Temgesic (buprenorphine) not as good as Suboxone (buprenorphine) for withdrawals

[I_UseD]

I posted a question about Temgesic a few days ago; the thread was answered and closed so I apologize in advance if I am beating a dead horse. It has been confirmed that Temgesic is the brand name for 0.2 or 0.4mg pills of buprenorphine that exist mainly outside the United States. It was manufactured as an alternative for mild to moderate pain relief with a lesser chance of dependence/tolerance. Since then, it has been approved for use in opiate withdrawal/maintenance in higher dose forms (we know these as subtex and suboxone).

Theoretically, since Temgesic and Suboxone are both buprenophrine they should both be dose-effective in alleviating opiate withdrawal symptoms. The research I have done suggests otherwise; i.e. that 20x0.2mg pills of Temgesic is much less effective than 4mg of Suboxone. I have had little to no success finding actual research on this topic, just anecdotal evidence from individuals on various forums who have tried using Temgesic for opiate withdrawal with less success.

I am very curious if anyone has or knows anyone with personal experience in using Temgesic for opiate withdrawal. Is it actually less effective? If so why?

 

[Lopex]

Its the same stuff. My local pharmacy once ran out of the 0.4mg Subutex and gave me Temgesic instead. I asked my drugs councillor and he said that the pharmacist had broken rules but not to worry as its all the same!

 

[chicpoena]

Yup, the active ingredient in both is buprenorphine. The naloxone in suboxone is a psych-out to keep you from shooting it up.

 

[I_UseD]

good to know, perhaps the accounts I read of people not having much success using Temgesic were either using it incorrectly or are among individuals that have no success with bupe alltogether.

Thanks for the feedback

 

[triiper]

Yup, the active ingredient in both is buprenorphine. The naloxone in suboxone is a psych-out to keep you from shooting it up.

but actually does nothing except maybe prevent a rush. never tried subutex iv so i couldn't say if it has any effect at all.

 

[chicpoena]

but actually does nothing except maybe prevent a rush. never tried subutex iv so i couldn't say if it has any effect at all.

That's why I used the term "psych-out." They are tricking addicts into thinking that if they shoot up suboxone the naloxone will force them into withdrawal. Buprenorphine has a stronger affinity at the receptor site than naloxone, so it's pointless to even have it in combination form.

 

[smackem]

Yup, the active ingredient in both is buprenorphine. The naloxone in suboxone is a psych-out to keep you from shooting it up.

Even though I have read this a million times, and know it to be true from experince, i can't figure it out. Would they really compound a pill with naloxone for the simple reason of psyching out the opiate addicts? Make politicians happy? Make doctors more likely to RX? Who are we kidding here? I don't understand why its in there.

 

[I_UseD]

As a researcher its hard to believe that they would actually include naloxone to induce a placebo effect and scare people into not main-lining. They probably based the inclusion of naloxone in suboxone on 80% theory and 20% insufficient research, where they asked people who iv'd it if they precipitated withdrawal.

It is difficult if not impossible to "force" someone to use drugs for research purposes, let alone IV them (you cant ask someone to get addicted to opiates, then let themselves go into withdrawals and shoot up a beta drug all for the sake of research). Therefore when investigating the efficacy of suboxone, researchers have to base the data off information from existing addicts that agree to take part in the study. This limits the amount and quality of data one can receive since there are so many variables present.

Since most people on this forum claim that the naloxone is a complete useless addition even when shooting up, the drug company probably didn't spend enough time testing the theory, and just rushed the drug to market. That, or they knew it was useless bit wanted a reason to say "suboxone is better than subtex so buy form me!" Its all about the benjamins baby $$$$$$$$$$$$$$$$$$$$$

 

[jasoncrest]

A friend once told me that Temgesics were not as good, because to get 8mg, you had to put 40 x 0,2mg pills under your tongue, when it's only 1 pill with Subutex.

Eventhough the Temgesics are extremely small and Subutex kinda big, that's what makes the difference I believe.

(and BTW the generic Subutex that are ~5 times smaller than the brand work MUCH better: because of their smaller size, it makes more Buprenorphine that hits the sublingual mucosas at once, or the nasal ones for people snorting; that makes a stronger effect that hits quicker).

-

Besides that, Buprenorphine is Buprenorphine. There shouldn't be much of a difference except for the reason explained above.

(maybe it should also be noted that most people who try Temgesic in the US get it from overseas pharmacies, where it is widely available; maybe the quality of these indian or thai generics have something to do with efficacy too...)

---long time no posts... I'll come back for long one day, maybe in a few months---

 

[sp0r]

several misunderstandings

I saw a few things in the thread that I think I can answer. First off it was probably mentioned that temagesic is less likely to work than subutex just because of the dose.. When a medicine is dosed at .2mg it is meant to be taken at .2 and nothing higher. Subutex 8mg generic?? To my best knowledge there is no generic Subutex. It is still name brand and extremely expensive.
And it is not a legend that the naloxone is a scare tactic.. I have read in many scientific articles ((including the package insert)) that to start treatment the user is usually started on subutex then moved to suboxone to curb the act of IV misuse. For some reason it works too.. I know very few people to shoot suboxone while basically everyone I know that has subutex shoots it.
I asked my doctor to prescribe me subutex and he said no. I then told him I have migraines and the naloxone triggers them (it really does, or maybe its the die, flavor?), and he then prescribed me the subutex. It didnt take long until I started banging them every day (up until this morning) while the whole time on suboxone I never once attempted IV. These pharmaceutical companies have to go through YEARS of research before they are even allowed to let a drug on the market, and I do believe that reckit-bensicker (sp) did know what they were doing when prescribing SUBUTEX and SUBOXONE. Another thing, the subutex is about 50% more costly per pill than the suboxone. This could also be a way for the drug company to make more money when they need to. They will eventually state when suboxone goes generic, that the naloxone is inactive at the dose and that subutex is the prefered method. Clients are going to be forced to pay for the pricier pill while waiting for the subutex to go generic as well. Or vice versa Im sorry Im spun.
When my dr first said no to prescribing me subutex, his reasoning was "Subutex is purely an opiod analgesic, it is the suboxone that is going to curb your cravings for misusing your medicine, and getting high off of it. Dont forget you are on this medicine to STAY AWAY FROM DRUGS, not to get opiod effect from them".
Its a confusing matter, and if it is just a scare tactic to include naloxone, the company will never let us know. For now it is what it is.
I might actually ask to go BACK on suboxone because the IV use is destroying my body. And Im forgetting what I am using them for in the first place, just as my doctor originally predicted.....

sp0r
"We like to believe we know it all, but there is a reason that our doctor's and psychiatrists spend grueling hours in school and externships"

 

[LivingOnValium]

(and BTW the generic Subutex that are ~5 times smaller than the brand work MUCH better: because of their smaller size, it makes more Buprenorphine that hits the sublingual mucosas at once, or the nasal ones for people snorting; that makes a stronger effect that hits quicker).

-[/I]

Hey, this is great news! The generics would be much better for IV abuse because of less fillers and gunk in the tab.

Looking forward to see these in the future where i live. :D

 

[LivingOnValium]

Subutex 8mg generic?? To my best knowledge there is no generic Subutex. It is still name brand and extremely expensive.

I believe the generic is out now at least in France (where the brand name stuff originates). At least Schering Plough's patent on Subutex has outdated a few years ago. Generic Temgesics (Schering Plough prepares the originals) have been out at least a year now in Europe.

 

[bingey]

A friend once told me that Temgesics were not as good, because to get 8mg, you had to put 40 x 0,2mg pills under your tongue, when it's only 1 pill with Subutex.

exactly , absorption is probably hindered by the huge amount of filler , try not taking them at once .


p.s jcrest good to have you back

p.s in france there are arrow and merck generics (buprenorphine) and they are really tiny and don't have the additives that are in subutex , i can wait till they get something comparable over here!

 

[Spaazkaz]

awesome post sp0r, I agree.

Also I have read that the rush from suboxone is unlike and inferior to the rush from subutex from numerous people. Maybe the naloxone doesn't prevent IV abuse, but I do believe it greatly hinders it.

-Spaz-

 

[I_UseD]

I wanted to follow up on my post now that I have actually taken Temgesic. It is exactly the same as suboxone, minus that yummy orange flavor The note that Sp0r made about the inactive ingredients in the pill hindering the absorption of the bupe is most likely why some individuals find Temgesics to be less effective.

While I have made this point several times on other threads I must reiterate that less is more when it comes to bupe. Perhaps this is somewhat subjective and different for every individual, but I am able to fend off withdrawal with a MAXIMUM of 2mg, and able to quickly taper down to less than 1mg within a week. With that, the most 0.2mg Temgesics I ever took in a day was 10, and since I spaced dosing out (5 in the am 5 in the pm) i ran into no absorption issues.

I will say that comparing my Temgesic experience with my Suboxone experience, I noticed a but more of an antidepressant effect with the suboxone. It is my opinion however that this was because i was taking more suboxone than I really needed (4mg per day). I always try to take as little as possible for as short of a time as possible when it comes to bupe...because i take it in order to stop taking pills all together, and bupe withdrawal is crap.

 

[ingannilo]

With so many temgesic pills, it must take much longer (more than one round) to get everything dissolved and absorbed. Thus, a greater percent of the buprenorphine/saliva mix would be swallowed rather than absorbed under the tongue.

Hard to quantify, but I bet that's the culprit.

 

[johanneschimpo]

When my dr first said no to prescribing me subutex, his reasoning was "Subutex is purely an opiod analgesic, it is the suboxone that is going to curb your cravings for misusing your medicine, and getting high off of it. Dont forget you are on this medicine to STAY AWAY FROM DRUGS, not to get opiod effect from them".
Its a confusing matter, and if it is just a scare tactic to include naloxone, the company will never let us know. For now it is what it is.
I might actually ask to go BACK on suboxone because the IV use is destroying my body. And Im forgetting what I am using them for in the first place, just as my doctor originally predicted.....

Your doctor is wrong. Subutex and suboxone have the same effect in curbing cravings and/or maintenance. Any difference is placebo. Also, suboxone can be shot, so if you switch back to suboxone and start shooting those, its just going to be worst for your veins in the long run.

 

[Captain.Heroin]

The Truth behind Naloxone in Suboxone

Yup, the active ingredient in both is buprenorphine. The naloxone in suboxone is a psych-out to keep you from shooting it up.

But you still can, bupe is more affinitive towards the receptors than naloxone is at the levels it's in the pill.

That's why I used the term "psych-out." They are tricking addicts into thinking that if they shoot up suboxone the naloxone will force them into withdrawal. Buprenorphine has a stronger affinity at the receptor site than naloxone, so it's pointless to even have it in combination form.

Yee speaketh the truth! %)

Just how deep do you believe?

When you BITE THE HAND THAT FEEDS...
will you chew until it bleeds?
can you get up off your knees?
are you brave enough to see?

Do you want to change it?

Even though I have read this a million times, and know it to be true from experince, i can't figure it out. Would they really compound a pill with naloxone for the simple reason of psyching out the opiate addicts? Make politicians happy? Make doctors more likely to RX? Who are we kidding here? I don't understand why its in there.

From my understanding, it's to make the class of drugs different.

The difference between CII and CIII is an added active ingredient that prevents abuse...like APAP or naloxone...but this is something someone will have to concur with me on here.

Your doctor is wrong. Subutex and suboxone have the same effect in curbing cravings and/or maintenance. Any difference is placebo. Also, suboxone can be shot, so if you switch back to suboxone and start shooting those, its just going to be worst for your veins in the long run.

Can you explain why shooting suboxone is worse than street grade dope?

This is where all rational explanations end.