Bupe Subutex / Buprenorphine = conversion ratio

[45acp]

I am thinking of trying the Subutex for pain management. I have used prescription buprenorphine in both transdermal U.S. dosing maximum 20 mcg patch as well as buccal form I believe 360 mcg 2/day. Trying to understand what an equivalent in Subutex will look like?

I understand Sub is a sublingual lozenge typically in the 2mg – 8 mg range with a equivelent subutex to bupprenorphine ratio of 1 mg = 1 mg. However, that doesn’t help me figure understand how many mg of bupe converts into the extended-release dosing I was accustomed to.

Can someone offer some guidance on dosing? My understanding is these lozenges in general are very potent and there is a real risk of overdose despite the fact bupe is partial opioid agonist. If some has any input on my using the subutex sublingual, I would appreciate it . Also I know about suboxone not really looking at that from what I understand its a way to increase the efficacny of the bupe while minimizing tolerance whether it works or not I think is up for debate never the less just looking at subutex to keep it simple.

 

[DeathIndustrial88]

I'm not very good with math, but whatever dose was working for you before, you will want to stick with that dose. I assume those patches probably released anywhere from 2-7 micrograms every few hours, maybe more. Bupe is very potent and generally used only in the microgram dosage range for pain. Except you may need to redose every 4-6 hours, similar to how your patch would be releasing the next dose after a specific time. Bupe has a long half life & technically is "extended release" in any of it's forms, but unfortunately the pain relief from it does not last the entire duration that it is in your body, which is why you may need a dosage schedule.

The higher dosages of 2mg (Suboxone / Subutex) and up are used for opioid maintenance, because it keeps your receptors saturated, blocks other opioids and you reach a ceiling effect in these high doses where it no longer gives a "buzz". For pain management, it is best to stick to microgram doses or doses under 2mg every 4-6hours. So you will have to find a way and eyeball it or use some kind of measuring tool to measure out your doses so that they're accurate.

Fatal overdose is very rare with bupe (not impossible tho), but if you were to take an entire 8mg with no tolerance and you want pain relief, you'd probably be uncomfortably high for a few days (a non-fatal OD if you will) but then you'd be tolerant to that dose and quickly reach the ceiling effect after dosing a few more times, which would mean you would eventually stop getting any pain relief at all, even if you raised your dose. These dosages are for people who have incredibly high tolerances to heroin, fent and other potent opiods.

Not sure what you were saying about Suboxone. The naloxone in Suboxone is pretty much useless because bupe will compete with it at the receptor and always win. So essentially Suboxone and Subutex are the same thing, except one has a drug in it that is pointless to be putting in your body (but that's lovely big pharma for you), but my personal experience is that both versions do the same & feel the same.

Maybe some one can jump in and figure out the math and how many micrograms those patches were releasing, but I feel everything else I just mentioned is important to know if your'e going to utilize buprenorphine for pain, especially if it's in the maintenance forms (Subutex / Suboxone).

 

[45acp]

I'm not very good with math, but whatever dose was working for you before, you will want to stick with that dose. I assume those patches probably released anywhere from 2-7 micrograms every few hours, maybe more. Bupe is very potent and generally used only in the microgram dosage range for pain. Except you may need to redose every 4-6 hours, similar to how your patch would be releasing the next dose after a specific time. Bupe has a long half life & technically is "extended release" in any of it's forms, but unfortunately the pain relief from it does not last the entire duration that it is in your body, which is why you may need a dosage schedule.

The higher dosages of 2mg (Suboxone / Subutex) and up are used for opioid maintenance, because it keeps your receptors saturated, blocks other opioids and you reach a ceiling effect in these high doses where it no longer gives a "buzz". For pain management, it is best to stick to microgram doses or doses under 2mg every 4-6hours. So you will have to find a way and eyeball it or use some kind of measuring tool to measure out your doses so that they're accurate.

Fatal overdose is very rare with bupe (not impossible tho), but if you were to take an entire 8mg with no tolerance and you want pain relief, you'd probably be uncomfortably high for a few days (a non-fatal OD if you will) but then you'd be tolerant to that dose and quickly reach the ceiling effect after dosing a few more times, which would mean you would eventually stop getting any pain relief at all, even if you raised your dose. These dosages are for people who have incredibly high tolerances to heroin, fent and other potent opiods.

Not sure what you were saying about Suboxone. The naloxone in Suboxone is pretty much useless because bupe will compete with it at the receptor and always win. So essentially Suboxone and Subutex are the same thing, except one has a drug in it that is pointless to be putting in your body (but that's lovely big pharma for you), but my personal experience is that both versions do the same & feel the same.

Maybe some one can jump in and figure out the math and how many micrograms those patches were releasing, but I feel everything else I just mentioned is important to know if your'e going to utilize buprenorphine for pain, especially if it's in the maintenance forms (Subutex / Suboxone).

This is good information thanks. One thing you mentioned - "it is best to stick to microgram doses or doses under 2mg every 4-6hours." - did you mean micrograms?

 

[LivingOnValium]

With 20mcg/h patch you get 480 micrograms on 24 hours. So that is 0,48mg buprenorphine per day you're getting from the patch alone. If you use you're buccal formulation twice that is 0,72mg/Day.

So you're using total of 1,2mg buprenorphine per day.

Taking 2mg suboxone in single dose is a quite a bit more than what you're used to. You should catch a nod If toi decide to take that. And If you aren't nodding it will be at least nice buzz.

 

[45acp]

Ok thank. I am not in it for the nod I am thinking of using it for pain mangement just need to take the edge off so i can get thru the day. the 20 mcg patches I used were not terrivble effective they were dose dumping so I really could not guage. The belcucca were the 360 mcg 2x day now that I think about it and it was effective if you can stand the side effects. I have never seen the suboxone strips but I assume I can cut them down somehow I will need to experiment.

 

[LivingOnValium]

Suboxone strips are easy to cut down to even peaces.

 

[DeathIndustrial88]

This is good information thanks. One thing you mentioned - "it is best to stick to microgram doses or doses under 2mg every 4-6hours." - did you mean micrograms?

Yes I did mean micrograms.

For pain management, it's better to stick to sub-milligram dosaging.

Taking 2mg all at once for instance, would probably have you really high and nodding. Not only that, but even though buprenorphine stays in your body a long time, it only provides pain relief for the first 4-6hours. So by taking 2mg every 4-6hrs, you are going to reach the ceiling dose much faster (the ceiling dose is generally variable depending on the person & most agree that it is lower than the literature says it is) and once you are there you will not be able to increase your dose to get more effects and you will become tolerant to the ceiling dose, which means buprenorphine will become ineffective at managing your pain. This 'ceiling' that buprenorphine has, is why it's used so liberally to treat opioid addicts, because bupe is very limiting on how much it can agonize receptors.

So yes, when I say microgram dosages, I do mean dosages under a half a milligram.

LivingOnValium did the math and says you would have been using 1.2mg a day. So you would want divide that by maybe 3-4 daily doses to treat pain, which I'm sure is gonna be a bit of a pain since it's such incredibly small doses.