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Buprenorphine, sold under the brand name Subutex, among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain.
It can be used under the tongue, in the cheek, by injection, as a skin patch, or as an implant.
For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health care provider.
The combination formulation of buprenorphine/naloxone (Suboxone) is recommended to discourage misuse by injection.
Maximum pain relief is generally within an hour with effects up to 24 hours.
Side effects may include respiratory depression (decreased breathing), sleepiness, adrenal insufficiency, QT prolongation, low blood pressure, allergic reactions, and opioid addiction.
Among those with a history of seizures, there is a risk of further seizures.
Opioid withdrawal following stopping buprenorphine is generally less severe than with other opioids.
It is unclear if use during pregnancy is safe and use while breastfeeding is not recommended.
Buprenorphine affects different types of opioid receptors in different ways.
Buprenorphine was patented in 1965 and approved for medical use in the United States in 1981.
In 2017, 14.6 million prescriptions for the medication were written in the United States.
It is also a common drug of abuse, being used in place of heroin.
Buprenorphine may be used recreationally by injection or in the nose for the high it produces.
In the United States, it is a Schedule III controlled substance.