buprenorphine naloxone
Brands: Suboxone
Last reviewed 2026-02-12
Reviewed by PsychMed Editorial Team.
Quick answers
What is buprenorphine naloxone?
Buprenorphine-naloxone (brand Suboxone; generics) is a combination medication used to treat opioid use disorder (OUD). Buprenorphine is a partial opioid agonist that reduces withdrawal and cravings, while the naloxone component is included to discourage injection misuse (label/guideline).
What is Suboxone?
Suboxone is a brand name for buprenorphine naloxone.
What is Suboxone (buprenorphine naloxone) used for?
Label indications include: Opioid use disorder treatment (induction and maintenance) (label).
What drug class is Suboxone (buprenorphine naloxone)?
Combination of buprenorphine (partial μ-opioid receptor agonist) and naloxone (opioid antagonist) used for treatment of opioid use disorder. Naloxone has low bioavailability sublingually but deters injection misuse (label/guideline).
What strengths does Suboxone (buprenorphine naloxone) come in?
Sublingual film and sublingual tablets (multiple strengths) (label).
Snapshot
- Class: Adjunctive therapy
- Common US brands: Suboxone
- Therapeutic drug monitoring not routinely recommended.
- Last reviewed: 2026-02-12
Clinical Highlights
Buprenorphine-naloxone (brand Suboxone; generics) is a combination medication used to treat opioid use disorder (OUD). Buprenorphine is a partial opioid agonist that reduces withdrawal and cravings, while the naloxone component is included to discourage injection misuse (label/guideline). In opioid use disorder care, buprenorphine-based treatment is supported by guideline and systematic-review evidence for improving retention and reducing illicit opioid use compared with placebo/no medication (review/guideline).
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- A key practical risk is precipitated withdrawal if buprenorphine is started too soon after recent opioid use. Induction is typically timed to objective withdrawal, and switching plans are individualized by opioid type and dependence severity (label/guideline).
- Buprenorphine can cause sedation and respiratory depression, especially when combined with alcohol, benzodiazepines, or other CNS depressants. Safety planning often focuses on polysubstance use and medication reconciliation (label/clinical).
- Compared with methadone, buprenorphine has a ceiling effect on respiratory depression and can often be prescribed in office-based settings, but retention and symptom control can vary by patient and severity; choice is commonly individualized (guideline/clinical).
- The compare view, buprenorphine-naloxone evidence feed, and buprenorphine-naloxone print page support counseling when opioid use disorder (OUD) treatment is being discussed alongside depression, anxiety, and sleep symptoms.
Dosing & Formulations
Sublingual film and tablets are available in multiple strength combinations (label). Treatment is typically structured in phases (induction, stabilization, maintenance), with dose adjustments guided by withdrawal symptoms, cravings, and safety (guideline/clinical).
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- Because induction timing is safety-critical, many programs use standardized induction protocols and close early follow-up, especially when fentanyl exposure is suspected (clinical).
Monitoring & Risks
Respiratory depression risk increases with alcohol, benzodiazepines, sedating sleep medications, and other opioids. Care planning often includes overdose-risk counseling and review of co-prescribed sedatives (label/clinical). Hepatic considerations: labeling includes liver-related warnings and clinicians often monitor liver enzymes when baseline liver disease is present or when symptoms emerge (label/clinical).
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- Diversion and misuse risks are part of routine practice; many programs use structured follow-up, prescription monitoring, and urine drug testing as clinically indicated (guideline/clinical).
- Pregnancy: buprenorphine is used in opioid use disorder treatment in pregnancy, and formulations and treatment setting are individualized to balance maternal stability and neonatal outcomes (guideline/clinical).
Drug Interactions
Additive sedation and respiratory depression can occur with alcohol, benzodiazepines, Z-drugs, gabapentinoids, and other CNS depressants (label/clinical). CYP3A4 inhibitors or inducers can alter buprenorphine exposure; overall regimen review often focuses on sedatives and on withdrawal/over-sedation signals during medication changes (label/clinical).
Practice Notes
Guidelines emphasize that medication for opioid use disorder (MOUD) can be effective with or without formal counseling; many patients still benefit from additional supports (therapy, peer support, housing resources) when available (guideline/clinical). Treatment decisions often include naloxone access planning and coordination with primary care, psychiatry, and pain management to reduce overlapping sedative prescribing (clinical).
References
- SUBOXONE (buprenorphine hydrochloride and naloxone hydrochloride) sublingual film prescribing information — DailyMed (2026)
- The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update — Journal of Addiction Medicine (2020)
- TIP 63: Medications for Opioid Use Disorder — SAMHSA (2021)
- Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence — Cochrane Database of Systematic Reviews (2014)