Subutex is the brand name for buprenorphine without naloxone. For more information about Subutex, please click below on the link for buprenorphine.
The naloxone component of Suboxone is not absorbed in any significant amount into the body when the medication is taken as intended, which is sublingually (under the tongue). This is true for both the pill form and the film form. The naloxone exists to discourage the abuse of Suboxone because if the medication is crushed and snorted or liquified and injected, the naloxone component is active and will block all opioid receptors. This means the opioid component in Suboxone (i.e., buprenorphine) will also be blocked.
Due to this reason, the combination therapy (buprenorphine + naloxone) is the preferred treatment for opioid use disorder. However, there are times when buprenorphine monotherapy (i.e., Subutex) is appropriate. Two reasons for this are as follows:
1. During pregnancy: While there is no evidence that naloxone causes fetal harm, naloxone has not been studied extensively during pregnancy. Due to this reason, it is generally advised that patients who are pregnant switch to Subutex for the duration of the pregnancy.
2. Nalxone allergy: Patients with true allergy to naloxone, particularly with severe symptoms, are also often treated with Subutex to avoid the effects that would come from the use of Suboxone, which has naloxone in it.
There is no indication for use of Subutex during breastfeeding, and Suboxone is the indicated formulation to be used after delivery of the baby.