxone, and the naloxone in it doesn’t put them into withdrawal. At least, they don’t go into intolerable withdrawal.

 It just shows me again that people are so different in the way they react to medications.

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29 responses to this post.

  1. Posted by tonya c on September 30, 2010 at 11:03 pm

    i do not like the thot of this disolvable form anyone on this medicine knows that the slightest amount if exposure to moisture ruins the medicine and i for one hate the posers who are misusing the medication that saved my life tonya cheek sutton w va

    Reply

  2. Posted by John on October 22, 2010 at 2:44 pm

    Naloxone doesn’t prevent anyone from being able to inject it.
    For some reason the doctors who prescribe this stuff don’t seem to know that anyone can inject suboxone.
    Suboxone IS essentially Subutex in terms of functionality.
    I personally hate this new film because I feel like the medicine isn’t all getting through, the taste is much more bitter, the tabs are so inconvenient for so many reasons, you can accidentally rip them when opening the packet they come in, if a little moisture gets on them they immediately start to dissolve and once I lost an entire dose because when I put it under my tongue it got wet and stuck to my finger and it wouldn’t come off if I tried to swipe it under my tongue.
    All this is is a ploy for the company to hold onto their patent rights for a little while longer so they are giving this stuff away for free.
    Don’t be fooled, this new formulation is in every way worse than the tablets, but it’s just for greed reasons that they made it.
    I hate opiate dealers.

    Reply

    • I don’t know what to make of the above comment. The writer is saying that he can inject what is essentially five times the dose of a normal Narcan .4mg dose into his veins, and not go into withdrawal. This puzzles me. Either he’s not an opioid addict, or he has unusual biologic makeup.

      As for the bit about patent rights, of course that’s why the drug company is releasing this re-formulation now. And to get patients to switch to the film, they are offering a nice discount now. But patients can save a nice amount until March, 2011, then decide if they want to pay the extra for the film versus less for a generic tablet. It’s nice to have more choices.

      Reply

      • The poster was right you can in fact inject suboxone it does not put you in withdrawal because nalaxone does not block buprenorphine (except in doses much higher than 2mg). Most doctors do not seem to get this fact. I’ve tried it myself.

      • Well, the studies do show that buprenorphine is relatively resistant to naloxone, but that’s at the usual doses of .4mg IV. The studies show naloxone will reverse the opioid effect of buprenorphine at doses of 2 to 4 mg. But everyone’s different. I’m sure it’s possible for some people, like you, to inject the buprenorphine/naloxone combination without causing opioid withdrawal. But available data suggest that’s unusual.

        By the way…I hope you are no longer injecting anything. Please get help if you haven’t already.

    • Posted by jeremy on September 18, 2012 at 9:00 pm

      i know the above comment is the dumbest stuff ive heard, please dont listen to this dumbass dont inject suboxone ull prob die, and if u dont ur sure as heck arnt going to git high, please dont listen tothat dumbass!!

      Reply

      • Posted by Chrissy on December 6, 2012 at 7:20 pm

        Um… you deffinitly can inject it without being sent into withdrawl symptoms. I know people who ARE opioid abusers on suboxone who do inject it and say it works better for their normal withdrawl symptoms than takin it under the tounge, I also know people who dont have opioid addiction and gget high off of it. And to the comment above, learn how to spell. It’s not “git” its get!

  3. Posted by doing-what-i-can on December 9, 2010 at 1:17 am

    if you have even a trace amount of an opiate inu like vicoden,perks,eroin,methadone etc. and u inject a suboxone it will send u into the worse withdrawal youve ever felt. However if u are clean of all opiates and have been taking your suboxen under your toungue like u were prescribed than you can start injecting suboxone with no problem. Im not at all bragging about this but I am prescribed to take 3 8mg suboxone’s every day and i just simply cant afford it so i found out that if i inject just 1/4 of a pill it last me all day long i dont get high or catch a buzz from it at all . Am I proud that I have to do this HELL NO but theres no way I can afford to pay for these. 3 pills a day at $8.87 per pill I dont have insurance and I have 3 kids and a wife. I repeat im not proud of this but i need the medication and his is the only way i can receive my medicine and take care of my family. Im sorry

    Reply

    • Sublingual buprenorphine will last as long as injected buprenorphine (maybe longer). If you think you are injecting because you have no other choice, your addiction is fooling you.

      Reply

      • Posted by Dave H on December 22, 2010 at 1:04 am

        Actually you are totally wrong on this.
        Buprenorphine is a paterental opioid. When you take the drug sublingually it has a bio-availably of 40-50%. That means half the drug is lost. When you inject the drug 99% reaches the brain. Thus injecting 2mg is the same as taking 4-5mg SUB.
        Don’t act like you know shit…
        She is completely correct. You are not.

      • Posted by kelly on February 15, 2011 at 1:03 am

        i agree with dave & doing-what-i-can-do. if you inject suboxone and it works for you and saves you money then thats the way you should do it. suboxone is not cheap, and when your taking it sublingually and losing half of the drug your completely wasting your money you might as well be out there getting high. people can say whatever they want about injecting suboxone if its saving you money and your getting 100% of the drug in your system and your staying off opiates and doing the right thing i dont see a problem with it.

      • Dear Kelly,
        OK, now I’m starting to think this is a put-on. Is this one of my wacky friends, trying to rile me?? Because surely this can’t be for real…You are saying it’s ok – no, even better – to inject your Suboxone instead of taking it as directed, because it will save you money? Friend, you will pay in ways you haven’t even imagined if you continue using drugs intravenously.

        Let me tell you something the rest of the world already knows: people who use needles to inject drugs into their bodies don’t live as long as people who don’t inject drugs into their bodies.

        Most addicts know about the physical hazards: track marks, cellulitis, necrotizing fasciitis, abscesses, HIV, Hep C and hep B, endocarditis, nephritis, angiitis, spinal cord stroke with paralysis, septic thrombophlebitis, talc lung…maybe I need to write a whole separate blog on this.

        Your above comment reminds me of that line in the Narcotics Anonymous Basic Text: “We began to see that we had rationalized the most outrageous sort of nonsense to justify the mess that we made of our lives with drugs.” (p21)

        Now, if you want to talk harm reduction, it’s possible that injecting suboxone is less dangerous that injecting heroin, but don’t kid yourself into thinking it’s safe or OK. And if you must, simply must use needles, please get new ones, don’t share, and wipe skin with an antiseptic, to reduce the risk of complications.

      • Posted by kelly on February 15, 2011 at 1:09 am

        to janaburson; you have absolutely no clue what your talking about.

    • Posted by Dave H on December 22, 2010 at 1:10 am

      You are correct. I bet they will delete my explanation of why. Be careful when injecting suboxone. Make sure you use a micron wheel filter. Do not inject into a muscle either. Only IV. There is a high risk when injecting. Injecting over 2mg in one dose is a waste also.

      I only recommend experienced IV persons and I only recommend when money is the main factor. It is far cheaper to inject, but if you can afford it. Then its retarded to inject the drug.

      Reply

      • My cranky reader is partly correct – any injected drug is, by definition, 100% bioavailable. And it’s that bioavailablility that gives the rush of euphoria. Addicts not in recovery are focused on that rush.

        But that’s not the issue, if you re-read the post. Drug half life and drug bioavailability (two different things) aren’t the real issues anyway.

        I considered deleting the above reader’s comments, as they are better suited for a forum for active drug users, not for people seeking recovery. But then I thought it could be a good demonstration of the mental processes of addiction.

        My irritable correspondent doesn’t actually say he uses drugs intravenously, but certainly that’s implied.
        And he, along with the other writer, shows a great example of some defense mechanisms seen in patients with addiction.

        Defense mechanisms are mental processes we all use to protect us from painful truths.

        Some addicts gain a sense of control and superiority by learning scientific facts about their drugs of abuse. They may use this information to invalidate anyone who dares to confront them about addiction. This is called intellectualization. It’s a way a deflecting attention from the real problem, and onto facts about drugs, relevant or not.

        Micron filters, bioavailablity…Cranky Reader has lost the forest for the trees.

        Injecting Suboxone is not OK. That’s the bottom line. Anyone injecting Suboxone isn’t in recovery, but in active addiction. To believe otherwise is delusional.

  4. Posted by DeeDee on December 18, 2010 at 5:09 pm

    I’ve been prescribed to Suboxone for 2 years now. It has worked wonders in my life. It is truly an amazing drug if you’re on it for the right reasons. Last week I received an email from the people at Here To Help (Suboxone’s support group) asking me to talk to my doctor about switching to the new films. When I went in to my doc he switched me right over with no problem. That was 3 days ago and I’ve felt like crap ever since. I’m not sure what the problem is. I’m keeping a headache that never goes away and I’m tired all the time. I hate this and I want to blame it on the new films considering this is the only thing different in my life & it started happening at the same time as I switched meds. Is there anyone out there who is having a similar problem? Or am I crazy?Would there be any possible reason medically that this should be happening to me? I’m curious since the absorption is faster am I getting more or less of the medicine? And as far as the taste goes, I do not see how they can justify that as an improvement! It is awful! Now I was never in love with the taste of the pills, but I did get use to it. I can’t see myself EVER getting use to this pure bitterness that burns my tongue. Yes, it actually BURNS!! I’m hoping my body adjusts and this all goes away, but I was not prepared to have to go through any type of transition at all. I was told it was EXACTLY the same! No worries! If anything, it’s BETTER! Was I fed a bunch of BS or what?

    Reply

  5. Posted by joe on December 21, 2010 at 7:54 pm

    well i have to say I have to stop looking up info on medications online…afetr reading this im just confused…today i just dropped off my script for the film will see how this goes now….i cant imagine it being much different…i was actually just trying to see if any nows how much its gonna cost…forgot to ask guy what my total was…doctor seems think its gonna be cheaper….yeah well after him giving me 75.00 offer card

    Reply

  6. Posted by nick on March 2, 2011 at 1:16 pm

    -joe-

    I’m in the midwest, my suboxone 8/2mg films cost 7.50 each. I’m grateful that my insurance covers this cost and I’ve found a psychiatrist able to prescribe them that only charges me a copay. Hunt around, or call local rehabilitation clinics for lists of doctors who prescribe. Unfortunately not everyone has health insurance (even though mine is shit) I would never be able to afford this without it. And seeing as I still find it hard to stay away from H entirely, without the meds I would stand no chance.

    Reply

  7. Posted by snowman on May 12, 2011 at 7:02 pm

    I have found that when taken orally a half of a strip is equivalent to a whole 8 mg strip.. Im serious they are better.. I would cut your dose in half and see if you feel any better

    Reply

  8. Hi ive been shootin h for about 2months and i got about four red sub strips should that be enough for me to quit? And how much of the strip should i take?
    Can someone please help me with some good info on this i did some h four hours ago wen should i start the suboxone

    Reply

    • It’s not only the quitting. It’s more about the staying quit. Addiction is so much more than the physical withdrawals. In fact, many people go through withdrawal completely, only to go back to using at the next opportunity. You need to treat not just the physical, but also the emotional and spiritual aspects of addiction.
      Suboxone doesn’t work well when used short-term for detoxification only, but it will ease withdrawal symptoms temporarily.I can’t give you medical advice since I don’t know your history, but in general, the guidelines say the patient should wait at least 24 hours since the last use of heroin, and start with 4mg, which of course would be half of one of the strips. In real life, many people have withdrawal much before the 24 hours. If the addict takes Suboxone before he’s in at least moderate withdrawal, it will cause withdrawal. That’s because as a partial opioid, the opioid effect is less than heroin. And it has a high affinity for opioid receptors, which means it sticks to them like glue. Once suboxone is in your system, it’s not letting go even if you use other stuff, so there’s no getting back out of withdrawal. That’s why it’s so important to wait until withdrawals are moderately bad.

      If you feel OK on Suboxone, consider going on it for maintenance. You can find a doctor in your area by going to the government’s website: http://buprenorphine.samhsa.gov and click on physician locator, or you can go to the manufacturer’s website at http://suboxone.com and just put in your zip code and it will give a list of the doctors in your area.

      If you can’t afford suboxone, go to an opioid treatment center, better known as a methadone clinic. This treatment can be life-saving.

      Whatever other treatment you get, please go to Narcotics Anonymous. There you will meet people who were addicted to opioids in the past, and who are now in good recovery. Go, and listen with an open mind. It works, and you can’t beat the price: it’s free. You can find meetings at http://na.org

      Reply

  9. Posted by faith on December 15, 2011 at 11:09 pm

    actually, some of you are wrong. yes it will make you sick, but only if your still harboring opioates in you. if not then putting it under your tounge is more effective than banging it, if your taking it correctly. it MUST stay under your tounge without you swollowing for at lease fifteen minutes..this will ensure 100% absorbtion. (with the films at least) if taking the tab, it has to sit under the tounge for thirty minutes for max absorbtion. and tho you may feel your getting less that way, think about how much is lost in your cotton when your injecting it….a lot more than under your tounge. im surprised many of you have not been schooled by the doctors who give you this medicine.

    Reply

  10. Posted by B. on March 6, 2012 at 4:15 am

    I realize this is an old post, but I needed to address an issue that I’m seeing here. I am saddened and frustrated with the typical “I am a licensed doctor so therefore I am the ultimate authority on everything medical” approach that janaburson is taking here. The level of pushiness and passive aggressiveness, commenting on her “cranky readers” and “irritable correspondents”, talking down to them and making personal judgement calls about them, merely for them trying to point out that you are wrong about quite a few things regarding Suboxone.

    I’m also growing tired of the willful ignorance when it comes to the IV use and abuse of this medication. Buprenorphine has a higher affinity for the naloxone. Hands down. Every time. ANY addict that takes Suboxone regularly, is able to inject suboxone without fear of withdrawals. There has not been one documented incident of someone who is addicted solely to Suboxone that has gone through withdrawal for injecting them. Stop feeding into the drug companies bullshit they use to obtain patents.

    Lastly, this is directly to janaburson. If you are truly an addiction specialist, do you not realize the harm you are doing any of your patients with the attitude you take? Getting immediately aggressive and accusatory, calling people out for being addicts and then talking down to them as a result of that, is disgraceful in the rehabilitation community. We are a community of harm reduction. Here is a valuable lesson in life: people are going to do what they want. You will not be able to stop Joe Shmoe from injecting his Suboxone, or anything for that matter, if he/she chooses to. He needs to come to that decision on his own. You can only help him get to that decision through kindness and thoughtful explanations of why it’s unsafe, and not taking an irritable and impatient stance. We have this wonderful thing called autonomy, which also dictates that even as someone’s doctor, you can not tell them how to run their life.

    Reply

    • So you reprimand me for being a condescending know-it-all by being a condescending know-it-all yourself? Hypocritical.

      Was I condescending? Yeah, I’ll own that. I’m not perfect. I have bad days. I’m on the same journey as everyone else, and I think I would write that comment differently today than I did then. I think the point I was trying to make was that while a patient on Suboxone, using it appropriately and getting counseling is in recovery, someone buying Suboxone illicitly and injecting is continuing to do something dangerous that may well shorten their life. Is it better than injecting heroin? I think so. But it’s still dangerous. People that inject Suboxone aren’t in recovery like patients who use it appropriately. Plus they endanger the availability of Suboxone for other people.

      You’re wrong about the Suboxone. I realize there are some people who are able to inject Suboxone without getting sick, but I don’t think it’s a high percentage. This country has NOT had large numbers of people injecting Suboxone like France and Scotland, where only the monoproduct was available (equivalent to our Subutex).

      Reply

  11. Posted by Naps on May 16, 2012 at 12:43 am

    hello, i would just like to tell you that i iv subs pretty much on a regular basis. i do not go into any immediate with drawels and i don’t ” buy it illictley” i am prescribed it and it saved my life. yes i do have a problem but its a needle fixation if anything. all i know is this drug is keeping me off heroin and oxy’s, i know exactly what is going into my body and know exactly how much i need to take to be baseline. and yes you will get a small rush and warm feeling of euphoria after injecting it is short but 100% noticeable. i dot not condone any of this and do not wish that anyone do as i do, i am just telling you the facts that i know because of what i and i’m sure thousands of other people around the world do as well. I do not consider my self and addict or a junky so i advise you really think about what you say before you write it.

    NAps out

    Reply

    • I’m curious as to how you define an “addict or junky.”

      And I advise you to consider getting a more intensive treatment for your addiction. Injecting drugs is dangerous, even buprenorphine. I just went to a lecture at the annual American Society of Addiction Medicine conference where the speaker discussed complications that are being seen from intravenous Suboxone abuse. For some reason, these patients get fungal infections of the eye, something that’s extremley rare, only seen in immunosuppressed patients.
      Pancreatitis (inflammation of the pancreas) has been seen, and I don’t think anyone yet knows why that happens. And there’s pumonary granulomatosis, but that’s seen frequently in IV users of drugs. In the past, it’s been found in patients using heroin cut with talcum powder. With this disease, the lungs develop lesions that look much like asbestosis. In severe cases, the blood pressure in the lungs becomes greatly elevated, leading to respiratory failure.

      Reply

  12. Posted by Barbara on March 13, 2013 at 5:09 pm

    Can anyone tell me if you’ve tried the new generic for suboxone tb ? I got my prescription filled today nd didn’t think to look at it while at the pharmacy I later realized it was a totally diff tb so i turned around nd went back to see if they had changed it or if there was a mistake. When I got there I told them my medicine was totally diff nd askd if it’d been changed. The lady at the pharmacy replied with didn’t they tell u ? Well obviously they didnt or I wouldn’t have came back . She told me they do not have the regular suboxone anymore nd that they quit making it nd the generic is all anyone will get unless they are prescribed the film . I dont think I could use the film so im going to try these new ones. but ive done had my doseage for today nd wont be able to try the new ones til the am.
    If anyone has already gotten these plz let me kno. Do they work as good as the original ? Do they disolve as fast since they appear to be thicker ? nd also I take a 1/2 at night nd these new ones r not serated.

    Reply

    • You are a trail blazer – I haven’t heard of anyone else getting the generic suboxone tablet yet – they were only approved a few weeks ago. Can you please write back with a report on how you like them?

      Reply

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