New Buprenorphine Product: Bunavail

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Manufacturer’s ad

Until this month, only buprenorphine in the sublingual form was FDA approved for the treatment of opioid addiction. This includes commonly known brands like Suboxone and Zubsolv, and generic buprenorphine both with and without naloxone added.

But earlier this month, the FDA approved Bunavail (B-YOU-na- vail), a buprenorphine product that is absorbed through the mucosa of the cheek. This method of delivery is termed “buccal.” The company making Bunavail says the product has an adhesive, which they call “BioErodible MucoAdhesive,” that improves absorption through the cheek mucosa. This product has twice the bioavailability of Suboxone film, and that’s the selling point for this new product.

Bioavailability is the percent of the drug that is absorbed into the bloodstream out of the total amount of the drug that is administered. If a drug is injected, by definition it has 100% bioavailability. Other routes of administration have less than 100% bioavailability because not all of the drug is absorbed orally, or due to the first-pass metabolism seen with some drugs like buprenorphine. When using a route of administration with lower bioavailability, more of the drug must be given to achieve the same blood level as when the drug is injected.

Buprenorphine has poor gastrointestinal availability. If a drug company made an oral tablet to be swallowed, less than 10% of the drug would be absorbed into the bloodstream. Sublingually (under the tongue), bioavailability of buprenorphine is said to be anywhere from 30 to 50%, and can be influenced by things like the pH of oral secretions (an acid environment interferes with absorption, which is why we tell patients not to drink any soft drinks, coffee, or tea for fifteen minutes prior to dosing).

So what does Bunavail’s higher bioavailability mean on a practical level? Bunavail’s films contain less buprenorphine than Suboxone, but deliver the same blood level. And if the blood level’s the same, the effect of the drug is the same. In other words, individual patients should feel the same.

Other than that, I can think of a few potential advantages. With higher bioavailability, fewer grams of buprenorphine would be prescribed, and fewer grams of buprenorphine that could make it to the black market.

Since less of the drug is needed per unit dose, perhaps the price will be lower. I have no information about the costs of this new product…but I’m going to make a wild prediction that Bunavail won’t be significantly cheaper than Suboxone. Zubsolv has higher bioavailability but I don’t think it’s significantly cheaper than its competitors.

The makers of Bunavail are making a big deal about the inconvenience of sublingual forms of buprenorphine compared to their new product, which sticks to the side of the cheek. In an interview on Bloomberg News, one of their scientists said patients taking Bunavail can talk and swallow while their medication is dissolving, something that can’t be done with their sublingual competitors.

OK, maybe that’s an advantage…but what are we talking about, five or ten minutes at most? I don’t know if patients will think that’s a big selling point, but time will tell.

On their website, the manufacturers caution, “Do not switch from BUNAVAIL to other medicines that contain buprenorphine without talking with your doctor. The amount of buprenorphine in a dose of BUNAVAIL is not the same as the amount of buprenorphine in other medicines. Your doctor will prescribe a dose of BUNAVAIL that may be different than other buprenorphine-containing medicines you may have been taking.”

To me this means I will have to be careful if I have a patient who wishes to switch buprenorphine products. However, the package insert says that 4.2/.7 mg of Bunavail is equal to Suboxone 8mg/2mg. The package insert goes on to say that patients should be started at 2.1mg and increased in increments of 2.1mg until a maintenance dose of 8.4mg is reached, though patients may go as high as 12.6mg

The insert also says not to tear or cut the film. Manufacturers of Suboxone say the same thing about their film, though cutting those films is fairly standard practice. I think that since the drug company hasn’t done any testing of their products when cut or torn, they can’t say for sure that it’s OK.

The company behind Bunavail, BioDelivery Sciences International Inc. (BDSI) has several other unique products. For example, they already market Onsolis, which is fentanyl also in a buccal (absorbed through the cheek) film. They’re also in phase 3 trials now with another buprenorphine product that uses the special mucoadhesive they developed, but it will be marketed for moderate to severe chronic pain. No information is available yet regarding the doses contained in this product.

Bunavail is expected to be marketed to doctors the last quarter of this year.

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84 responses to this post.

  1. I thought buprenephrine was subutex not suboxone. Which one is correct?

    Reply

    • actually there is no more subutex. That’s a brand name for buprenorphine with nothing added to it. and Suboxone is the brand name of buprenorphine plus naloxone, which is added to make it more unlikely for people to want to inject it. But the active ingredient in both subutex and suboxone is buprenorphine.

      Reply

      • Posted by David Stroud on September 8, 2015 at 3:25 pm

        also… I cannot believe you would even say that methadone “does not create a high in most patients”… being a Dr.(I’m assuming) you should know that it does! I have personally seen many addicts buzzing there behinds off from methadone to the point of sweating profusely, scratching every part of there bodies, and nodding the fuck out! Get your facts straight Doc. You are probably one of those Doctors who has been prescribing pain pills for everything your whole entire life for whatever kickback you get. You, along with many other Doctors should blame yourselves for pumping the nation full of narcotics then wondering why people have these problems… You Dr’s make me sick, thinking you are so daggone smart… when in fact you’re just a bunch of quacks. Funniest thing ive heard in along time… “oh well methadone doesn’t get you high” lmfao… what kind of kickbacks do the makers offer you to say shit like that!

      • Posted by ronniemacc on October 22, 2015 at 1:25 am

        Who said “Subutex” was no longer available? Prescription filled Monday(19 Oct 2015)for it. And doc or pharmacy hasn’t mentioned anything about discontinuation of Subutex?

      • Posted by Mememe on April 21, 2016 at 11:20 pm

        Yes there is still subutex I know a close person who still gets them cause she’s pregnant

      • Posted by Cody Wauford on May 3, 2016 at 7:08 pm

        I still get prescribed subutex it is still around….

    • Posted by Raeofsun on November 16, 2015 at 6:19 pm

      Suboxone is a combo drug of buprenorphrine and naloxone. Subutex is just buprenorphrine. Also please not that the are many brand name drugs that contain the drug buprenorphrine like Suboxone, subutex, zublov, buprenex, etc….

      Reply

    • Posted by Cody Wauford on May 3, 2016 at 7:09 pm

      Bupe is the active chemical in both suboxone n subutex only difference is the subutex has no neloxone which is ur blocker…

      Reply

  2. It’s great to see the drug companies finding more efficient ways of administering these potent medications, which also lead to less mg of medication on the black market. Maybe one day 500 years from now when opioid addiction is an even worse plague the government in America will legalize ibogaine for addiction medicine.

    Reply

  3. Posted by Benjamin Keith Phelps on June 29, 2014 at 10:30 pm

    Two comments/questions: 1) Whether there’s less mgs of medication on the black-market or not, if they’re absorbed better to equal the same overall, why would that matter? In other words, if Suboxone 8mg is equal to around about 4-5mg of Bunavail, what difference does it make on the black market? Sure, less medicine is out there, but if it kills at the same rate, then there’s been no benefit, right?

    2) This is more of a comment than anything, but as a methadone patient, am I the ONLY 1 who is sick of hearing about bupe this & bupe that, better/more formulations, faster takehomes, more prescribing, blah blah blah, but nothing whatsoever in the way of different/better forms of methadone formulations, faster earned takehomes (I’m sorry – I’ve seen FAR FAR too many illegally obtained bupe tablets in the pockets of FAR FAR too many people not in treatment to buy even for a minute that it’s somehow saving lives by not being a full-agnonist, other than MAYBE the fact that accidental OD is a bit harder.) Almost every (literally) addict I’ve encountered accidentally around construction sites & such while doing temp labor have shown me or told me of their abundance of Suboxone tablets they’ve scored from their buddies. This makes me REALLY angry, b/c it’s the reason I have to wait 59 years to get monthly takehomes (yes, that’s somewhat facetious, but not by too terribly far!) Why is there NOT A SINGLE methadone clinic in the ENTIRE EAST COAST of NC that offers tablets of methadone? They all are quick to scream “DIVERSION, DIVERSION!!!!” when it comes to methadone tablets, but that’s not true any more than tabs of bupe. Why do I say this? B/c my bottles of liquid are SEALED via foil that cannot be broken w/o evidence of tampering. Hence, why can’t I sell my bottles of methadone every bit as quickly as they can sell their tablets of bupe? I was on tablets of methadone 5 years ago (before they did away with them here), & I had no issue of anybody wanting any from me – literally! Not to say I couldn’t have found SOMEONE that would’ve taken some if I’d looked hard enough, but when I compare how many people want Suboxone tablets regularly, it’s no contest. The federal government said that there’s no reason we can’t be given dry meds – which are a HECK of a lot more convenient (you try spilling a tablet on the carpet versus a bottle of liquid on the carpet & then let’s have this conversation! Or try traveling with 27 bottles of liquid versus 1 or 2 bottles of tablets) – so why is this SUCH a problem? And why are clinics seemingly unwilling to offer tablets to MMT patients, as though even when we’re in recovery for decades, we can’t REALLY be trusted, no matter our drug tests, compliance, participation, etc? I just don’t get it.

    Reply

    • Posted by nat on January 13, 2015 at 10:50 pm

      Really not sure what any of that had to do with how often you have to go to the clinic or if your dose is liquid or pill. I will say different strokes for different folks. I tried methadone and took more and more and more. With suboxone i finally found something i didnt abuse and was able to make it last as long as i was supposed to. Not one time did my methadone last me. So about this new med bunavail. Just got it only because they offer two weeks of it for free. I hope it works as well. And they black market doesnt care if its less or more mgs if it does the same thing

      Reply

      • Posted by Benjamin Keith Phelps on January 16, 2015 at 5:24 am

        So sorry to hear you couldn’t control yourself with methadone, Nat. Not one time have I ever run out early in over a decade. So what did your inability to control yourself have to do with anything I said, OR the original post, for that matter? Are you suggesting that your inability to control your intake of methadone is reason enough for me to be more restricted? I shot up buprenorphine in 1996 when it was given to me by Dr Peter Coleman in liquid form to take home while detoxing (it was in trials in Richmond, VA at that time & was the brand name Buprenex, before anybody tells me it wasn’t out until 2001). Does my injecting bupe mean we need to restrict your access to it now when you have control over your intake? Just wondering, as that seems to be your point. My post had to do with exactly what I said: I’ve listened to how buprenorphine is being less & less restricted everywhere, but I’ve run into a million & one people at construction jobs & server jobs who were pill-heads & most all of them had bought Suboxone pills/strips/etc off people getting it from a doc, & I just wonder why nobody’s paying any attention to that, when every time a single person OD’s on methadone, it’s plastered throughout the country in every newspaper almost, & 30 politicians at any given time will propose bills to further restrict methadone dose, availability, form of dose (liquid or tablet or dosage of tablet available to patients), patients’ ability to drive on it, etc, etc, etc. And people such as yourself feel some need to post that they couldn’t handle methadone & felt intoxicated or like they were still on dope or were in liquid handcuffs. That doesn’t negate the good it’s done for those of us who use it exactly as prescribed & have no problems with it. There will be people who abuse medicines ALWAYS. I’m not hating on bupe patients – I’m happy you found something that works for you. But I’m just curious as to why I see it all over the place, yet nobody’s bothering to mention that pesky little detail. It’s been almost non-existent the number of times I’ve seen methadone out there in the hands of someone who wasn’t supposed to have it during those same 10+ years, literally. I can remember, off top of my head, somewhere around 3 times. No lie. Compared to probably 15-20 times for buprenorphine, conservatively. And this is keeping in mind that I don’t hang with drug users & dealers – this was all people at a job or the likes, who were popping pills when they figured nobody was around who would tell on them or were trying to do so & I walked up on them unintentionally. I didn’t feel like my post was unclear in its point, nor that I had to directly relate to the original post any more than I did in order to write what I was thinking. I said what I wanted to say, & that is that. But I will say this much, as well – it’s rather annoying to listen to people who suggest, as you did, that because YOU couldn’t handle methadone or didn’t do well on it, it’s not a good treatment or one that should be as freely dispensed as the one you prefer. I’ve not called for the tightening of controls on bupe b/c I shot it up years ago. I’ve merely stated that I don’t understand why it’s never talked about that it’s available everywhere, when methadone is OVER-controlled & by comparison, hardly ever seen out there (again, I said BY COMPARISON), yet it’s talked about constantly – your post as a great shining example. Your post doesn’t highlight a need for greater controls… It highlights the notion that not every treatment is right for everyone. As does my statement that I injected buprenorphine. And truth be told, I’m not for the idea of them loosening controls to the point of no time in treatment required with methadone takehomes. But the fact that YEARS are required to earn monthly takehomes – it just gets overly restrictive & costly, & people get treated like crap by clinic staff because they CAN BE. All these restrictions mean that nobody can choose a doctor & pick a different one if that doctor isn’t a good one – we get stuck in one of two available places in an area (sometimes less than that, if we have to drive a distance), & that’s all we have to choose from. People on Medicaid often only have one clinic in an area that will serve them, & they’re treated like the scum of the earth, even with years clean. I lost takehomes when I moved to DC this past summer, simply for moving. Not for doing anything wrong or whatever. This is common, & it’s wrong. But who’s gonna stop them from doing this when they’re the only ones in the game by law? And since there are no paid clinics in DC anymore, EVERYBODY gets treated like absolute s**t. Like we’re dope addicts who shot up this morning before we came in to dose. Even if we’ve been clean 30 years. We get NO counseling time, only group. And group isn’t used for talking about anything – it’s for the counselor to read from a stupid xeroxed sheet from Hazelden. This is the treatment methadone patients can expect much of the time, or they can expect to pay $15/day if they want to be treated with any dignity & respect elsewhere. So my frustration is about the disparity in treatments, not crying that you’re not restricted enough. What’s good for the goose is good for the gander, bottom line.

      • Each package has a unique DEA identifier # on it…I can find methadone on the street any day of the week 24/7 – bupe, not so much…so what you’ve ‘seen’ hardly counts as the norm

      • Posted by heather kimbrough on May 21, 2016 at 3:37 pm

        I like the Bunavail just the same. i was on suboxone for a long time so i was a bit scared to try something new., In my opinion, methadone is the devil. I dont get high with the suboxone or the bunavail, it just keeps me feeling normal and keeps me from craving opiates. i can actual lead a normal life. Methadone had me more addicted than any other opiate and i was going to a clinic as well. it was never enough so i would buy it on the street. i am so glad that part of my life is over. i had to go to rehab to get off that crap and they gave the the suboxone to keep me from getting so sick. i have finally come down too, and instead of taking three a day i am down to 1 and a half which for me is great. my advice is stay away from methadone for life. this is just my opinion and we all have one so no bashing please.

      • Thanks for writing. I’m not bashing, but just saying that everyone IS different, and buprenorphine doesn’t work for everyone, just like methadone doesn’t work for everyone. And in other people, methadone is a life-saver

    • Instead of complaining about it , why not just get off methadone? (bi weekly detox/blind dosing/get off your ass and go to a medically supervised detox like I did – on the county’s dime no less) its an ancient, antiquated form of maintenance (before you tell me I don’t understand, I was on it for 10 years and could hardly sit down without nodding out) so what incentive do drug makers have to create MORE efficient ways for you to use it – is methadose not efficient enough? Its in your bloodstream minutes after you drink it. To echo what another commenter said – I could not control my methadone use either…with the recidivism rate of this disease its easy to understand why – what puzzles me is the willingness of methadone clinics to allow patients to keep jacking their doses up on a weekly basis. I got up to 230 mg of methadose a day – because it got me high – enough to sedate a freaking elephant and I barely weigh 140 lbs.

      Reply

      • Posted by Benjamin K Phelps on May 13, 2015 at 4:08 am

        If you could barely sit down without nodding out then 1 of 2 things was going on: 1) you were taking other drugs with it OR 2) you were OVER-medicated, which you could EASILY have prevented by asking for a decrease. I don’t feel my meds at all. The one time I did start to feel like I was nodding, I immediately had them take me back down. When I found my stable dose, I stopped there & I’ve NEVER increased above it. Some of us do fine on methadone, and I have no legal wiggle space – I would be a habitual felon if I got popped passing fake prescriptions again or buying dope or anything else, for that matter. Why would I want to risk my freedom just because you think methadone is antiquated & couldn’t control yourself with your dose like the other person above? I’m not saying either of you are bad people for it – I’m just saying I KNOW how addiction is, & if you couldn’t control yourself with it, I get that. But that’s where you have to step back, look at what’s going on, & say “enough already” & do something about it. Coming off methadone is NOT the answer for me. Even at 80mg, I crave to the point of getting into trouble. So it would be asking for trouble for me to just come off. And I HAVE tapered all the way off in 2011, btw, for 65 days. I almost wound up in handcuffs again before I could get back to the clinic. So stopping treatment isn’t my answer. And some clinics won’t just “jack up doses on a weekly basis”, as you spoke about. There are some people that obviously appear intoxicated, as you describe you were, & some clinics still increase them – I don’t understand that either. But for those who are still craving or fast metabolizers, they NEED the clinic to be willing to work with them until they find their stable dose where they no longer crave & no longer use. Not raise them til they nod off. That one time that I mentioned where I asked to go back down was b/c I would nod about an hour after dosing, & I would feel nauseous. It was NOT a pleasant high like shooting dope or anything – it was just a sickly feeling to me. So methadone doesn’t automatically make everyone on it high – it makes people high if they’re taking other drugs with it OR if they’re getting over-medicated. I’ve never been at 230mg as you describe, & I’d never want to be. That would be WAY too much for me. But there are a few people who need that much or even more b/c of their metabolism. A blood test can reveal if you are over-medicated or are a fast-metabolizer. I ain’t mad at you or anyone else that had a problem with methadone – it’s not for everyone, just like every other treatment in the world. But telling me to come off it b/c I don’t like the way we’re treated is being a bit naive. If you need high blood pressure meds, do you want to be treated like sh*t when you go to get your script for it? Talked to like you’re scum? But you can’t just stop taking it if you have high blood pressure, can you? So that’s my point. My disease of addiction doesn’t just go away now that I’ve been on methadone a while. Some people can taper successfully, & I’d give ANYTHING to be one of those people. But thus far, I’ve not been successful at it. I won’t stop trying, though. In the meantime, I deserve respect at the clinic.

      • Posted by David Stroud on September 8, 2015 at 12:57 pm

        Sounds like you just love methadone and want that high…. you don’t get that with bupe (unless you are not really an addict) You just feel normal…. also with the naloxone its less likely you will OD. The reason ppl pay out the butt for methadone treatment is because they like the buzz, nuff said… otherwise youd take your butt to the dr in your town and get the subs for 35 a month/with insurance.

      • Please don’t assume your experience with methadone and bupe is the same as every other person’s. Methadone does not create a high in most patients.

      • Posted by tylogirl27aax on February 20, 2016 at 3:49 pm

        Doc, I respect your work so much. A couple people bashed you about saying Methadone doesn’t create a high, so let’s get it straight:

        Methadone is a FULL AGONIST. For an opiate NAIVE patient, it creates as massive a high as any other full agonist, and has a really long half-life to boot. Back in the day, Methadone would cause me to nod out for like 2 days. It was insane!

        HOWEVER, people who are dependent and properly dosed no longer get a full high from Methadone. Those are the people you deal with.

        On the streets, when diverted, Methadone causes a massive high when abused. Buprenorphine, being a partial agonist, may cause a small high in the same user, but much, much less degree. Like a couple order of magnitudes difference at least. Further, Buprenorphine has such a high binding affinity that it will prevent the user from getting high on any full agonist opiod for DAYS after a single dose. For that reason, I continue to believe that even when Buprenorphine is diverted, it’s still fulfilling a harm reduction goal. The same is not true of Methadone. When diverted, it might as well be Heroin++.

        Of course, I do not condone or participate in diversion of anything! It’s a quick way to go to jail.

    • Posted by Raeofsun on November 16, 2015 at 6:42 pm

      I totally understand and agree with your comments. I am on suboxone and have been for three almost four years (Feb will be 4 years) and it makes me sick and angry with the about of people who get suboxone scripts and sell them (must of them sell them to get high). It makes it harder on me as a legal prescribed patient and I am content targeted. It pisses me off. What also pisses me off is that I feel I have been on them too long and I want to wean off, my understanding is that these things weren’t meant to be on for life, however my doctors think I need to be on them indefinitely even tho I have completed a 31 day inpatient treatment, a 90/90 plus, still go to meetings and group therapies, go to individual therapy, and see a psychiatrist. Is it because the’re getting rich prescribing these damn things!!??!? ONE MORE THING: Why do people take what doctors, politicians, pharmaceutical companies, law enforcement, etc.say as the absolute truth end all be all?!?! Fine people realize how corrupt A LOT not all of these fools are… That’s why people think methadone is so bad and subs are better for you… Truth is what works for one or even the majority will not work for everyone and no one DRUG either prescribed or illicit is better or worse than any other.

      Reply

      • Posted by Andy on October 5, 2017 at 1:29 pm

        I think they should give the methadone pills out. The liquid is red and looks like fruit punch that kids might drink. Although mine is always locked in a safe. About Subutex I was given in 2005 to get me off of oc 80’s I was snorting about 20 a day the Subutex did nothing. The methadone worked when I got my dose up to about 80 mg as for getting high on methadone if you take it everyday you don’t get high at all. And the suboxone pills made me feel weird. The suboxone sublingual strips are about like mint strips you get at stores and come in a box. I think the pills are alot safer their to cause they are in a safety cap pill bottle. ;Then you are just trading one addiction for another so I did alot of research and only took the suboxone strips for 3 weeks 16mg first day then 8mg for about 2 days then 2mg for 3days then 2mg for 3 days then 2mg for 3 days then 1 mg for 3 days then .5 for 3 days then .25mg for 3 days, The three weeks it took to get methadone all they way gone and taking the suboxne for only 3 weeks I never got hooked and then took some xanax for about 2 weeks after and had very minor withdrawls. I was fighting with that opiod addiction the methadone got me hooked on for 7 years its way worse than coming off of any pain pills if you do it cold turkey,but i did a lot of research and many sites recommend this way to get off once and for all. They don’t like it at the done clinic cause they lose money when you stop going!

    • Posted by Melissa on September 7, 2016 at 11:56 am

      They give disks in knoxville

      Reply

  4. Posted by themetres halares on June 30, 2014 at 6:24 pm

    Themetres Halares facebook

    Reply

    • Posted by David Stroud on September 8, 2015 at 3:16 pm

      to janaburson…. Ok you are a Dr. so I am assuming you have never taken methadone… If you were an addict which clearly you are not you would know that it does in fact give you a “high”…. which is why and probably the only reason people travel and pay out the anus for it…. I know you want to believe the opposite, but you’re wrong…I have seen first hand the affects of methadone on opiate addicted patients and heard them explicitly tell me how they love they buzz and keep going back for more! Seems to me with methadone that you trade one addiction for another… with bupe you are easily weaned down and off of it totally (maybe after many years, depending on patient) however in most cases with methadone maintenance the patients dose continues to climb!

      Reply

      • Posted by Heaven Medlin on January 10, 2016 at 3:11 pm

        That’s just ridiculous. I was on methadone for two years and just got on Suboxone. Methadone absolutely does NOT get you high!! Yes its a bit stronger than subs, but NEVER got me high! Does pretty much the same thing as subs, the only reason I switched is because it was causing problems with my teeth and my knees and BC my insurance pays for Suboxone, but didn’t methadone.. But no never got high off of it. And never will.

    • Posted by Karen brown on October 23, 2015 at 3:56 am

      Sorry not fully know this site just started I am a former suboxzone switched to bunavail yes less side effects but my body says is not equivalent I had to take extra which this is my 1 week my sub.dose was 8 and this is 6 my bi by feels less of it when I started sub.had to take extra cause my oxy.dose was high like 800mill.a day so for treatment I would have to take 2 weeks of sub. And 2 weeks of oxys.cause they then said this and that and I don’t want people being a guinea pig like me been on it over 7 years if I don’t have it I go back to opi.don’t want to have to start this treatment that way…it is a better drug but boy the jelly stuck inbetween mouth and gums suck so I pull it out hence not getting it fully.so I take a another and it sticks and stays for like 2 hrs.up on my gums so bare with us doctors it i not suboxzone different made with same drug and better effect but I still hurt all over fill antz.and anxious going back r ember in felling bad those were side effects of with draw.that was 2 days 3 day I took it upon myself and took more not going through this again like w/sub,I know better better yet my body does too,so I don’t get the equivalent of them .I wonder how to put it like oxys. …was main ingredients of oxycodone,because I shoot it snort it or in anyway getting in my system just hit quicker and your doing reg dose don’t mean it has more or less in another competitive company with same drug 10 mill. Perkocet to 10mill.oxycodone
      That it is the same which both are same drug just done differently

      Reply

      • Posted by Karen brown on October 23, 2015 at 4:15 am

        Ment to add one thing just because it delivers a more efficient way don’t mean it is same millagram or getting same amount t of drug just quicker and less side effects hence less active ingredient but I took more of bunavail and didn’t have bad side effects better cause I got the feeling of being on sub. 10 pounds is 10 pounds 5 milligrams of Lortab is 5 milligram even it I snort it ,swallow shoot in just some ways are quicker. For non taking imagine getting a package delivered but one by ups other fed x put same thing in it delivered regardless might of non been a better delivery system going with the other guy but u still got same thing sorry I feel that 10 millagram is 10 just delivered different with less active other ingredients that my body is picking up on the side affect . Same with insulin I mean I could go on but hopefully you get it

      • Posted by ronniemacc on October 25, 2015 at 9:16 pm

        Omg what did I just read? Translation please

      • Posted by Karen brown on October 26, 2015 at 5:44 am

        Sorry Ronniemac what is it u would like to know?

  5. Posted by Abbie on July 2, 2014 at 5:46 pm

    Ben, money maybe…? Clinic’s make money by you coming into the clinic everyday, no matter how inconvenient it is… In MD where I live, I think they charge upwards of $12 (maybe more) a day just for your medication, that’s not your urine’s or anything else. If they were to switch to a different formula that wouldn’t warrant coming into the clinic everyday – what would they charge you? Right now they charge $360 just for medication for 30 days… Would they sell you a bottle of medicine for $360?? I really don’t know?? But whatever the answer is be sure to trust it has SOMETHING do with MONEY! Always! Companies want to make MONEY so much MONEY with as LITTLE cost as necessary!! Also I just wanted to say I understand the importance of coming into the Clinic and making face to face contact with staff… I get that, I just feel bad sometimes for patients on Methadone, when I go into the Clinic for my Monthly Script of Subutex, I do meet some people who are on a stable dose of Methadone and shouldn’t maybe have to sit thru the 20 year long wait to get take home… I am just fortunate that I am able to be kept stable on Bup…some are not like me and have to switch back to Methadone and if I was that person I would be feeling the same way… Why do I have to come here everyday!

    Reply

    • Posted by Benjamin Keith Phelps on July 2, 2014 at 8:08 pm

      Abbie, while some things may be a bit off that you wrote, you are likely right – money is the underlying issue. Thankfully, I don’t have to go to the clinic everyday. I go once weekly, but have been at once monthly for a while. When I changed clinics, I had to start over (not all clinics transfer takehome levels). Anyway, am earning my way back up slowly – it takes 4 years to get to monthly takehomes by state regulation in NC. I’m about to move to DC though, which is only bound by the federal government, so my treatment becomes free AND I no longer have state regs to think about. I am lucky in that respect. Good luck in your treatment, & I am happy for you that you are able to take Suboxone & do well so that you don’t need daily treatment like so many. I have yet to understand why people don’t work w/the doc to get their dose right if they’re on an inadequate one & can’t stop opioids & therefore, can’t get takehomes. But I think almost ALL of the instances where people have been on for years & still come daily are attributed to the use of other drugs – not opioids, usually. Anyway, good luck to you & good day!

      Reply

  6. Posted by Craig on November 5, 2014 at 5:57 pm

    there is a big reason why 4.2/.7 mg of Bunavail is equal but better than Suboxone 8mg/2mg. Lower dosage means fewer side effects. In the phase III 40% of those who were switched no longer complained about constipation. That is a big improvement for many. Other side effects would reasonably be reduced, also.

    Reply

    • Hmmm…but they claim the same blood level, so I don’t see how the side effects are less.

      Reply

      • Posted by Steve on November 14, 2014 at 12:44 pm

        If you take a Suboxone 8mg, 2mg is absorbed into bloodstream and has therapeutic effect, 6mg goes to GI tract. Buprenorphine is an opioid, all opioids have topical effects on the GI Tract, constipation is one of those side effects of opioids.

        If you take a Bunavail 4mg film, 2mg is absorbed into bloodstream and has therapeutic effect, 2mg goes to GI tract. You’re exposing the GI tract to about 1/3 less opioid.

        2mg to GI tract vs 6mg to GI tract.

        Not sure why this is so complicated.

      • Interesting description of pharmacodynamics, but I don’t think it’s accurate.

      • Posted by Ronnie McCullough on July 17, 2015 at 4:13 pm

        I don’t know what it is but I was on subutex 8/2 and switched to bunavail 4/.7 and I feel fine and I’m excited to say I no longer have the mild headache that I kept while on subutex……..not to mention bunavail has minimal effect on my gag reflex (TASTE)

      • Posted by David Stroud on September 8, 2015 at 3:28 pm

        Someone should take your license… you are without a doubt a moron who has no business practicing medicine… especially not in the field of addiction… go get addicted then come talk to us lady! You really have no idea what you are talking about.

      • Posted by ronniemacc on October 22, 2015 at 1:46 am

        Psychosomatic symptoms? Because of the change and reading lower doses of active medication?

  7. Posted by Joe strummer on November 18, 2014 at 8:32 pm

    My dr is having me try this new product. I was prescribed 8mg suboxone that I tear into tiny tiny 1/4’s and I am fine. I switched to this product 4.2 and I swear it made me go into straight kick mode. Anyone else try this product yet?

    Reply

    • Posted by celeste on November 26, 2014 at 3:39 am

      how long does it take for it to “kick in” with you? or is that what you meant by “straight kick mode”? it take almost TWO HOURS to kick in! i take it in the morning and in the evening and while i took the suboxone 1/2 hour before i wanted to feel it, i now need to take this 1&1/2 hours before!!! what gives? and unfortunately since it’s so new i can’t find any forums online for anyone to answer my questions. i hope you can help. thanks!

      Reply

      • I think the comment’s author meant by “straight kick mode” to say that he started having serious withdrawal symptoms. Some people use the phrase “kicking” to mean withdrawal, due to the muscle cramps and involuntary muscle movements, or kicks of the legs. This is where the phrase “Kicking the habit” comes from.
        Or I could be wrong.
        If you are taking buprenorphine (as Suboxone or any other brand) daily, you won’t have much variation in your blood levels after taking a dose because it’s so long-acting. But if you were in withdrawal, and had no buprenorphine on your receptors, you would feel it “kicking in” at 45 min to an hour, with relief of withdrawal.
        This is one benefit from buprenorphine…opioid addicts don’t tend to “feel it.” They just feel normal with no withdrawal symptoms, hopefully.

      • Posted by Marie on December 9, 2014 at 9:49 am

        I agree. I wish I could help you, however I like so many, are searching for any feedback, non pharmaceutical literature but replies and experience to taking this med. I’m new to it, as in 3 days in. I prefer suboxone by far. Maybe it’s just me, but I’ve felt sick for past three days. This is miserable and I feel mentally out of it. I’m not sure what’s up however I am not happy with this med. I’m going to call my doctor tomorrow and ask what to do because I also have been given suboxone for pain management . I now am in pain again & my overall feeling is less than ok.

  8. Whats straight kick mode?

    Reply

  9. Posted by Alisha on January 27, 2015 at 4:40 pm

    Sounds to me like they are trying to trick patients once again. I have went from the original stop sign tablets to the films. And now they want people to try this but with what I have read sounds like a way to actually give you less bupe than what we are already getting. Why else offer two weeks free? They didn’t do this with films? And every doctors office or treatment center has different rules. One will say tablets are bad and only prescribe films and vice versa. I honestly think some of these docs have no idea what the reality of living each day being addicted to something is really like. Needing something just like water food and air to go about your day, it is miserable. Not to mention cost! And the cost of the bunavail is actually twice the price of films so I don’t think that this medicine is gonna be a success. The only good points being , the taste, and less constipation, definitely isnt out weighed by a higher cost and less opioid. What are they thinking?

    Reply

  10. I was on Suboxone 8 mg for 2 years. I just recently got prescribed Bunavail 4.2 films. I can def say I like Suboxone better. The only reason I switched is bc i was put on Prescription Assistance Program and it pays for my script for a year. But I def prefer Suboxne.

    Reply

  11. You know what truly amazes me? Why do people trying…no doing better. By. Meth, sub’s , or whatever. ! Just like. Christians. Find A path towards. God…..then when normal sets in. And. Brain becomes active….the first and loudest thing you hear is att a cling others striving to do sasme, maybe you approach different. But. Dam???????? You are both doing good things! Attack the negative. Not the ones striving! Like churches attacking other churches cause some thoughts different!!!! So what! Attack. Evil that is not trying!! But people attack what’s. Safer, so they won’t. Feel. Any. Backlash like they would dissing a non do good type.. Encourage good. For good. Not! My way or you are jerk!
    They jerks. As still in the. Streets hurting innocents and themselves! Try talking to them that way. ! Ain’t gonna happen!

    Reply

    • Posted by magicmike2 on May 26, 2015 at 10:43 pm

      Methadone gets u high and suboxone dosent. Also wanted to add that bunavail works way better for me than reg suboxone did. I feel much better was taking sometimes 3 to 4 strips as compared to just 1 single bunavail. Idn if it’s the same for everybody but I would recommend the switch asap. And my health first covers after first 2 week free supply otherwise 10 bucks a piece same as on the street. But u can’t find bunavail on the streets yet too new.

      Reply

      • Posted by magicmike2 on May 26, 2015 at 10:47 pm

        Also wanted to add haven’t had any urges to get high from bunavail can’t say the same for suboxone. After a while of taking subs on week I would be fine and the next I would feel like shit. Hasn’t been like that at all yet with bunavail. I’m telling u make the switch guys ull thank me!!!

      • Well everyone is different. Yes, since methadone is a full opioid, patients unaccustomed to opioids may feel a high from it. If a patient is opioid-tolerant, she usually won’t feel a high from methadone when started at proper doses. Of course, street use is different.
        Even patients accustomed to opioids sometimes feel a mild buzz for a few days after a methadone dose increase, but tolerance to that develops quickly. Many patients feel only relief of their withdrawal symptoms when methadone is dosed properly.

      • Posted by Benjamin K Phelps on May 27, 2015 at 12:13 pm

        Would you people cut it out with the “methadone gets you high” stuff, please? It only gets you high if you MISUSE it. I don’t feel a thing from my dose AT ALL. I have actually missed taking my takehome dose before because I can’t tell if I’ve taken it without counting my tabs or checking my bottles if I forget whether I took my meds this morning or not, so no, it does NOT get everybody high. It gets you high when you mix it with other meds or abuse it. Even then, once you have a tolerance, it’s still hard to get high from it for more than a few days because it stays in the receptors so long. So please stop accusing methadone patients of being high all the time. Just because you’re not on it doesn’t give you the room to be judgmental about those who need it instead of Suboxone or Bunavail. Those have a ceiling affect & can’t be dosed high enough to stop cravings for some people who abused very high doses of heroin or other opioids, & therefore, methadone is the only medicine we can use to do that at this time. We used to have LAAM as a choice, but that’s gone now, so what other options do we have? If you can take bupe & be ok, I’m proud of you & glad for you. Why can’t you give me that much? I’ve been clean 12+ years from opioids because of methadone. But my dose exceeds what bupe can cover, & I have been down low enough to where bupe could have covered it, but I craved like hell & ended up seeing old behaviors start coming back & had to go back up to stop them. You need to understand – NA/AA, methadone, bupe, church – WHATEVER WORKS FOR SOMEONE – we should be applauding them for getting off illicit drugs HOWEVER they managed it. Not slinging accusations at how all the other treatment modalities suck & ours is best. I don’t encourage everyone to get on methadone just because it works for me. Stop acting like bupe is the ONLY answer. It’s not.

      • Posted by Benjamin K Phelps on May 27, 2015 at 12:25 pm

        Also, thanks for making my point – bupe IS on the street, just like methadone – available for illicit use. You even gave us the price people are paying for it on the street in your area. Evidently, you’re not doing so great if Suboxone left you craving constantly after the first few days/weeks. I don’t know if Bunavail will eventually do the same, but if it does, then why would you be satisfied to be on something that leaves you craving? Then you might as well not be on anything, in my opinion. Methadone doesn’t get me high OR leave me craving. If I’m gonna deal with being on something for addiction, I’m gonna be at a point where I don’t crave, I don’t feel high, I don’t think about drugs, I don’t find out street prices, I don’t want to know about who’s selling it & where it’s at… And that’s where my treatment has me. I don’t know a SINGLE heroin, methadone, or other drug dealer in DC since moving here last July, because I haven’t looked for one. Yes, I’m quite positive I could find one very easily IF I WANTED TO. But I have zero desire to look for it, & that’s EXACTLY where I wanna be. EXACTLY. When I start worrying about those things, something is not right with my treatment. I’m not judging you – I’m merely saying you don’t sound like your dose is covering you with the things you are saying. If that’s the case, maybe you need an increase. If you’re at the max, maybe YOU need to think about methadone & the possibility of a full agonist to get to where you don’t care about drugs anymore. I can GUARANTEE you – if you take your daily dose on time everyday, don’t take other drugs, & be honest with your doc & counselor when/if you’re craving, you WON’T ever get high off the methadone, except MAYBE the first 3 days or so that you take it. And that’s still “if-y”, since you’d be transferring from bupe, not taking it out of the blue with no tolerance.

  12. Posted by Benjamin K Phelps on May 23, 2015 at 8:40 pm

    It has to do with bioavailability, Lindi. We all know 4.2 doesn’t equal 8 no matter how you spin it, but if your body only absorbs an average of 4.2mg from the 8mg tablet, then it is fair to say that a 4.2mg product that is 100% absorbed is all that is needed. NOW, I understand that EVERYBODY is evidently saying this product is not 100% absorbed, or even close, & evidently 4.2mg is less than they were absorbing from the 8mg tablet or some combination thereof. Theoretically speaking, I could manufacture 100mg morphine tablets all day long & sell them on the black market as such, but the truth is, if I can’t do a study with control patients & the whole 9 yards to PROVE that each patient who takes it is actually ABSORBING 100mg of morphine from it & has it in their bloodstream, I could be making 100mg morphine tabs that only allow for 10mg to be absorbed, which is useless to someone needing higher doses for chronic pain. 10mg is only what is used on opioid naive patients in most cases for severe pain, not tolerant patients needing high doses. SO, what we can surmise is that 1 of 2 things is going on here: Either a) Bunavail did not do sufficient research & is not being absorbed as well as they claim, or b) 4.2mg is not sufficient to cover what is absorbed from an 8mg Suboxone tablet in reality. You & I don’t know the answer to that, because we can’t do our own blood draw & establish how much buprenorphine is in each deciliter of your blood after an 8mg Suboxone. Likewise, we can’t do one after a Bunavail to see the difference. But you can’t just automatically say 4.2 doesn’t equal 8 & therefore it’s false advertisement. That’s inaccurate. The REAL question at hand is: Does Bunavail ACTUALLY deliver the equivalent of what Suboxone does to the bloodstream when all is said & done. It would SEEM that the obvious answer is NO, based on anecdotal evidence here. But evidently, if the makers of Bunavail are telling the truth, they had a group of addicts that claimed it did, & maybe even did blood tests after taking each of Suboxone & Bunavail to show that it did. I don’t know which of the 2 happened – IF EITHER of the 2 did. But evidently the manufacturer CLAIMS at least 1 or both of those things were done & they wrote out results to send to the FDA to suggest it was accurately holding dependent people. I personally think an independent agency should do BOTH of the tests on a large group of people. Put them on Suboxone – not for just a day, but for – let’s say – a 3 week period. Then measure the blood level a couple of hours after dosing, then 12 hours after dosing, then right before dosing again the following day. Then switch them to Bunavail for the SAME length of time. ASK how they feel after the switch & document the responses. Then do blood tests at the same intervals as done with Suboxone. Establish once & for all whether or not they are or are not equivalent IN BLACK & WHITE. That should take care of all questions. I don’t know, but I hear all this type of talk about the differences between the 3 brands of cherry methadone – Vistapharm, Roxane, & Mallinckrodt. I have been on all 3, long-term (meaning more than 6 months on each). When I switched, I felt ZERO difference. Over the following weeks, I felt ZERO difference. The ONLY difference I could find was that the cherry taste is slightly different between all 3. HOWEVER, I’m NOT a fast metabolizer. So a fast metabolizer might have a totally different experience when switched between brands. I’ve also taken Mallinckrodt tablets (the white Methadose brand tablets – 40mg & 5mg). When I switched from those to Roxane liquid, I noticed ZERO difference, as well. One thing to note for this particular debate (I know nobody’s having it here) is that methadone is ALL manufactured by Mallinckrodt in the USA as a bulk item. So it’s then sold to Roxane & Vistapharm as a bulk product to be made into tablets & concentrates accordingly. All 3 are ACTUALLY selling the exact same bulk methadone item to clinics. HOWEVER, if one of them were to use something in their liquid or tablets that inhibits bioavailability, then it might as well be powdered sugar they’re putting in the liquid or tablets, b/c it can’t be absorbed by the patients very well or even at all in some cases! So YES, tablets that don’t seem to do much of anything can have the full amount of active ingredient in them! But if something inert that shouldn’t affect absorption actually DOES affect it, then it gets in the way of the active ingredient doing its thing & there’s then a BIG problem! That’s why many generics are pulled from the shelves (not “many” as in droves each day, but over the years) – if the studies of bioavailability are rushed, fraudulent or forged, then the FDA may find out through patient complaints over time that this particular brand did not do its homework before releasing its product & they have to pull it from the shelves. I’m trying to remember which brand it was & I can’t, but a generic brand of Wellbutrin got pulled for this very reason. The People’s Pharmacy did a big write-up on it.

    Reply

    • Posted by mlmiller6 on November 15, 2015 at 9:41 pm

      I know it’s way after the fact but just wanted to say that i agree with all you’ve said about how utterly ridiculous the restrictions on Methadone are compared to the Sub/Bun crap. I was “fortunate” enough to have a doctor Rx me Methadone for “pain” for 4 years but it was my pain med of choice because it kept me from craving any and all of the Rx meds, alcohol, and illicit drugs i had been known to abuse, and I discovered that quite by accident when i started getting it off the streets. In 4 years i never got high and never felt the need for more than the 80 mgs my doctor prescribed (I started at 40 mgs). My doctor stopped taking my insurance, no other PCP was willing to Rx it, so i went from paying $60 a month for 240 Methadone a month (dr visit was covered, Dones were not, but that’s 240 10 mg Methadone for $60 AT FULL PRICE!) to paying $300 for a visit per month to a Suboxone dr plus i have spent thousands of dollars on Subs (minus the 30 per month my insurance would cover SOMETIMES) not to mention having to get a PA for it every other month (Insurance company makes the pharmacy send the doctor WHO JUST WROTE THE SCRIPT a piece of paper that doctors office has to fill out and send back to pharmacy) which can take DAYS even with fax machines and modern technology. And did i make this up or doesn’t Methadone’s structure block other opiates from working too? The only ones benefiting from the Subs are the doctors and pharmaceutical industry because NOW we that got suckered into this have gotta find a way to get off this crap….i am sure big PHARMA are busy in their labs right now making something else to “help” us with that problem as we speak. Hopefully it wont cost 10 X more than the Subs. By the way after a year on Subs my insurance refused to pay for even half of my monthly script and now only pays for Bunavail, which we have all heard about by now the pros and cons of, and which i understand costs more than Subs (have not researched or had to pay OOP yet so don’t know). I still get treated like a junkie drug addict by all doctors, pharmacists, insurance company, and anyone else in the medical field who know i am on Sub. I guess until i hit rock bottom with this “replacement therapy” they keep making for us, i will continue to be a victim….it sucks. I wish you, me, and all others who are UNABLE TO (but not because we don’t want to) “JUST put the shit down and move forward” the very best, regardless of whatever maintenance we choose or are forced into. If I didn’t have a small child and have to work for a living maybe i could go to detox and treatment for my addiction to this crap that not only does not get me high but that keeps me from getting high off anything else (not that I’ve tried). It’s almost funny when you think about it….

      Reply

  13. Posted by marc taylor on July 10, 2015 at 6:57 pm

    I was prrscribed the new bunavail and can get no relief very disapointed going back to dr to get suboxone brand that works.Bunavail is shit!!

    Reply

    • Posted by Karen brown on November 11, 2015 at 8:56 am

      I agree and I did go back myself I think that there trying to trick us but our body knows no matter how much we tell our self that bunavail is better I think insurance got some big vacation or bonus from bunavail its sickening to know that we all have went though this in the last several months because someone gave are insurance a bonus or incentives to switch us but hay not going to knock bunavail for weeker addicts just wouldn’t give bunavail a recommendation to people with way high tolerance I wouldn’t of made it on bunavail coming off oxys and now most our trying to come off herion fell sorry for those who’s doctor may be going along with this glad mine has been lessening to his/her patients but if it works for u good luck I am for anyone ting to quit the hard stuff

      Reply

  14. Posted by Ronnie McCullough on July 17, 2015 at 4:07 pm

    FIRST- This is some awesome reading haven’t been able to put the tablet down!

    Not sure if this is the proper location for my question/concern if it’s not please delete.

    I Would like to know why are there only specific doctors authorized to prescribe bup medications (suboxone, subutex etc) ? I’ve checked around and in Tennessee these doctors (quacks) charge anywhere from $300-480 per visit (sometimes every 2 weeks) plus the cost of these medication. The pharmacies are charging (no-insurance) anywhere from 12-17 per pill? WHY

    How come your primary care physician can’t write a prescription for these medications and I’m curious of the wholesale price for these medications also?

    And in closing guess what it’s not only the doctors offices that treat us like s*** but also the pharmacies and WALMART AND WALGREENS are the worst!

    Reply

    • Why? Because in 1914, the Harrison Act made it illegal for doctors to prescribe any opioids to people with drug addiction, for the purpose of keeping them out of withdrawal. Doctors went to jail if they prescribed opioids for known opioid addicts. That didn’t change until the 1960’s when Drs. Nyswander and Dole started experimenting with methadone in heroin addicts. Eventually, laws were changed so that an opioid treatment program could get special permission to treat addiction with methadone, but had to get numerous approvals from DEA, CSAT, state opioid treatment authority, state’s department of health and human services, and state’s division of facility services.
      That was the law until 2000, when the Drug Addiction Treatment Act was passed, which allowed properly trained and credentialed physicians to be able to prescribe sublingual buprenorphine from an office setting, without having to go through all the expense of getting approval from 3 state agencies and two federal agencies.
      In other words, only within the last 15 years have doctors been allowed to prescribe medication from an office setting to treat opioid addiction. This is a relatively recent thing, and federal authorities are still quite cautious about which doctors they will allow to prescribe buprenorphine.
      Sadly, some buprenorphine doctors have engaged in price gouging, particularly where the demand for services has been the greatest (Eastern Tennessee). Since in this country we do not have nationalized health care, all medical care is viewed as a privilege, not as a right. So if you don’t have money, you won’t get treatment. (I don’t necessarily agree with this. If you think everyone should be allowed healthcare regardless of ability to pay, then go vote for people who will make this happen.) It is legal for doctors to charge whatever they want for services they deliver. Ditto with medications, drug companies, and pharmacies. If you don’t like that, go vote!!

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  15. Posted by David Stroud on September 8, 2015 at 3:40 pm

    OMG… methadone gets you high…. DUHHHHHHHH, again, why would you travel and pay ridiculous amounts of money compared to receiving Bupe in your hometown from a waivered Dr. Come on people, you are addicts because you cannot admit you are one, just like you cant admit that your “maintenance drug” gets you high as well! I am so over these methadone addicts saying o well it doesn’t get me high…. well that’s probably because you have been drinking a 2-liter of the shit a day for 20 years and you have more methadone in your body than blood itself… Im guessing you probably don’t know reality from euphoria…. im out! Smoke weed everyday! Its better than all that other shit anyway!

    Reply

  16. Posted by Old Granny on October 14, 2015 at 4:59 pm

    At least companies are coming up with more options other than suboxone. Don’t get me wrong– suboxone has saved lives, but it only started to lower prices and offer more of a savings until Zubsolv and Bunavail hit the market.
    Now if we can just convice law enforcement that patients don’t get high of buenophrine (sp), addicts are looking for it to feel normal.

    Reply

  17. Posted by Nicole on October 21, 2015 at 1:25 am

    I have a bunivail strip in my cheek as I am typing. I have bn on suboxone 3 yrs now. I got switched to bunivail yesterday. I hate it. I feel funny. I feel sick, dizzy,& tired. Should I wait a few days to see we happends? I’m ready to switch bk

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    • Posted by Karen brown on October 23, 2015 at 4:40 am

      I also have bunavail just got on this week. but that seems just like the side effects of suboxzone try a couple days the u should seem but my head hurting went away hopefully the yawn affect if I have gotten to my sub.for say does seem to last long but equivalent is diff.to me I live in tenn.and and on tenn care there ones who made me switch and backing equivalent up I think something fishy cause there more expensive than sub

      Reply

  18. Posted by ronniemacc on October 22, 2015 at 1:17 am

    This is the same active ingredients as your previous medication. Just a slightly lower doses, however the delivery system is different and according to publications I’ve researched you are absorbing more active medication than suboxone even though the dose is almost 2 mg lower. You may be experiencing some psychosomatic systems or possibly some type of reaction to the fillers in the bunavail (those usually effect site of absorption live redness, blister, burning etc) good luck but in the long run this is gonna be a winner if they can figure out how to keep the medicine side from “balling,gelling” up

    Reply

    • Posted by Karen brown on November 11, 2015 at 8:45 am

      It was not the same just because it’s absorbed different don’t mean a thing to me don’t care how it gets in my system it’s still 6 is 6 8 is 8 but in this case 6 is like 2 there is something I can’t put my hand own that is missing from bunavail but I am not having to go though withdrawal symptoms no more because I went back to suboxzone I tried it it didn’t work for me but hay if it works for u than good luck glad it does but alot of addicted people I have spoken with have went back to subs and some that were only taken a half a strip was doing a whole 6.3 and was in with draw but to each there own till they Try it that’s the key try it u never know just because it hasn’t worked for me or other I have talked doesn’t ,mean it want gor u but only after we tried for a week and got the same results of feeling sick did we mention it in group but good luck to all who it does help just glad it wasn’t that drug for me getting of oxys I would of never made it on bunavail suboxzone is my winner here

      Reply

  19. Posted by tyrone on November 8, 2015 at 9:18 pm

    I tried the Bunavail and its not for me.i been on suboxone for almost a year and i was talking a strip a day. Suboxone was a blessing till the insurance decided to make a change in stop paying for suboxone.so am on day 4 and am tired, dizzy,sick, sad.lost feeling all the time.subs i could go to work and ferl normal.bunavail i will lose my job.i dont take that much to feel like this.am in tennesse and wonder can i get my subs back and just pay.because i want my life back.

    Reply

    • Posted by Karen brown on November 11, 2015 at 8:34 am

      Yes, I went back to subs myself only made it on bunavail 2 weeks and went through major with draw it was because of my insurance that I had to change but now I will have to pay for the med. Suboxzone my doctor said over half of her patients went back to suboxzone and that we all should write the insurance and she was going to send in a letter also of how the changes made us in with draw gl to u I just have to pay for it now but least I can work to pay for it other than being in bed it was horrible for me switching like a bad joke I felt no way is bunavail equal to suboxzone I had the 6.3 and done like 7 to 8 of them a day and still was hurting all over best of luck to u. Like I said I just pay for my suboxzone now and what really makes me mad is that they said it was to have less drug on the street but what does that help if I am having to take more than written to me and still can’t cope normal

      Reply

      • Posted by tylogirl27aax on February 20, 2016 at 4:00 pm

        This is exactly my experience. See my post at the end. I found the ONLY way to get proper absorption is to place a film against your cheek, and then lay down with that side of your head against the pillow. Use a whole film as cutting these and retaining proper absorption seems impossible. HOWEVER, I have found that it’s nearly impossible to get a doctor to put you back on Suboxone after you go to Bunavail. As soon as you ask for ANY CHANGE, they will look at you as a drug-seeking patient. So, better to keep your mouth shut and go with the flow. It sounds like your doctor is an exception to the rule. Must be a private practice doctor.

      • Posted by Karen brown on February 20, 2016 at 6:51 pm

        No hun that is your taking the chance of going back ur doctor needs to know that u have urges of pain without suboxzone that bunavail is not working better to let them know than u go seeking off streets to be just normal

  20. Posted by ernestine on November 10, 2015 at 11:40 pm

    yes you can..my dr said i could stay on sux but id have to pay its just tenncare want pay for it any longer just the bunavail…

    Reply

  21. I’m previous on suboxone films which are 8 milligram and it does help completely with the withdrawals but makes me sick bad headaches, stomach cramps, severe sweating and chills vomiting, ill moods, can’t sleep etc.. And I know it’s not the buprenorphine for sure. I spoke to my suboxone doctor about it and she was wanting to try me on the bunavail next week but medicaid does not pay for it and that’s what I have is Medicaid. it seems to my doctor that I’m allergic to the naloxone.. and patients with insurance can not use the bunavail discount card I already checked into it with my pharmacy so what other choices does my doctor have because I don’t want to go to another clinic like methadone and I don’t know or think she prescribes subutex. if it is really the naloxone then any type of suboxone that contains naloxone will make me sick even in lower doses. So if all else fails would my doctor have no choice but to write me subutex for my addiction? I don’t iv meds never have nor do I snort pills. Don’t want to abuse these meds just want to get better without getting sick. Im very dedicated to this recovery without trying to get high! I could care less about that anymore. Just want to do better and buprenorphine itself is a blocker the naloxone only prevents people from shooting it up or snorting it. Which as I mentioned I never abused any of my street pills in that manner. Only orally. I don’t mind my doc doing a pill count or drug testing me at all. I don’t sell drugs so I will be more then happy for my doc to do a pill count and test Me for the drug or any other drugs if she would just put me on subutex.. She knows suboxone makes me sick and normally a doc will switch u to buprenorphine without naloxone but she wants me to start on bunavail next week and Medicaid don’t pay for it at all. And the discount card don’t do any good cause I have insurance. Any answers or advice will be appreciated thanks so much and have a blessed day

    Reply

    • Medicaid may pay for your prescription, if your doctor is willing to tell them about your problems with their preferred medication, Suboxone. It seems like she could get an authorization for you from Medicaid to try a different form of this medication. The mono-product buprenorphine is not out of the question in a patient who is willing to do pill counts, who has no history of IV use.

      Reply

      • Today I called my main Clinic Dr office and ask if they prescribed subutex and they said no not unless you’re pregnant only I do not mind the pill count at all or the drug test I never in my life iv any drugs. Always been scared of needles and doing stuff like that I don’t even snort medication when I was taking pain pills off the street I just popped them orally. And another thing a lot of pharmacies do not carry bunavail and I can only go to one pharmacy because I have no car so I have to walk to my pharmacy it’s only a five minute walk so that’s no trouble I’m just scared if nothing else works and the doctor really don’t prescribe subutex then they will stop treating me and I’m going to be back in square one back on pain pills real bad on the street buying them and I cannot afford to do that I’m only trying to get better I’m not trying to abuse or sell nothing people out there makes it hard on people like me to get the subutex and that is a shame

      • If naloxone in the suboxone keeps making me sick even after I try bunavail which has a bit of naloxone on it what will my doctor do? The office at front desk said they don’t prescribe the pill with just 8mg of buprenorphine the which is known as the subutex so if that’s the case will the clinic kick me out or make me go somewhere else? will they stop my treatment? There is ppl out there that don’t abuse the buprenorphine pill.. I don’t want methadone at all I use to abuse that orally but never something like this. I thought any doctor that prescribes suboxone should be able to prescribe subutex buprenorphine pill without the filler! I know plenty of ppl that gets them that’s allergic to the naloxone and I’m having problems with the naloxone as well.. They are suppose to help ppl that has bad reactions to the naloxone.. I don’t want to ask my doctor if I can get switched to buprenorphine pills cause she might think I want them for the wrong reasons and I don’t! I want to feel better. And don’t want to lose this program it’s the only one local that accepts Medicaid. Idk what to do. Just don’t want to start back on pain pills on street and get bad off again. I’m serious about this program. Just don’t agree with suboxone or anything that has naloxone. Not to mention naloxone is awful on your liver. Doctors are suppose to care about you and give you something that agrees with your body. They should give ppl like me one chance to try it and do the pill count and drug testing. So sick with this suboxone and it makes me not want to do nothing and the effects keep adding on to different symptoms. Ppl like me wants to get clean and stay clean without trying to get high! I just want normal.

    • Posted by Karen brown on February 20, 2016 at 6:44 pm

      I have found the don’t want to write subutex to anyone unless pregnant in tn.. cause of the way u can abuse its, bull but the naxlalone makes me sick also and my experience with bunavail was bad so I take the headache and move on when I have chills and all the other things u mentioned except for vomiting it’s because I need to take more sub. That’s been my experience I get very nausea with it but haven’t vomit but wished I had fenergren for sure just make sure u can go back to suboxzone with ur doctor if u do try bunavail it didn’t seem to curve my withdrawal so I would at least make sure with her u can go back to suboxzone gl, on your way hope u find your min.. bliss like me but very min… cause sick in bed with withdrawal on bunavail or sick without withdrawal been on suboxzone 7to 8 years I am very bad with addiction and as I was taking but loads of oxys and now herion if I don’t have my suboxzone gl to u but been clean for 4 years straight now for me just the first couple of years I went back and forth cause I couldn’t get enough suboxzone so it was like 2 weeks on suboxzone to 2 weeks on oxys till I got my tolerance down now oxys or any of the drugs that suboxzone treat against don’t work so I am happy of that took a long time to get there and threw off for 2 months trying bunavail during bunavail I went back to herion for the pain it sucked which I spoke all this with my doctor were all so fragile in are way to being free hope u have a understanding doctor to help u gl gl gl

      Reply

  22. Posted by tylogirl27aax on February 20, 2016 at 3:55 pm

    I have been on Bunavail for almost a year now and can say that it’s variance in bioavailability is extremely frustrating. If not taken JUST RIGHT you can lose your entire dose. It can get stuck on your teeth, or your mouth PH is wrong, etc.. and you just don’t ‘get the dose’.

    However, I have found that if you go to sleep with it on your cheek, facing your cheek against the pillow to achieve pressure, you will get the proper absorption. It’s like night and day, at least for me, when compared to normal daily administration the way they recommend.

    The charts they distribute about plasma levels are a bit shady. Something isn’t right. The norbuprenorphine metabolite is ‘off’, for one. Also, it leaves your system faster than Buprenorphine, likely due to less in your GI (despite that so little gets absorbed).

    Another HUGE problem is that it’s harder to cut and administer because once you cut it, the surface area is smaller and this makes it harder to properly apply — again, it being so sensitive to the way it’s applied. It’s also possible they put all the medication in a cricle in the middle of the film, which would make sense…

    To make matters worse, their lowest form is 2.1mg (4mg Suboxone equivalent). Without cutting, that means that’s the lowest dose possible. With Suboxone, it was 2mg, which would be about 1mg Bunavail. But there’s no 1mg Bunavail. Why not? Heck, we need 1mg Suboxone and 0.5mg Bunavail for patients tapering.

    I can say this to summarize: I *never* ran out of Suboxone, always had extra left. But Bunavail equivalent dose, and I am always cutting it close, again because of missed doses and such. It’s frustrating.

    Reply

  23. Posted by Karen brown on February 20, 2016 at 6:25 pm

    Hi u comment about your doctor , looking at u crazy I suggest u find another doctor my tenn care no longer pays for suboxzone but pays for the visit, when I told my doctor that hay bunavail is not working she understood she told me (well her staff) that over 50%of the patient it’s not working for. I live in tn… if that helps any but she immediately put me back on suboxzone i told her hay I am having to take double the dose of bunavail the 4mg. Being equal to the 8 mg suboxzone this is crappie no way in comparison she wrote me 2 6s.I was taking 4 6s,Instead of the 2,4mg…bunavail and wow I couldn’t take it I called only after 2 weeks and had took my whole month supply of meds.. of bunavail and told her this u have to remember they haven’t done all there homework on this bunavail we yet again are guinea pig like the suboxzone which is way better I have had a relationship with my doctor over 3 years of just trying to taper off don’t take that as them looking at u as drug seeking look back and say maybe I am I am not getting my fix on bunavail if u went through the withdrawal symptoms like I had I hurt everywhere wasn’t going to work just felt like I was all alone again in this fight against my drug addiction but if ur doctor want change u back cause what I am thinking is u pay out of pocket for visit and meds… u can go anywhere where I don’t pay for visit I had to say with my doctor cause of being on tenn care which is state funded health insurance just let her know bunavail is not for me it’s not for everyone were all different and at first I thought that about well she just thinking I am seeking drugs but guess what she was right drugs that help me not put me in withdrawal there is no way I could lay on a pillow for the hour some wait for a drug that don’t help I am so sorry u are going thur all this I feel ur pain been there just had a doctor that understand addiction and one I love that I will never leave just because she does her homework and listen to me… now not all of her patients went back to suboxzone cause the first few months she asked me which I was taking sub. Or bun…. so I do know that some it worked for or they were to scared to ask her I am so sorry I didn’t get over the hump like I told her the first 3 days were ok (guess it was the suboxzone still in my body)it was sure a great mix though till all the suboxzone left then it was down hill for me hope u can explain it’s not for u or it is for u some stayed on bunavail just cause the couldn’t afford suboxzone

    Reply

  24. Posted by Jess on March 29, 2016 at 3:58 pm

    I had to switch from Suboxone strips to Bunavil due to my insurance and for me personally I can say that Bunavil is awful. It takes FOREVER to dissolve and it gets goopy and sticks to my teeth. Also, I could go days between taking suboxone but after only 24 hours of my Bunavil dose I’m feeling mild withdrawal symptoms. So I’m taking more as a result. Legally of course. Also, I got the answer for why you can’t cut Bunavil. Apparently the manufacturer of Bunavil decided to put all of the buprenorphine in one location on the patch and the naloxone all in a separate location on the patch in an effort to curb the abuse potential so if you cut it you may not be getting any of the buprenorphine on that particular part of the patch. I miss the Suboxone strips. And there is a huge difference in my opinion and it’s all negative.

    Reply

  25. Posted by Shayshay on June 10, 2016 at 6:02 pm

    No, bunavail is not cheaper by any means, they do however offer a more discount with their patient assistance program/discount card.
    I have used it under my tongue like sub and it works that way.

    Reply

  26. Posted by Shayshay on June 10, 2016 at 6:05 pm

    Also,
    You have to be able to cut Bunavail because a patient can stop at 2.1 mg. they have cut them in half and then cut them in half

    Reply

  27. Posted by Heather from Indiana on February 18, 2017 at 9:54 am

    I was reading through each thread and even though some are from a few years ago, for the new Bunavail patients. I just wanted to add a few points for those currently seeking info on bunavail. After being a severe addict for 15 years, I had been taking suboxone for several years off the street. When I finally got to where I legally sought treatment for not only my addiction but also chronic pain management, 3 years ago, My wonderful Doctor, only prescribed zubsolv and bunavail. I was on put on bunavail, and like many had said they hated it and wanted their suboxone back. After a serious open heart to heart with my doctor, he broken down exactly how the bioavailability for bunavail works vs. Suboxone. One thing the pharmaceutical maker had figured out was even though people were taking 8mg suboxone, your body can only absorb so much buprenorphine, so your body is voiding out excess once ingested. This is why they have different mg’s available so you can find the correct dosage in time. Also, one of the major perks bunavail has over silicone or subutex, you will not go into detox for 36 hours after taking the dose. As I type that, I know some may want to argue the fact, but as an addict you have to consider anyone can subconsciously make themselves sick, and believe they are detoxing. But as I’ve been on these for several years now, I can honestly say I can live a “normal” life. I don’t have to take it as soon as I get out of bed. I have found myself well I to late afternoon before I realize I haven’t taken my medicine. It does help tremendously with my pain management, and I have not had the urge to seek out any other sources for a fix. For those who have commented about being allergic to naloxone or just sick from to much, they also have a new buccal medicine called Belbucca. It comes in micromilligrams. I also want to jump back and mention to those who take bunavail, and have issues with the gummy factor and it sticking to your teeth, if you are ending up swallowing it at this point, you are not getting the full benefit of whatever mg you are on. You are just pooping it out, as my Dr. Had informed me. If it gets to the point you cannot stand it, at least slip it under your tongue for you to get the most benefit of your dosage. This medicine has truly saved my life. If you were like me at first I didnt like the change, but now that I’ve given it a chance, I’m glad to not have cravings or worry about am I going to be sick today. I look forward to finding out what medicine the makers of bunavail are working on for severe pain that was mentioned by the author. I just recently had to increase my 4.2 mg up to the 6.3mg bunavail simply because of the pain I am having with flair ups. For those who are searching for more information on Bunavail, I would be happy to try and answer any questions. My husband was put on zubsolv at the same time I started bunavail, and there is something about pill addiction the mentally stays with us,no matter how long you’ve been sober, and he would run out way sooner than he should have. He talked to the dr. About it and he has now been on bunavail as well. And doing just as well as I have been. It is a much more costly prescription, but with prior authorization our insurance covers it fully. For the 4.2mg quanity 56 is $646.00 at the pharmacy we use. When I switched to the 6.3 mg, a 56 quantity went up to $927.00. However, the pharmaceutical company does have a wonderful discount for those who pay cash. I also would like to say before I wrap this up, anyone of you who is being mistreated, judged or just being treated badly by any doctor, clinic staff or pharmacies; you should not take their abuse. Everyone has some sort of addiction, at least you are doing something about it! Unlike the ones looking down on you, they need to be put in their place. If you have to call corporate offices for pharmacies, Do It! If you have to report a certain staff members to your Dr, Do it! These people need a lesson in compassion, and need to stop focusing on you when I’m sure they have plenty of issues of their own they are choosing to hide by abusing someone with a mental illness. Good luck to all.

    Reply

  28. Posted by mikey on October 17, 2017 at 10:50 pm

    Subutex is just a “generic buprenorphine” and its still available as a painkiller or when starting suboxone. They will give you a couple days worth when say your coming off an opiate it could be methadone or morphine etc. You can still be prescribed without being pregnant. which if your pregnant you should not be on opiates unless you want a drug addicted baby. I am male and get subutex for my back the sublingual works fast and well Doctors don’t give it out easy due to abuse that’s all.

    Reply

  29. Posted by Heather from Indiana on October 22, 2017 at 5:15 am

    I just wanted to weigh in on this blog. I couldn’t find a date it was written. However, my husband and I both have been on bunavail 4.2/0.7mg for over 2 years. The cost from Sam’s Club in Indiana for 56 strips cost our insurance $479.88 a month. I just recently have been put on a higher dosage of 6.3/1mg as we also take bunavail for pain management. The cost for 56 strips at the same Sam’s Club increased to $997.00 billed to my insurance. (Thank God for coverage!). I will say I wasn’t thrilled 2 years ago when they said their office only prescribes Bunavail or Zubsolv. But after being on Bunavail, we no longer wake in the morning just ready to dose ourselves! Some days it can be 1pm give or take before I find myself needing it for pain relief. There are major contributions we have found himself to have over suboxone,subutex, or methadone. Bunavail 4.2 mg having the higher bioavailability vs. Suboxone 8mg, You will not experience Any withdrawal symptoms for 36 hours after last dose! That in itself is a huge selling point. I was addicted to whatever I could gets a hold of for over 15years, so to me it’s a Godsend to not feel like a slave to substances. The company used the buccal dosing as a selling point, but I am here to tell you, as suboxone is usually dissolved in under 7 minutes. Bunavail takes up to 20 minutes to dissolve, and it gets really gummy and will not stay stuck on your cheek. We place ours under our tongue, simply because if your swallowing any portion of Bunavail or Suboxone, your basically just wasting medicine that goes to your stomach unprocessed and you void it out with bowel movement. Bunavail doesn’t have that bitter orange taste like suboxone does. It also does not have a generic form. I will also give a little insight on Zubsolv, as we had to switch to it for a month, while it taste good with a cool mint flavor, these pills are TINY! While they are sublingual tablets, I still run into the mentality of an addict and one is never enough. I burnt through that months prescription in no time. So if you are like us and part of your addiction had you taking multiple pills to achieve your high, I would be honest with your Dr and have him switch you to the film of Bunavail. It took me a few months to get over the switch of suboxone for Bunavail, but now I am happy I stuck with it, because now I know longer have that addicts mindframe of “oh I gotta get my fix!”. Now if the company of Bunavail can come up with a cheaper film or an assistance program, those who do not have insurance Need help to obtain sobriety or pain management.

    Reply

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