Can you take Subutex with opioids in your system?

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 29, 2023.

Official Answer by Drugs.com

No, Subutex should not be initiated with opioids in your system.
Subutex needs to be initiated at least 6 to 12 hours, or longer, after the last dose of a short-acting opioid, such as heroin.
If taken too soon, Subutex could precipitate premature withdrawal symptoms, because Subutex will rapidly displace any opioid that is occupying a mu-opioid receptor.
The Subutex brand of buprenorphine has now been discontinued and in most cases, replaced by Suboxone.

Subutex is an oral sublingual medication that contained buprenorphine and was used to treat opioid addiction. Subutex was not approved to relieve pain. The Subutex brand of buprenorphine has now been discontinued.

Subutex was recommended to be initiated at least 6 to 12 hours after the last opioid use for short-acting opioids such as heroin, or when withdrawal symptoms started.

If Subutex was initiated too soon, it could precipitate premature withdrawal symptoms because it rapidly displaced any opioids that were already present on the mu-opioid receptor. Subutex when taken daily, blocked the effects of any opioids that people tried to take in addition to Subutex.

How did Subutex work?

Subutex contained buprenorphine which is a high-affinity partial agonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor.

Because buprenorphine is a high-affinity partial agonist, it attaches strongly to the mu-opioid receptor but has very low activity, which explains why it does not produce a “high” (euphoria) and has a low overdose risk.

This also explains why it displaces other opioids that are in the bloodstream at the same time, and also prevents other opioids from binding to the mu-opioid receptor if these are given after a dose of buprenorphine has been taken. Subutex “fooled” the brain into thinking opioids were already present in the body.

Subutex was usually started at a low dose and the dose titrated upwards if withdrawal symptoms were not adequately suppressed.

References

Subutex. The Recovery Village. https://www.floridarehab.com/treatment/medication-assisted-treatment/subutex/
Subutex (buprenorphine) Drugs.com

Why was Subutex discontinued?

Reckitt Benckiser Pharmaceuticals Inc., the manufacturer of Subutex, chose to discontinue the drug in the United States in 2011 after developing new formulations that were less likely to be abused. Subutex is still available in other parts of the world, and generic forms of sublingual buprenorphine are available in the United States. Continue reading

What happens if you swallow Subutex?

While swallowing Subutex (buprenorphine) is unlikely to be harmful, it will reduce how much medicine your body takes in and make the medicine much less effective. Continue reading

How long do you keep Subutex under your tongue?

Subutex should be kept under the tongue until it has completely dissolved (which takes 4 to 8 minutes on average). Do not swallow, chew, or move the tablet after it is placed under the tongue, as doing any of these makes the medicine less effective. Before taking Subutex, do NOT smoke, eat or drink for 15 minutes before putting the tablet under your tongue, and do not smoke, eat or drink for 15 minutes after putting it under your tongue.

Can you take Subutex with opioids in your system?

Related questions

How did Subutex work?

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Why was Subutex discontinued?

What happens if you swallow Subutex?

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