Buprenorphine/Naloxone - Revision history

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:05Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

Maintenance script: Terminology: medicine → med (shorter form per user preference)

2026-05-16T02:42:47Z

Terminology: medicine → med (shorter form per user preference)

← Older revision		Revision as of 02:42, 16 May 2026
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	\| legal = Schedule III in US; X-waiver no longer required (as of 2023)		\| legal = Schedule III in US; X-waiver no longer required (as of 2023)
	\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.		\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.
	\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of ~~medicine~~-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.		\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of med-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.
	\| indications =		\| indications =
	\| dosing =		\| dosing =

Maintenance script: Terminology sweep (site-wide): drug/medication → medicine

2026-05-16T02:30:58Z

Terminology sweep (site-wide): drug/medication → medicine

← Older revision		Revision as of 02:30, 16 May 2026
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	\| legal = Schedule III in US; X-waiver no longer required (as of 2023)		\| legal = Schedule III in US; X-waiver no longer required (as of 2023)
	\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.		\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.
	\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of ~~medication~~-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.		\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of medicine-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.
	\| indications =		\| indications =
	\| dosing =		\| dosing =

MDElliottMD: Create Suboxone combo scaffold

2026-05-15T15:30:25Z

Create Suboxone combo scaffold

New page

{{MedTemplate
| generic = Buprenorphine / Naloxone
| brand = Suboxone, Zubsolv, Bunavail, Cassipa
| classes = Opioid agonist therapy (OAT); Partial μ-agonist + abuse-deterrent
| uses = <vote slug="oud-treatment-use">Opioid use disorder (OUD) maintenance</vote>, <vote slug="opioid-withdrawal-use">Opioid withdrawal</vote>
| starting_dose = Induction: 2/0.5 to 4/1 mg SL once in moderate withdrawal; titrate to 12–16/3–4 mg/d by day 2–3
| preparations = SL film or tablet, 2/0.5 to 12/3 mg per dose
| fda_max = 24/6 mg/d (most labels)
| routes = Sublingual film or tablet (buccal for some)
| onset = 30–60 min (SL)
| duration = 24–36 h (driven by buprenorphine)
| halflife = 24–42 h (buprenorphine); 1–2 h (naloxone)
| bioavailability = Buprenorphine ~30% SL; naloxone <10% SL (intentional — inactive sublingually, matters only if injected)
| pregnancy = Category C (buprenorphine-only formulations preferred in pregnancy)
| legal = Schedule III in US; X-waiver no longer required (as of 2023)
| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.
| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of medication-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.
| indications =
| dosing =
| effects =
| pk_absorption = Buprenorphine ~30% SL; naloxone negligible.
| pk_distribution = Buprenorphine ~96% protein binding.
| pk_metabolism = Buprenorphine: CYP3A4 → norbuprenorphine (active). Naloxone: hepatic glucuronidation.
| pk_elimination = Fecal (buprenorphine and metabolites); renal (naloxone glucuronide).
| pharmacodynamics =
| interactions = <pharmaInteractions/>
| pregnancy_details = Prefer buprenorphine monoproduct (Subutex) in pregnancy when possible — more pregnancy data.
| monitoring = Withdrawal scale (COWS) during induction; LFTs at baseline + periodically; toxicology screens per program.
| counseling = '''Precipitated withdrawal''': do not induct until in moderate withdrawal (COWS ≥ 8–12). Hold under tongue until fully dissolved — do not chew or swallow. Combine with counseling and recovery support.
| anecdotes =
| seealso = [[Buprenorphine]], [[Methadone]], [[Naltrexone]], [[Naloxone]]
| references = <references/>
}}

[[Category:Medicines]]

← Older revision		Revision as of 03:16, 19 May 2026
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	\| duration = 24–36 h (driven by buprenorphine)		\| duration = 24–36 h (driven by buprenorphine)
	\| halflife = 24–42 h (buprenorphine); 1–2 h (naloxone)		\| halflife = 24–42 h (buprenorphine); 1–2 h (naloxone)
	\| bioavailability = Buprenorphine ~30% SL; naloxone <10% SL (intentional — inactive sublingually, matters only if injected)		\| bioavailability = Buprenorphine ~30% SL; naloxone <10% SL (intentional, inactive sublingually, matters only if injected)
	\| pregnancy = Category C (buprenorphine-only formulations preferred in pregnancy)		\| pregnancy = Category C (buprenorphine-only formulations preferred in pregnancy)
	\| legal = Schedule III in US; X-waiver no longer required (as of 2023)		\| legal = Schedule III in US; X-waiver no longer required (as of 2023)
	\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent — inactive SL but precipitates withdrawal if injected.		\| mechanism = Buprenorphine: high-affinity partial agonist at the μ-opioid receptor with ceiling effect on respiratory depression. Naloxone: abuse-deterrent, inactive SL but precipitates withdrawal if injected.
	\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of med-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression — far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.		\| intro = Buprenorphine/naloxone (most widely known as Suboxone) is one of the two pillars of med-assisted treatment for opioid use disorder. The partial-agonist nature of buprenorphine gives it a ceiling effect on respiratory depression, far safer than full agonists like methadone. The naloxone is essentially inert SL; it exists as an injection deterrent. See [[Buprenorphine]] for the pharmacology of the active component.
	\| indications =		\| indications =
	\| dosing =		\| dosing =
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	\| pharmacodynamics =		\| pharmacodynamics =
	\| interactions = <pharmaInteractions/>		\| interactions = <pharmaInteractions/>
	\| pregnancy_details = Prefer buprenorphine monoproduct (Subutex) in pregnancy when possible — more pregnancy data.		\| pregnancy_details = Prefer buprenorphine monoproduct (Subutex) in pregnancy when possible, more pregnancy data.
	\| monitoring = Withdrawal scale (COWS) during induction; LFTs at baseline + periodically; toxicology screens per program.		\| monitoring = Withdrawal scale (COWS) during induction; LFTs at baseline + periodically; toxicology screens per program.
	\| counseling = '''Precipitated withdrawal''': do not induct until in moderate withdrawal (COWS ≥ 8–12). Hold under tongue until fully dissolved — do not chew or swallow. Combine with counseling and recovery support.		\| counseling = '''Precipitated withdrawal''': do not induct until in moderate withdrawal (COWS ≥ 8–12). Hold under tongue until fully dissolved, do not chew or swallow. Combine with counseling and recovery support.
	\| anecdotes =		\| anecdotes =
	\| seealso = [[Buprenorphine]], [[Methadone]], [[Naltrexone]], [[Naloxone]]		\| seealso = [[Buprenorphine]], [[Methadone]], [[Naltrexone]], [[Naloxone]]