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If you have become dependent on opioid medications, a healthcare provider may prescribe Subutex. This narcotic works to help treat opioid dependence by affecting certain receptors in the central nervous system. This medicine comes in the form of a small tablet that is dissolved under the tongue once a day. Possible side effects may include headaches, nausea, and insomnia.

What Is Subutex?

Subutex® (sublingual buprenorphine) is an opioid narcotic used in the treatment of opioid dependence, which may include a dependence on opioid medications such as morphine or oxycodone. It comes in the form of a tablet that is dissolved under the tongue.
Not all healthcare providers can prescribe Subutex. In order for your healthcare provider to be able to prescribe this medication, he or she must take a special class and must have a special registration. Unlike most other medications used to treat opioid dependence, Subutex can be dispensed by pharmacies in an outpatient setting, rather than by special dependence clinics.
(Click Subutex Uses for more information on this topic, including possible off-label uses.)

Who Makes This Medication?

Subutex is manufactured by Reckitt Benckiser Pharmaceuticals, Inc.

How Does Subutex Work?

Subutex contains buprenorphine, an opioid narcotic medication. Buprenorphine binds to specific types of opioid receptors, called opioid mu-receptors, which are located throughout the body. While the main effects occur in the central nervous system, buprenorphine can produce effects anywhere opioid mu-receptors are found.
Buprenorphine does not work well when swallowed, as only a small amount of the medication is actually absorbed into the bloodstream, mainly because it is destroyed by the liver first. However, Subutex is dissolved under the tongue and is absorbed directly through the tissues, avoiding this "first-pass effect" of the liver.
Some of the effects of buprenorphine are desirable. Others are undesirable and cause the side effects associated with buprenorphine use, which may include but are not limited to:
  • Pain relief
  • Drowsiness
  • Changes in mood, including feelings of unease (dysphoria) or unusually pleasant feelings (euphoria)
  • Cough suppression
  • Slowed or shallow breathing
  • Slowing of the digestive tract
  • Physical dependence.
Interestingly, buprenorphine is a partial (not full) agonist of mu-receptors. This means that it binds to the receptors, but only partially activates them. This usually translates into less of a chance of abuse, although this is not always the case.
Compared to full agonists, such as morphine, partial agonists, including Subutex, usually have a "ceiling effect." This means that there is a certain dosage after which taking more of the drug does not cause any further effects. This might make Subutex less dangerous than full agonist drugs, particularly in the case of an overdose.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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