Subutex is on occasion used “off-label” by doctors to help with an acute or chronic ache in sure sufferers. “Off-label” use of a drug refers to when a physician prescribes a medication for an exclusive motive than the ones formally accredited by the FDA and observed in the package labeling.
Suboxone (buprenorphine and naloxone) sublingual film is NOT authorized via the FDA to be used as a pain alleviation remedy. Suboxone is the simplest authorized to treat narcotic (opiate) dependency (opioid use disorder). Only single agent buprenorphine (without naloxone) is authorized to deal with pain.
How does Suboxone come?
The Suboxone sublingual film comes within the following strengths: Suboxone carries a mixture of buprenorphine (a partial mu-opioid receptor agonist, kappa opioid receptor antagonist, and ORL-1-receptor agonist) and naloxone (a pure opioid antagonist). Suboxone works within the brain to help with opioid addiction. Suboxone is run as a movie that dissolves below the tongue (sublingually) or inside the cheek location (buccal use) and is given as a single day-by-day dose for opioid dependence. It is used as part of a complete remedy application that also consists of counseling and behavioral therapy.
Off-label use of Suboxone for the treatment of pain
The FDA has NOT approved the use of Suboxone for pain. Some doctors may still use this medicine “off-label” for pain in certain patients already using Suboxone to treat opioid use disorder. Research studies have been published that address the “off-label” use of Suboxone for the treatment of both acute and chronic pain.
- Acute pain, which is usually short-term, can occur after surgery, a medical or dental procedure, or trauma (sprain, broken bone) from an accident.
- Chronic or long-lasting pain might involve various forms of ongoing joint or back pain, cancer pain, or nerve (neuropathic) pain.
Advantages to Buprenorphine
- As an opiate, buprenorphine still has the potential for abuse and is a controlled substance. However, it is a Schedule III narcotic, which may ease prescribing and patient access to Schedule II opioids used for chronic pain.
- Suboxone also has a longer duration of action than many opioids, but a 30 to the 60-minute onset of action. It may produce fewer withdrawal symptoms upon discontinuation.
- Buprenorphine may be safer than some full opioid agonists when used for chronic pain. It may cause less physical dependence and euphoria (feeling of “high”), less respiratory depression, and less opioid-induced hyperalgesia.
- It also has a ceiling effect for respiratory depression, but respiratory depression can still occur, especially when used with benzodiazepines (like Xanax or Valium), alcohol, or other respiratory depressants (including street drugs). When combined with any of these products, it can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.
Does buprenorphine treat pain?
Buprenorphine has pain-relieving effects and is approved by the FDA as a single agent in several forms for pain. An extended-release, transdermal (skin patch) formulation of buprenorphine (brand name: Butrans) is approved by the FDA for the treatment of moderate-to-severe chronic (long-lasting) pain. Butrans is NOT to be used to treat acute pain on an as-needed basis. Belbuca (buprenorphine buccal film) is also used to treat chronic pain not controlled by other medicines.
