page_title: Buprenorphine/naloxone
section_title: Medical uses
hierarchical_section_title: Buprenorphine/naloxone / Medical uses
caption_attribution_description: English: Suboxone tablet - both sides.
context_page_description: Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a combination medication that includes buprenorphine and naloxone. In combination with counselling, it is used to treat opioid use disorder. It decreases withdrawal symptoms for about 24 hours. Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek.
  Side effects may include respiratory depression, small pupils, sleepiness, and low blood pressure. The risk of overdose is lower with buprenorphine/naloxone than with methadone. However, people are more likely to stop treatment on buprenorphine/naloxone than methadone. Methadone, or buprenorphine alone, are generally preferred when treatment is required during pregnancy.
  Buprenorphine, at lower doses, results in the usual opioid effects; however, high doses beyond a certain level do not result in greater effects. This is believed to result in a lower risk of overdose than some other opioids. Naloxone is an opioid antagonist that competes with and blocks the effect of other opioids if given by injection.
context_section_description: Buprenorphine/naloxone is used for the treatment of opioid use disorder. Long term outcomes are generally better with use of buprenorphine/naloxone than attempts at stopping opioid use altogether. This includes a lower risk of overdose with medication use. Due to the high binding affinity and low activation at the opioid receptor, cravings and withdrawal for opioids are decreased while preventing a person from getting high and relapsing on another opioid. The combination of the two medications is preferred over buprenorphine alone for maintenance treatment due to the presence of naloxone in the formulation, which helps function as an abuse deterrent, especially against intravenous use.
  Buprenorphine/naloxone has been found to be effective for treating opioid dependence, and serves as a recommended first line medication according to the U.S. National Institute on Drug Abuse. The medication is an effective maintenance therapy for opioid dependence and has generally similar efficacy to methadone, which are both substantially more effective than abstinence-based treatment.
  Because it may be prescribed out of an office setting (as opposed to methadone which requires specialized centers), buprenorphine/naloxone allows for more freedom of administration for the person. It also thus comes with more risks in this vulnerable population. Buprenorphine/naloxone may be recommended for socially stable opioid users who may not be able to retrieve medications from a center daily, who may have another condition requiring regular primary care visits, or who may have jobs or daily lives that require they maintain all their faculties and cannot take a sedating medication. Buprenorphine/naloxone is also recommended over methadone in people who may be at high risk of methadone toxicity, such as the elderly, those taking high doses of benzodiazepines or other sedating drugs, concomitant alcohol abusers, those with a lower level of opioid tolerance, and those at high risk of prolonged QT interval. It is also helpful to use the medication in combination with psychosocial support and counseling for the person.
caption: Sublingual tablets
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