What you’ll learn
This guide explains the key differences between Suboxone® and Subutex®, when switching medications might be appropriate, and what to expect during the transition. You’ll learn about naloxone’s role in Suboxone®, why the pregnancy safety myth has been debunked, and QuickMD’s approach to prescribing these medications.
You’re on Suboxone® for opioid use disorder, but you keep hearing about Subutex®. Maybe you’ve come across people online who swear one works better than the other. Now you’re wondering: should you make the switch from Suboxone® to Subutex® to better manage opioid withdrawal?
It’s a question that comes up more often than you might think. Both medications contain the exact same active ingredient, buprenorphine, yet some people report feeling completely different on one versus the other. Others notice no difference whatsoever.
We’ve walked thousands of our patients through Medication-Assisted Treatment (MAT) and helped them find what works best for them. Over the years, we’ve seen how medications used in MAT can be the difference between someone just getting by and actually thriving in their recovery from opioids. We’ve also learned that what works perfectly for one person might not be ideal for another. That’s completely normal.
The thing is, switching medications isn’t something you should figure out on your own. There are important considerations about ingredients, timing, and necessary dose adjustments that can make all the difference in how this transition goes.
Let’s break down what you need to know about these two medications, when switching might make sense, and what to expect if you and your provider decide to make a change.
Suboxone® vs. Subutex®: what’s the difference?
The only difference between Suboxone® and Subutex® is that Suboxone® includes naloxone while Subutex® contains only buprenorphine.
Both medications work the same way in your body. Buprenorphine, the active ingredient in both, attaches to opioid receptors in your brain but only partially activates them.
This is what helps reduce withdrawal symptoms and cravings without giving you the high that comes with other opioids.
- Suboxone® combines buprenorphine with naloxone, an opioid antagonist. The naloxone is mainly a deterrent. If someone tries to inject Suboxone®, the naloxone blocks opioid-like effects. It can also reverse opioid overdoses (you might know naloxone by its brand name, Narcan®). That means Suboxone® is much less likely to be misused compared to Subutex® because of the presence of naloxone.
- Subutex® is just buprenorphine on its own. Interestingly, it was the first of these medications to get approved anywhere. It happened in France back in 1995 during the AIDS crisis, when officials were looking for safer ways to help people with opioid addiction avoid HIV infections. The U.S. approved both Subutex® and Suboxone® at the same time in 2002. While the brand-name Subutex® was discontinued in 2011, generic buprenorphine tablets are still available and work the same way.
Both have the same ceiling effect, meaning there’s a limit to how much they can slow down your breathing, making them much safer than drugs like heroin or prescription painkillers.
For more comparisons of these medications, check out our guide on Suboxone® vs. Subutex®.
Naloxone in Suboxone®
When you take Suboxone® as prescribed (under your tongue), the naloxone barely gets absorbed and won’t interfere with your treatment.
Some people worry it might cause problems, but when taken correctly, most patients don’t notice any difference between Suboxone® and Subutex®.
So, when might switching actually make sense? There are a few specific situations where it could be worth considering.
When switching from Suboxone® to Subutex® might make sense
While both medications are effective treatment options for opioid dependence and serve as maintenance medication, there are specific situations where patients and providers might consider switching from Suboxone® to Subutex®.
- You’re having side effects you think are from naloxone: Headaches, nausea, trouble sleeping, or just feeling “off” in a way that seems connected to Suboxone®.
- You simply feel different on one versus the other: This happens more than you’d think. Some people just feel better on Subutex®. For now, we don’t fully understand why individual responses can vary so much.
- You’re also managing chronic pain: A few providers prefer prescribing just buprenorphine (Subutex®) for people dealing with both addiction and pain, thinking naloxone might interfere.
The pregnancy question: what research actually shows about taking Suboxone® and Subutex®
One of the most persistent myths in buprenorphine treatment is that Subutex® is safer than Suboxone® for pregnant women.
Let’s look at what current research actually shows.
Historical recommendations vs. current evidence
When these medications first came out, doctors weren’t sure about naloxone during pregnancy. Since there wasn’t much research on it yet, they figured it was safer to stick with Subutex®, which only has buprenorphine.
That made sense at the time. But it also created this idea that Subutex® was automatically the better choice for pregnant women.
Recent research has largely debunked this myth:
- Studies comparing pregnant women on both medications found no differences in outcomes for mothers or babies.
- Studies have shown that naloxone exposure during pregnancy, when Suboxone® is taken as prescribed, appears to be minimal due to poor oral absorption.
- The American College of Obstetricians and Gynecologists now states that both medications are fine to take during pregnancy.
- Whether researchers looked at birth weight, pregnancy duration, or newborn withdrawal symptoms, basically everything they could measure, the outcomes were the same.
What does this mean for you?
Are you pregnant and doing well on Suboxone®? Most doctors will tell you to stick with what’s working. Staying stable on a medication that’s already helping you is usually more important than worrying about the tiny amount of naloxone.
If you’re thinking about getting pregnant and you’re stable on Suboxone®, it’s worth talking to your provider about whether switching makes sense for your situation. But don’t assume you need to.
What to expect when going from Suboxone® to Subutex®
If you and your provider decide that switching from Suboxone® to Subutex® is the right move, here’s what the process typically involves.
The transition process from Suboxone® to Subutex®
Most of the time, you can switch at the exact same dose. Since both medications have the same amount of buprenorphine, it’s usually pretty straightforward.
For example, if you’re taking an 8mg Suboxone® dose, you’d typically switch to 8mg of Subutex®.
Monitoring period
Your provider will want to check in with you more often during the first few weeks. This is to make sure you’re doing okay on the new medication.
Potential adjustment period
Some people notice they feel a bit different for a few days or weeks after switching, even though the buprenorphine amount is the same. This is normal and usually settles down pretty quickly.
What might need adjusting
- Dose modifications: While most people do fine with the same dose, some need small adjustments based on how they respond to Subutex®.
- Treatment schedule: Switching medications doesn’t change your addiction treatment plan. You’ll keep the same schedule for visits, counseling, and any other support you’re getting.
- How you feel: Some people notice they feel slightly different for a few days or weeks after switching, even though it’s the same amount of buprenorphine.
What about switching from Subutex® to Suboxone®?
If you’re currently on Subutex® and considering switching to Suboxone®, the process is just as straightforward, and maybe even more common.
Some patients switched from Subutex® to Suboxone® because they experienced specific benefits:
- They want the extra safety feature: the naloxone in Suboxone® provides peace of mind against misuse.
- Their provider recommends it: some treatment programs prefer Suboxone® as the standard approach.
The switch works the same way: same dose, same monitoring, same adjustment period if you feel different for a few days.
But since you’re adding naloxone rather than removing it, most people don’t notice any change in how they feel.
Will QuickMD prescribe Subutex® for opioid addiction?
Most of the time, no. QuickMD providers will only prescribe Subutex® if you have a documented allergy to naloxone, and you’ll need medical records showing that allergy.
Our approach to prescribing buprenorphine
Suboxone® has been proven safe and effective for treating opioid use disorder. When taken as prescribed, the naloxone is poorly absorbed and doesn’t interfere with your treatment.
Actual documented medical allergies to naloxone are rare.
Open communication about your concerns
Considering switching to Subutex®? Have an honest conversation with your QuickMD provider about why you’re interested in the change.
Are you experiencing side effects you believe are related to naloxone? Do you have documented allergy concerns? Understanding your specific reasons for using opioid medications helps guide our discussion.
When we might consider Subutex®
The main reason QuickMD providers would prescribe Subutex® is if you have:
- A documented allergy to naloxone
- Medical records that show this allergy
- Documentation you can share with your provider
Exploring alternatives first
A lot of times, what feels like a reaction to naloxone can actually be fixed in other ways.
Before jumping to a medication switch, your QuickMD provider will want to understand several things:
- How long you’ve been on treatment
- How stable you are on your current medication
- What side effects you’re having and when they happen
- Whether adjusting your dose might help
- What you’re hoping to get out of your treatment
We’re always here to talk through what’s bothering you. Maybe simply tweaking your current Suboxone® treatment might solve the problem.
Our telemedicine platform makes it easy to have these conversations from home and work together on finding the right approach for your specific situation.
Safety considerations for addiction treatment
If you do switch to Subutex®, there are a few safety aspects worth thinking about.
- Misuse risk: Since Subutex® doesn’t have the naloxone safety feature, if you’ve struggled with injection drug use before, your provider will want to make sure you have solid support in place.
- More check-ins: Your QuickMD provider will probably want to see you more often when you first switch to Subutex®, just to make sure everything’s going smoothly.
- Emergency situations: Whether you’re on Suboxone® or Subutex®, always tell emergency room doctors or paramedics that you’re taking buprenorphine. It can affect how they manage pain if something happens.
Making the right choice for your recovery from opioid use disorder
Switching from Suboxone® to Subutex® isn’t necessary for everyone, but it can be the right choice for some patients. The decision should be based on your individual response to medication, any adverse effects you’re experiencing, and your specific treatment goals.
Both medications work well for treating opioid addiction. What matters most is finding the one that helps you treat addiction effectively and supports where you want to go in your recovery.
If something doesn’t feel right with your current medication, or if you’re just curious about your options, bring it up with your provider. Being honest about how you’re doing, the good and the not-so-good, is one of the best things you can do for your opioid addiction treatment.
At the end of the day, we’re all working toward the same thing: helping you build a stable, lasting recovery. Whether that happens with prescribed Suboxone® or Subutex® entirely depends on what works for you.
Frequently asked questions about switching from Suboxone® to Subutex®
Do Subutex® and Suboxone® show the same on a drug test?
Yes, both Subutex® and Suboxone® will show positive for buprenorphine on drug tests since they both contain the same active ingredient. They won’t show up as opiates like heroin or oxycodone, but will show as buprenorphine. But specialized laboratory tests can detect naloxone specifically, which would only show up if you’re taking Suboxone®.
Does Subutex® have a different shelf life or storage requirements compared to Suboxone®?
They’re pretty similar when it comes to storage. Just keep Subutex® in its original packaging and away from heat, moisture, and sunlight, same as you would with Suboxone®. Always check the expiration date and never use expired medication, as buprenorphine can lose potency over time.
Can I split or crush Subutex® tablets like I might with other medications?
No, you should never split, crush, or chew Subutex® tablets. Like Suboxone®, Subutex® is designed to dissolve completely under your tongue (sublingually) for proper absorption. Crushing or splitting the tablet can affect how much medication your body absorbs and may reduce its effectiveness.
