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 currently taking Suboxone® for opioid use disorder, but you’ve started hearing about Subutex®. Maybe it’s from people online who claim one works better than the other, and now you’re wondering: should you make the switch from Suboxone to Subutex to better manage opioid withdrawal?
For most people, there’s no meaningful difference between Suboxone and Subutex when it comes to treatment success. In fact, for the vast majority of patients, there is absolutely no difference between treatment with Suboxone or Subutex. The active ingredient in both (buprenorphine) is identical, and no differences exist between the formulations of buprenorphine in either medicine.
At QuickMD, 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.
That said, 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, though rare, 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.
The naloxone in Suboxone is included to prevent people from taking Suboxone by injection or nasal route. If someone were to misuse Suboxone, the naloxone would become active and cause instant opioid withdrawal (just as with Narcan). It’s important to know that naloxone in Suboxone is NOT absorbed into your body if Suboxone is taken correctly, by placing it under your tongue.
Both Suboxone and Subutex 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, methadone, or even prescription painkillers.
Many of the side effects from taking Suboxone (nausea, vomiting, upset stomach) come from swallowing your saliva while the Suboxone is dissolving. By avoiding swallowing your saliva while the Suboxone film or tablet is dissolving, most of the side effects from Suboxone can be avoided.
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 is not 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? In rare cases, switching to Subutex might be appropriate, but for the vast majority of patients, Suboxone works well and remains the preferred option.
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 some rare situations where patients and providers might discuss switching from Suboxone to Subutex. These conversations often come up when patients experience lingering side effects or just don’t feel quite right on their current medication.
Some patients on Suboxone experience side effects like headaches, nausea, sleep issues, or just feeling “off.” Often, it’s assumed these effects are due to naloxone, but naloxone has never been shown to cause allergic reactions. No verified allergy to naloxone has ever been documented.
If you’re having side effects, they’re almost always caused by the buprenorphine or another component of the film or tablet, and not the naloxone. Fortunately, these side effects usually decrease with time. If you’re experiencing side effects or have concerns about your medication, it’s always best to bring them up with your provider.
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 8-2mg 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 adverse drug reaction to naloxone, and you’ll need medical records showing that effect.
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 adverse reaction to naloxone
- Medical records that show this adverse reaction
- 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 adjusting 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 is rarely necessary, 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 opioids like heroin or oxycodone, but will show as buprenorphine. But specialized laboratory tests, which are rarely performed, 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.
