How does the Belbuca strip differ from Suboxone?
Is Belbuca the same as Suboxone? If your pain management doctor prescribes the Belbuca buccal film, you may notice on the package that the generic name for the drug is buprenorphine. When you search the web to see what your doctor has prescribed, you will soon discover that buprenorphine is also an ingredient in the Suboxone sublingual film.
Did your pain doctor just prescribe an addiction drug to treat your pain? Many chronic pain patients become angry when their doctor suggests they take Suboxone for pain.
A Suboxone prescription seems to indicate that the doctor believes the patient is addicted. When a doctor argues that buprenorphine is an excellent analgesic treatment for chronic pain, the patient may doubt their doctor’s intentions.
The fact is that buprenorphine is an opioid, and it does work well for pain. In fact, it works better than other opioids in many cases.
Suboxone is a strip that dissolves under the tongue or inside the cheek, on the buccal mucosa. Belbuca is a strip that is designed to stick to the buccal mucosa.
Both medications contain buprenorphine as their main active ingredient. With so many similarities, how could these two drugs be different?
There is no Belbuca generic.
While you may find a Belbuca coupon online, you will not find a generic form of this medication. That is because it has only been on the market for a short time.
Belbuca was released in 2015. Prescription drugs are protected for many years by patents that prevent generic manufacturers from making generic versions.
Yet, Suboxone does have a generic version. This is because the Suboxone film has been on the market for much longer.
Additionally, there was a landmark court battle between Indivior, the Suboxone manufacturer, and Dr. Reddy, an Indian generic drug company. Dr. Reddy won, and we now have many generic versions of the Suboxone film.
Hence, if you have a Suboxone prescription, your pharmacist may substitute an affordable generic in place of the expensive brand name product. However, if you have a Belbuca prescription, the only way to get the price down significantly is to use insurance, and possibly a copay assistance card.
If you attempt to use your health insurance to pay for Belbuca, the company may request a prior authorization from your doctor. This means that your doctor will have to fill out an extensive form and provide additional records and documentation to try to get your prescription coverage approved.
What are some Belbuca side effects to be concerned about?
Since Belbuca and Suboxone have the same active ingredient, buprenorphine, we would expect the side effects to be similar. For example, Suboxone insomnia, headaches, sweating, difficulty urinating, constipation are all side effects that can occur with Belbuca as well.
If you experience a new side effect after starting Belbuca, it is important to tell your doctor. Some side effects may be difficult to identify.
For example, if a man in his 50s or older notices that he cannot urinate as easily, he may attribute the symptoms as being age related, due to an enlarged prostate. However, it is possible that Belbuca could be causing the side effect.
A woman experiencing excessive sweating could blame menopause for her symptoms. Yet, if she is taking Belbuca, she could be having a drug side effect.
Since Belbuca is a lower strength medication compared to Suboxone, we might expect that it would have less side effects. Often, when a Suboxone patient experiences side effects, lowering the dosage will improve the drug-related symptoms.
Is Belbuca stronger than Suboxone?
Belbuca is available in a variety of strengths, ranging from 70 mcg to 900 mcg. Suboxone films are available in strengths ranging from 2 mg to 12 mg. There may even be a 16 mg film, though most pharmacies only carry the 2 mg and 8 mg dosages.
If you convert micrograms to milligrams, the highest strength of Belbuca is 0.9 mg, which is just under half the strength of the weakest Suboxone film, the 2 mg. Since both products are designed to absorb into the oral mucosa, they should be comparable in bioavailability.
Therefore, Belbuca is not stronger than Suboxone, because it is only available in much lower strengths than Suboxone. However, buprenorphine does have unique properties, so taking a very small amount of the drug may still be very effective in relieving pain for patients not used to taking opioids.
Interestingly, buprenorphine’s effectiveness levels off at higher dosages. The reason for this is that the drug blocks opioid receptors while it is activating them, so as a person takes more buprenorphine, the receptors become saturated.
A typical starting Suboxone dosage for an addiction patient is about 16 mg. Some patients may start as high as 24 mg, and rarely as high as 32 mg. Any higher, and the medication will not likely have any additional effect, because of the receptor saturating ceiling effect.
Can Belbuca be taken with Suboxone?
The FDA has approved Suboxone for treating opioid dependence, and it has approved Belbuca for treating pain. Could a person who takes Suboxone for opioid addiction also take Belbuca if they are in pain?
While, in theory, a patient could be prescribed both drugs to be taken together, it is unlikely that any doctor would write these two prescriptions. It would be like taking Advil and Motrin together. Taking two drugs together that have the same ingredients does not make sense.
Would it be dangerous to take Belbuca with Suboxone? Considering how low the available Belbuca dosages are, it would probably not be dangerous to take Belbuca and Suboxone together.
Imagine that a patient takes Suboxone 8 mg, and they take Belbuca 900 mcg at the same time. This would be equivalent to buprenorphine 8.9 mg, which would have little, if any, additional effect on the patient.
More concerning would be the principle of taking these two similar medications together. Suboxone is one of only a few drugs approved to treat opioid addiction. Belbuca is an opioid approved for treating pain.
If a Suboxone patient took Belbuca on their own at the same time as Suboxone, the additional drug would probably have little or no effect. Yet, it would be considered addictive behavior, taking extra opioids without informing the doctor.
What’s the difference between Belbuca and Suboxone?
Belbuca has one active ingredient, buprenorphine. Suboxone contains both buprenorphine and naloxone. The purpose of naloxone in Suboxone is to lower the abuse potential.
If a drug user attempts to melt a Suboxone film and inject it with a needle and syringe, the naloxone will cause a precipitated withdrawal reaction. The IV drug abuser will get physically sick from shooting up Suboxone, because it contains naloxone.
Why does Belbuca not contain naloxone? For whatever reason, the manufacturer determined that there was not a significant risk that the medication would be diverted to drug abusers who might try to shoot it up into their veins.
Of course, since Suboxone is marketed for use in known opioid addicted patients, we would expect there to be a potential for attempted abuse of the medication strips. Belbuca, on the other hand, is marketed to chronic pain patients, who are not necessarily known to have opioid addiction histories.
While there are opioid pain meds that contain abuse deterrents, Belbuca does not contain one. Suboxone contains the same opioid as Belbuca, buprenorphine, and it does contain naloxone as an abuse deterrent.
Otherwise, the main differences between Belbuca vs. Suboxone are that Belbuca comes in lower strengths, and it is optimized to adhere to the buccal mucosa. Suboxone can be used on the buccal mucosa, but it is intended for sublingual, or under the tongue use.
Can Suboxone be prescribed for pain?
Since Belbuca is a buccal film that is FDA approved for treating pain, why would a doctor consider prescribing Suboxone for pain? When considering the differences between Belbuca and Suboxone, FDA approvals are a major factor.
Any licensed US physician who has a DEA registration allowing them to prescribe Schedule III drugs may prescribe Belbuca for pain. The same doctor may also prescribe Suboxone for pain, but this prescription would be “off-label”.
Off-label means that the prescription is written for a use other than the drug’s FDA approved uses. Doctors are allowed to prescribe any drug for any use, as long as they can justify it medically.
In the case of prescribing Suboxone off-label for pain, the doctor should write explicitly on the prescription that it is for pain. This will remove any confusion that it might be intended to treat opiate addiction.
When a doctor prescribes Suboxone for opioid use disorder, they must have an “X” number and a DATA-2000 waiver. This means that the doctor attended an 8-hour course and applied for the waiver and the “X” number, and they have agreed to follow special procedures when prescribing Suboxone.
How is Belbuca for fibromyalgia pain?
Fibromyalgia is a pain syndrome in which the patient has various tender points that are sensitive to light touch. Doctors prefer to avoid prescribing opioids for fibromyalgia pain, if possible.
However, because buprenorphine is safer than most opioids, and it is effective at low dosages, Belbuca may be a good option for fibromyalgia pain. Fibromyalgia pain is similar to neuropathic pain, and it can be severe, limiting a patient’s ability to function in their daily activities.
Unfortunately, it can be difficult to confirm a diagnosis of fibromyalgia with testing. It is one of a handful of pain syndromes that are difficult to confirm objectively.
Reflex sympathetic dystrophy (RSD) is a condition that is now known as type 1 complex regional pain syndrome (CRPS). CRPS is another condition that is very painful, but difficult to prove.
Like fibromyalgia, doctors are hesitant to prescribe opioids for complex regional pain syndrome. Part of the issue is that doctors are worried about malingerers.
A malingerer is a patient who tries to get opioids prescribed for the purpose of misusing them. If the doctor cannot see a test, such as an MRI, that shows the problem, they do not want to prescribe opioids.
Belbuca may be a perfect compromise, because it contains buprenorphine, a drug that is also used to treat opioid addiction. And, buprenorphine is less likely to cause opioid tolerance or opioid addiction, compared to other opioids.
Additionally, buprenorphine happens to work well in treating fibromyalgia pain. So, putting aside all other concerns, Belbuca may be a good choice for treating fibromyalgia pain or CRPS pain, because it works well in making pain more tolerable and improving functioning.
For patients suffering from intractable benzodiazepine withdrawal pain, Belbuca might also be a good choice. Interestingly, protracted withdrawal from benzo use can be a very painful experience.
Can Belbuca be placed under the tongue?
Belbuca is intended to be placed on the buccal mucosa, inside the cheek. It adheres well in that location.
The manufacturer provides clear instructions not to cut the film, not to swallow it, or manipulate it with fingers or tongue. They threaten that using it improperly could lead to choking, overdose, and death.
I do not know if there have been cases of these things happening from misuse of Belbuca, but the safest course of action is to use the medication as instructed. If the manufacturers insist on using Belbuca only on the buccal surface, then patients should comply.
Interestingly, some Suboxone patients have claimed that their Suboxone films are more effective when applied to the buccal mucosa. The manufacturer instructions that come with Suboxone allow for buccal use for experienced patients with their doctor’s approval.
It is possible that the mechanism that helps Belbuca to stick well to the inner cheek makes it more of a swallow and choking risk if placed under the tongue. Just to be safe, it is best not to use Belbuca under the tongue.
Are there addiction treatment programs for Belbuca addiction?
Belbuca contains buprenorphine, and there is some concern over buprenorphine abuse. While authorities insist that the drug is diverted and abused, multiple studies have revealed that most buprenorphine on the streets is used for opioid detox and not to get high.
Belbuca addiction is not a major issue at this time. However, it is still possible that an individual could become addicted to the drug.
Or, more likely, a patient taking Belbuca for pain might become physically dependent. Many people confuse physical dependence and addiction.
Physical dependence on a drug means that the patient will become physically sick if they stop taking it abruptly. While addiction can occur with physical dependence, they are not the same.
A Belbuca addiction treatment program should acknowledge that prospective clients may require detox for dependence, but not addiction. If you, or a loved one, are looking for private addiction treatment in Miami or South Florida, Please use the contact form on this website.
We have extensive experience in helping people with addiction and drug dependence. If you are having difficulty with Belbuca, or you are interested to find out if Belbuca could help with your pain, please contact us.
