Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a combination medication that includes buprenorphine and naloxone. In combination with counselling, it is used to treat opioid use disorder. It decreases withdrawal symptoms for about 24 hours. Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek.
Side effects may include respiratory depression (decreased breathing), small pupils, sleepiness, and low blood pressure. The risk of overdose is lower with buprenorphine/naloxone than with methadone. However, people are more likely to stop treatment on buprenorphine/naloxone than methadone. Methadone, or buprenorphine alone, are generally preferred when treatment is required during pregnancy.
Buprenorphine, at lower doses, results in the usual opioid effects; however, high doses beyond a certain level do not result in greater effects. This is believed to result in a lower risk of overdose than some other opioids. Naloxone is an opioid antagonist that competes with and blocks the effect of other opioids (including buprenorphine) if given by injection. Naloxone is poorly absorbed when taken by mouth and it is added to decrease the risk that people will misuse the medication by injection. Misuse by injection or use in the nose, however, still occurs. Rates of misuse in the United States appear to be lower than with other opioids.
The combination formulation was approved for medical use in the United States in 2002. In the United States the wholesale cost as of 2017 is between US$2.32 and US$3.15 per day. In the United Kingdom a similar dose costs the NHS £0.90 to £2.72 per day, according to 2015 data. A generic version was approved in mid 2018.