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Probuphine Implant

Generic name: buprenorphine (implant) [ BUE-pre-NOR-feen ]
Brand name: Probuphine

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 26, 2024.

What is Probuphine?

Probuphine is an opioid medication. An opioid is sometimes called a narcotic.

Probuphine implants are used to treat narcotic addiction in certain people whose addiction has already been treated and controlled with other forms of buprenorphine (such as Subutex or Suboxone). Probuphine implants are for adults and teenagers who are at least 16 years old.

Probuphine implants are available only from a certified pharmacy under a special program. You must be registered in the program and understand the risks and benefits of using this medicine. The implants are not for use as a pain medication.

Warnings

Inserting and removing Probuphine implants can cause serious or life-threatening complications.

Talk with your doctor about the risks and benefits of using Probuphine. Read all patient information, medication guides, and instruction sheets provided to you.

Before taking this medicine

You should not use Probuphine implants if you are allergic to buprenorphine.

To make sure Probuphine is safe for you, tell your doctor if you have ever had::

If you use buprenorphine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on buprenorphine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Buprenorphine can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby. Ask your doctor about any risks.

Probuphine implants not approved for use by anyone younger than 16 years old.

How is Probuphine implant administered?

A Probuphine implant is a 1-inch rod that is inserted through a needle (under local anesthesia) into the skin of your inside upper arm. You will receive a total of 4 implants.

After the Probuphine implant is inserted, your arm will be covered with 2 bandages. Remove the top bandage after 24 hours, but leave the smaller bandage on for 3 to 5 days. Keep the area clean and dry. Apply an ice pack to the area every 2 hours during the first day, leaving the ice pack on for 40 minutes at a time.

For at least 1 week, check the incision area for warmth, redness, swelling, or other signs of infection.

Call your doctor at once if you notice any of the following symptoms after the implants are inserted:

Tell your doctor if you cannot feel the Probuphine implant under your skin. Your doctor may perform medical tests or refer you to a surgeon.

Probuphine implants can remain in place for up to 6 months and must be surgically removed. Do not attempt to remove the implants yourself.

If an implant comes out of your arm, keep it in a place where others cannot get to it. As soon as possible, return the implant to your doctor. MISUSE OF A PROBUPHINE IMPLANT CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the implant improperly or without a prescription. Selling or giving away a Probuphine implants is against the law.

Probuphine is only part of a complete treatment program that may also include counseling and other types of addiction support. Tell your doctor if the Probuphine implants are not helping to improve your symptoms of addiction.

Any medical care provider who treats you should know that you are being treated for opioid addiction and using buprenorphine. Make sure your family members know how to provide this information in case they need to speak for you during an emergency.

Dosing information

Usual Adult Dose for Opiate Dependence - Maintenance:

For use in opioid-tolerant patients who meet ALL of the following criteria:
-Achieved and sustained prolonged clinical stability on transmucosal buprenorphine as evidenced by a stable dose for 3 months or longer without any need for supplemental dosing or dose adjustments.
-Currently receiving buprenorphine maintenance (with or without naloxone) at doses of 8 mg/day or less, or equivalent transmucosal product (e.g. Bunavail buprenorphine 4.2 mg/naloxone 0.7 mg per day or less; or Zubsolv buprenorphine 5.7 mg/naloxone 1.4 mg per day or less)
-Patients should not be tapered to a lower dose for the sole purpose of transitioning to the implant.

Insert 1 dose subdermally in the inner side of the upper arm
-Remove at the end of the sixth month

Comments:
-Probuphine implant insertions and removals should be performed by certified healthcare providers.
-Each dose consists of 4 implants; each implant contains 74.2 mg of buprenorphine
-After 1 insertion in each arm, most patients should be transitioned back to transmucosal products for continued treatment as there is no experience with inserting additional implants into other sites in the arm or into a previously-used site.

Uses: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support. There is no maximum recommended duration for maintenance therapy as indefinite treatment may be required; when the decision is made to discontinue, doses should be tapered.

buprenorphine, naltrexone, Suboxone, Vivitrol, buprenorphine / naloxone, Subutex, Sublocade, Brixadi

What happens if I miss a dose?

As Probuphine implants are implanted under your skin, low-level doses of buprenorphine will be continuously delivered into your body for up to 6 months, it is unlikely you will miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of buprenorphine can be fatal.

Overdose symptoms may include severe drowsiness, pinpoint pupils, weak or shallow breathing, or loss of consciousness.

What should I avoid while using Probuphine?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or operating machinery until you know how buprenorphine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid using any opioid pain medicine without approval from your doctor. Opioid pain medicine will not work as well while you are using Probuphine. Talk with your doctor about other options for pain relief.

Probuphine side effects

Get emergency medical help if you have signs of an allergic reaction to Probuphine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Inserting or removing the Probuphine implant can cause serious or life-threatening complications, including damage to nerves or blood vessels. Ask your doctor about these risks.

Call your doctor at once if you have:

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common Probuphine side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Probuphine?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

This list is not complete. Other drugs may interact with buprenorphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Does Probuphine interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Alternatives to Probuphine

There are alternative drugs and different dosage forms available to treat opioid use disorder.

Talk with your healthcare provider which option would be best suited to you.

Buprenorphine

Buprenorphine and naloxone

Lofexidine

Methadone

Naltrexone

For opioid overdose in an emergency situation:

Naloxone

Other related medicines:

Buprenorphine for severe pain:

Popular FAQ

What are the different brands of buprenorphine?

It is available in a number of dosage forms under the brand names Sublocade, Brixadi, Probuphine (discontinued), Belbuca, Butrans, Buprenex, and Subutex (discontinued). Continue reading

Is Probuphine better than Sublocade?

Probuphine and Sublocade are long-acting forms of buprenorphine. There is no evidence that one is better than the other. They are both used in long-term medication-assisted treatment (MAT) for opioid use disorder (OUD). Continue reading

When was the Probuphine implant discontinued?

Probuphine implant was discontinued by Titan Pharmaceuticals in October 2020 and no generic is available in the US. In former studies, roughly two-thirds of patients treated with Probuphine had no evidence of illicit opioid use throughout the six months of treatment – similar to the number of those who responded to sublingual (under the tongue) buprenorphine alone. Continue reading

How long does opioid withdrawal last?

How long opioid withdrawal lasts depends on the opioid you have been taking and whether it is a short-acting or long acting opioid.

If you have been using a short-acting opioid, acute opioid withdrawal lasts 4 to 10 days, with withdrawal symptoms starting 8 to 24 hours after last use.

If you have been using a long-acting opioid, acute opioid withdrawal lasts 10 to 20 days, with withdrawal symptoms starting 12 to 48 hours after last use. Continue reading

How long does buprenorphine stay in your system?

After one sublingual (under the tongue) or buccal (in the cheek) dose, buprenorphine stays in your system for about 5 to 8 days if you are healthy or 7 to 12 days if you have liver disease. Continue reading

What is the difference between Sublocade and Brixadi?

Sublocade and Brixadi are both subcutaneous long-acting buprenorphine injections that may be used for the maintenance treatment of opioid misuse disorder in adults. Sublocade was approved on November 30, 2017, and Brixadi was approved on May 23, 2023. Sublocade is administered once a month, with a minimum of 26 days between doses. If extended travel is deemed necessary, a single 300mg injection may be given to cover 2 months. Brixadi is given once a week or once a month. Continue reading

What are the different types of buprenorphine/naloxone?

Buprenorphine and naloxone is a combination medicine used for the maintenance treatment of opioid dependence in adults. It is available in sublingual film and sublingual tablet dosage forms under the brand names Suboxone, Zubsolv, Bunavail (discontinued), and Cassipa (discontinued). Continue reading

More FAQ

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Probuphine only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.