Buprenorphine
Brand: Suboxone, Zubsolv, Sublocade, Brixadi (Subutex discontinued)
Boxed warning · ISMP high-alert drug
Sublocade and Brixadi injections only: serious harm or death if self-administered intravenously (they form a solid mass), so they are dispensed only under a REMS to healthcare settings; sublingual products such as Suboxone carry no boxed warning.
- Caution
- Profound sedation and death when combined with benzodiazepines or other CNS depressants; precipitated withdrawal if started while other opioids are still active.
- Pregnancy
- Neonatal opioid withdrawal syndrome is expected with use in pregnancy but is treatable; buprenorphine (with or without naloxone) is a standard treatment for opioid use disorder in pregnancy.
Common side effects
- Constipation
- Headache
- Sweating
- Withdrawal if started too soon
Key interactions
- Additive sedation with benzodiazepines
Counseling points
- Let sublingual film or tablet dissolve fully: swallowing wastes the dose
- Do not eat or drink until it has dissolved
- Any prescriber with Schedule III authority may prescribe it since the X-waiver was eliminated
- Naloxone in combination products deters injection misuse
We ask 7 questions about Buprenorphine.Practice Buprenorphine →Test yourself on medications like Buprenorphine.Practice Medications →
High-yield study aid for exam prep, not a substitute for the package insert or a pharmacist’s dispensing reference.