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Bupe Suboxone/Buprenorphine Mega Thread and FAQ v17.0 + v18.0

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Mr.Scagnattie

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Feb 3, 2004
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What: Suboxone = buprenorphine/naloxone. Bupe is a partial agonist(mu) and antagonist(kappa). Bupe has higher mu affinity that most opiates, including some antagonists(naloxone, naltrexone). Its higher affinity allows you to shoot suboxone tablets. It also may cause precipitated withdrawals if you are dependant on other opiates. Also, its higher affinity blocks the affects of other opiates when taken in conjunction with bupe.

Dose: Depends on tolerance. .25-1mg(max) is a typical recreational dose for someone with no tolerance. Bupe is incredibly potent and those with no tolerance report many ill effects like vomiting, sweating, headaches, etc, if exceeding those doses. If you're using bupe to taper off of another opiate, you should dose once you're experiencing wd's(typically 36-48 hrs. for most opiates). Start with 2-4mgs and dose at 2mg increments every 30-45minutes until a dose holds you. Most people take their full dose once a day.

Withdrawal: Typical physical and psychological symptoms associated with opiate withdrawal. Insomnia, chills, diarrhea, depression, anxiety, lacrimation, sweating, increased heart rate, etc. They are not as strong as a full agonist's symptoms, but may last longer. Physical symptoms last 1-2 weeks on average and psychological symptoms may last months.

As most opiates, it's recommended to taper down to the lowest dose possible before stopping. <1mg is ideal. The best way to dose at that level is to crush up a tablet and divide the powder into lower doses.

Ceiling: 24-32mgs

Bioavailability: Buprenorphine bioavailabilities:

intraduodenal: 9.7%

intrahepatoportal: 49%

intramuscular: 68%
"The observed mean intramuscular bioavailability was 68%"
"Studies of buprenorphine bioavailability have also examined the intramuscular (bioavailability, 50%–100%)"


intranasal: 50%
"Studies of buprenorphine bioavailability have also examined the [...] intranasal (bioavailability, 48%)
"The bioavailability of buprenorphine, HCl (BPP) in sheep after nasal administration of two formulations has been studied. 0.9 mg BPP in 150 microl was administered nasally and compared to 0.6 mg i.v. The test solutions were formulated with 30% polyethylene glycol 300 (PEG 300) and 5% dextrose, respectively. The bioavailability for PEG 300 was 70% (S.D.+/-27%, n=6), whereas the bioavailability for 5% dextrose was 89% (S.D.+/-23%, n=6)."
"Mean intranasal bioavailability was 48.2 +/- 8.35% (mean +/- s.e.m.) of the intravenous value"


intrarectal: 54%
"bioavailability of the drug was found to be: [... ]intrarectal (54%)..."
"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] intrarectal, 54%..."

intravenous: 98%-100%

oral: 10%
"the oral bioavailability for buprenorphine is state to be 10%"
"due to extensive first-pass metabolism, buprenorphine has very poor oral bioavailability (10% of the intravenous route) if swallowed"


sublingual: ~30%
"Buprenorphine is well absorbed sublingually, with 60% to 70% of the bioavailability of intravenous doses"
"Study results indicate that bioavailability of sublingual buprenorphine is approximately 30%"
"Literature on bioavailability of sublingual buprenorphine presents variable numbers ranging from. 19–58% of the administered dose."

"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] sublingual, 13%"

transdermal: 15%



Other Notes:

  • Bupe is CIII in the US.
  • Metabolized by CYP3A4(see potentiation thread for potentiators).
  • Half-life: 37 hours.
  • Drug tests: Not detected by regular 5 panel tests.
  • A interesting thread by 'medicine cabinet' about a new version of Suboxone that's currently being tested can be found here.
  • Buprenorphine gets metabolized into norbuprenorphine and into conjugated buprenorphine and norbuprenorphine.

Images:
p05331b1.jpg

Subutex

p05331a6.jpg

Suboxone

Buprenorphine4%28a%29.preview.jpg

Generic Subutex Manufacturer: Roxane

bupr5378.jpg
bupr5379.jpg

Generic 2mg Manufacturer: Teva | Generic 8mg Manufacturer: Teva

sub01-0005-11.jpg

12mg Suboxone Film Strip

RBK12080.JPG

8mg Suboxone Film Strip

RBK12020.JPG

2mg Suboxone Film Strip

bupe_tablets.jpg

Temgesic, 0.2mg

16buprenex.jpg

Buprenex Ampules

zubsolv_r_411626.jpg

Zubsolv 1.4mg/.36mg and 5.7mg/1.4mg

zubsolv-vs-suboxone-g.png

Zubsolv vs Suboxone Comparison

Locate a doctor that prescribes Suboxone.

Suboxone Assistance Program - Free Suboxone for Low Income Patients

[/QUOTE]

Alcohol and Suboxone - Alcoholic Solutions for Higher BA With Sublingual Use**
Buprenex - should I IM or IV?
Buprenorphine and Antihistamine IV FAQ
Buprenorphine as a recreational drug?
Buprenorphine dosages commonly prescribed are unnecessarily high
Buprenorphine for depression?
Buprenorphine patches
Buprenorphine withdrawals?
Ketoconazole Potenation of Suboxone
Mephedrone and Buprenorphine
Micron Filtering Mega Thread and FAQ - How to Micron Filter Suboxone
Nasal Administration of Suboxone - Issues
Rectal (Plugging) Buprenorphine
Suboxone in place of Naloxone in the event of an opiate overdose*
Suboxone sublingual film official thread
Subutex has gone generic
Tramadol and Suboxone

Discussion in the Suboxone mega thread goes along quite quickly, so we have a few other threads to promote intermediate/advanced discussion of buprenorphine and its formulations. These threads are meant to divert some of the more advanced discussion that otherwise becomes buried in the mega thread.

If there's another link you think which would go well in this list of related buprenorphine threads, please let me know. We're trying to reserve extra threads on buprenorphine for more intermediary/advanced discussion mostly to reserve the mega thread for a place for questions that can be answered quickly, and the other threads for a place for questions which will otherwise not get the same discussion going on in the mega thread, due to its quick pace.

If you have an idea for a new thread on buprenorphine, it's probably best to figure out by talking to a moderator first to see if it's thread worthy or should be discussed in the mega thread.

*Not Advised. Opiate antagonists are the only safe thing to do in case of an opiate overdose. Please do not give people Suboxone if they have overdosed.
**also known as "6/7's method" or "SixPartSeven's method"
 
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Rtrain: in reply to your post on ver. 16, Zubsolv does kick in quicker, especially when snorted. If I snort my zubsolv it kicks in within 5 mins. It's incredible, I don't know how or why, but they are truly superior in every way. Best decision I've made since I started treatment. Tastes better, dissolves better (5 mins instead of 15), easily snortable and breaks down very easily...

Also, Mr.Scagnattie: you might want to include the image for Zubsolv since it's a new form of Bupe/Naloxone tablet that's starting to get prescribed a lot more now...
Here are pics of the two different strengths:
ORX09140.JPG

ORX09570.JPG
 
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I was just looking at the "other notes" section regarding the new suboxone pill, that would be the zubsolv =] guess it took a while for them to get their "new higher BA formula" patented and released... Worth the wait IMO, Zubsolv is superior.
 
Oh right, I was wondering what the hell this Zubsolv was - I'd never heard of it until today...it sounds kind of Russian. So, it's a bupe/naloxone formulation with a higher BA? Sounds interesting. Is it made by the same company that makes suboxone? If so, I'm hoping the pill makes it's way to the UK. (Suboxone and whoever make it have a monopoly on buprenorphine over here).

Edit: just read the Sub and Tramadol thread at the top. It's a combo I've been using for a fair while now. When I reduced my bupe dose to levels low enough to make me as sick as a dog, the tramadol eliminated that completely, and got me high as a kite as well. I couldn't believe there was an opiate that'd work with bupe, although it's an "atypical" opiate.
 
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^^

No it is a different company than the one that makes suboxone. Zubsolv comes from Orexo Pharmaceuticals, a Swedish based company, while Suboxone is made by Reckitt Benckiser, who are UK. They are in competition with each other.
 
It's made by orexo which is a Swedish pharmaceutical company. It is available in the EU, though I'm not sure of specific countries. It is just like suboxone in that it contains bupe and naloxone, though that's the only similarity. Here's what sets zubsolv apart from suboxone in my experience:
- it dissolves so much faster, night and day difference
- it tastes so much better, I much prefer the menthol over the nasty orange taste
- suboxone made my mouth numb and killed my taste buds for about 1-2 hours, zubsolv doesn't make me numb, and the taste is gone within a minute max. (Subs also gave me headaches, I have yet to get any on my Zubsolv)
- it seems to kick in faster than subs do, ESPECIALLY if you snort it.
- oh yeah, it breaks up as easily as roxicodone tablets do!
- I don't know of this next bit is a pro or a con to you guys (it's a plus in my book), but I get quite a pleasant buzz off of my zubsolv, subs only made me feel normal, zubsolv does that and then some, especially if I snort it.
 
^^

No it is a different company than the one that makes suboxone. Zubsolv comes from Orexo Pharmaceuticals, a Swedish based company, while Suboxone is made by Reckitt Benckiser, who are UK. They are in competition with each other.


Yeah, these pharmaceutical companies are seriously competitive, and Suboxone has complete dominance here; even subutex is a rarity. It's a real shame, too - apparently this product tastes better, dissolves faster, and has a higher BA, according to PKPro; it sounds like a superior product to me.
 
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^^^

Well it's very new. It just got FDA approval this past year. So, we'll see what happens in time, if maybe it ends up overcoming suboxone as the go-to brand for bupe therapy.
 
I'd certainly like to see Reckitt and Benckiser lose most of their profit on buprenorphine. They did some outrageously shady shit trying to keep their patent. Fortunately the FDA saw through their bullshit.
I think everyone should switch over to Zubsolv just out of principal...plus it sounds like they make a better product to boot!
 
good Zubsolv info up there.

I'd like to make the change from my regular Subs but dont want my Dr. thinking I am looking up drugs or thinking of new ways. My sub. has done nothing but great things but if Zubsolv taste better, melt faster, and are somehow stronger, then by all means give me the Zubsolv.
 
good Zubsolv info up there.

I'd like to make the change from my regular Subs but dont want my Dr. thinking I am looking up drugs or thinking of new ways. My sub. has done nothing but great things but if Zubsolv taste better, melt faster, and are somehow stronger, then by all means give me the Zubsolv.

I don't see why he'd think negative of you wanting to be on zubsolv, it's not like you're looking to get high. It's the same meds in suboxone, just a better formulation. If you lay out the pros to why you think Zubsolv is better, he should consider it.
 
I don't see why he'd think negative of you wanting to be on zubsolv, it's not like you're looking to get high. It's the same meds in suboxone, just a better formulation. If you lay out the pros to why you think Zubsolv is better, he should consider it.

I agree with ^this. I mean does the Dr expect you to live inside a box of ignorance regarding the medications/treatments for your condition? I wouldn't think so.

On a side note, one question I have regarding switching to Zubsolv, or being placed on it instead of Suboxone, is insurance co.'s paying for it. To insurance companies it is basically the same medication, to treat the same "disease". If its more expensive it might be something a lot of insurances will not cover because as far as they are concerned you can just take the cheaper Suboxone. For instance, I take a beta blocker (Nebivolol) and one of my recent insurer's wouldn't pay for it because it wasn't generic or offered in generic, but there are "alternatives" (Atenolol or Metoprolol) to it that treat the same condition which are much cheaper. So to the insurance company I did not require this medication because a much cheaper alternative existed for me to use, even though they are not the same medications, just both beta blockers designed specifically for hypertension. In the case of Suboxone to Zubsolv its not even different active ingredients, so its hard to argue an insurance company should cover the more expensive option.
 
Best of all, Orexo is trying to competitively push their product so patients choose it over RBs Suboxone. zubsolv has a card like the one for suboxone which lowers the price at the pharmacy, and best of all, unlike for subs you can use your zubsolv card multiple times (5-6 I believe) which in the end saves you more money... Not to mention zubsolv is also cheaper altogether than suboxone is! Pay less and get a better tasting, acting, dissolving, stronger med? Yes please I said!
 
They have the same active ingredients: buprenorphine and naloxone.
 
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