Suboxone is a drug used to manage opiate addiction, particularly in the withdrawal phase of opiate use disorder. The drug has two main active pharmaceutical ingredients. These are buprenorphine and naloxone. Buprenorphine is an opioid agonist, meaning that it acts similarly to other opioids. At the same time, naloxone is an opioid antagonist, meaning that it blocks or minimizes the effect of opioids.
Factors Affecting How Long Suboxone Lasts?
How long suboxone lasts in the boy system is dependent on factors such as:
- The formulation of suboxone available
- Hepatic and Renal status of the patients
- Drug interactions with other medicines
- Other preexisting medical conditions
Formulations of Suboxone Available
Suboxone is available in several different formulations and dosages. The most common formulations include:
Suboxone Sublingual Tablet
The tablet is available as a white round tablet with a printed label of Suboxone on the side. Each tablet contains 12.5 mg of buprenorphine and 1 mg of naloxone. These tablets are taken orally. It takes approximately 15–20 minutes for the tablet to take effect. The duration of action for suboxone sublingual tablets is approximately six hours.
Suboxone Oral Film-Coated Tablet
The oral film-coated tablet is available as a white round tablet with a printed label of Suboxone on the side. It is crushed and mixed with water to form a paste before it is swallowed, which will then dissolve in the stomach and bloodstream within 2 hours to release buprenorphine and naloxone over time. Each film-coated tablet contains 12.5 mg of buprenorphine and 1 mg of naloxone. These tablets are taken orally. It takes approximately 10–20 minutes for the tablet to take effect. The duration of action for suboxone film-coated tablets is approximately four hours.
Suboxone Film Tablets
The film-coated tablet is available in a pink and blue box with Suboxone on the box lid and the center of the box lid. The film tablets are available as a white round tablet with a printed label of Suboxone on the side. Each film tablet contains 12.5 mg of buprenorphine and 1 mg of naloxone. These tablets are taken orally. It takes approximately 15–30 minutes for the tablet to take effect. The film will dissolve in the mouth more quickly than a tablet. Therefore, more convenient for use in those who cannot swallow pills or have difficulty swallowing tablets.
This formulation is used when buprenorphine is administered by injection into muscle tissue or intramuscularly into the thigh, abdomen, or upper arm. This formula contains 100 mg (8 mg buprenorphine and 2 mg naloxone) per 2 mL ampoule, which comes in a glass. Suboxone injection is preferred for unconscious patients who cannot take oral medication. It has a more immediate effect with the onset of action occurring within 3–6 minutes. However, it has a brief duration of action period of less than two hours.
How Hepatic and Renal Status Affects the Duration of Action of Suboxone?
The renal and hepatic function affects how a drug is metabolized and excreted from the body. When it comes to buprenorphine, its elimination is much slower than other opioids. The half-life of buprenorphine can last up to 10 hours. The elimination half-life of naloxone is 1 hour. Persons with impaired renal or hepatic function may require smaller doses of buprenorphine. The usual dose for these individuals is 2–4 mg sublingual tablets or 0.2 mg sublingual injection. Suboxone is a prodrug. It is metabolized into the active metabolite buprenorphine by the enzyme CYP3A4. The half-life of buprenorphine is about 10 hours, and it is more potent than naloxone. Naloxone has a half-life of one hour thus has a short action duration. For this reason, people with hepatic or renal impairment may need smaller doses of buprenorphine as compared to those without impaired function.
Drug Interactions That Affect How Long Suboxone Lasts
The following drug interactions can affect how long suboxone lasts:
- Posaconazole, a macrolide antibiotic, is metabolized by CYP3A4 and can increase the clearance of buprenorphine
- CYP3A4 inhibitors such as itraconazole, ketoconazole, clarithromycin, and erythromycin can increase the elimination of buprenorphine
- CYP2D6 inhibitors such as quinidine and fluoxetine inhibit the metabolism of buprenorphine. Therefore, concurrent administration of these drugs will prolong the duration of action of buprenorphine
- Cimetidine can decrease the elimination of buprenorphine
Pre-existing medical conditions like hypothyroidism, hyperthyroidism, and diseases that cause respiratory compromise, like obstructive pulmonary disease (OPD), may require dosage adjustments. Therefore, the pharmacist must make the correct drug adjustments for patients on concurrent medications and pre-existing medical conditions. In summary, the pharmacokinetics of buprenorphine and naloxone are dependent on the route of administration, the presence of other drugs, and patients’ characteristics. Call us at 833-846-5669.