Note that the brand Bunavail has been discontinued but generic equivalents are available under the name buprenorphine/naloxone. We have kept a record of this question for interest purposes only.

• Although Bunavail and Suboxone contain the same ingredients, they are not equivalent in terms of dosage
• A Bunavail 4.2mg/0.7mg buccal film is equivalent to a Suboxone 8mg/2mg sublingual tablet
• A lower dose of Bunavial is needed to achieve the same effects as Suboxone
• Bunavail is a buccal film that is placed on the inside of the cheek and allowed to dissolve. You can still talk while the film is in your mouth
• Suboxone is available as a sublingual film or a sublingual tablet. Both are placed under the tongue to dissolve. It is difficult to talk while the tablet/film is in your mouth
• A slight difference in half-lives has been reported with Bunavail and Suboxone; however, this is unlikely to translate into any noticeable difference in their lasting effect.

What is the difference between Bunavail and Suboxone?

The main differences between Bunavail and Suboxone are:

• A difference in their bioavailability – this is a measure of how easily and completely they are absorbed
• A difference in their equivalent dosages. An equivalent dose of Suboxone is considered to be approximately twice that of Bunavail
• The naloxone exposure from Bunavail is 33% less than that with Suboxone
• A slight difference in half-life between the preparations
• A difference in the way they are given.

Bioavailability differences

Bunavail is better absorbed than Suboxone so an equivalent dosage is considered to be half that of Suboxone.

The following are considered equivalent dosages by the manufacturer:

• Bunavail 2.1mg buprenorphine/0.3mg naloxone: Suboxone 4mg buprenorphine/1mg naloxone
• Bunavail 4.2mg buprenorphine/0.7mg naloxone: Suboxone 8mg buprenorphine/2mg naloxone
• Bunavail 6.3mg buprenorphine/1mg naloxone: Suboxone 12mg buprenorphine/3mg naloxone.

Even though the equivalent dose of Bunavail provides only a third of the naloxone that the equivalent dose of Suboxone contains, naloxone is better absorbed buccally than sublingually so the actual equivalent exposure is only 33% less.

Half-life difference

The product information states the half-life of Bunavail is 16.4 to 27.5 hours and the half-life of Suboxone is 24 to 42 hours.

A drug’s half-life is the time it takes for half of a dose to be eliminated from the body. Generally, it takes four to five half-lives for a drug to be considered totally eliminated from the body, which is 82 to 137 hours for Bunavail, or 120 to 210 hours for Suboxone.

However, this doesn’t really translate into a difference in effect, as both are usually given once a day even though they stay bound to opioid receptors for three to four days.

The actual length of time the effect of either Bunavail or Suboxone last for varies among individuals depending on their weight, presence of liver disease, or history of drug abuse.

Delivery differences

Bunavail is a buccal film that is placed directly on the inner cheek and allowed to dissolve directly into the bloodstream of the inner cheek. The film has a backing sheet that prevents most of the active ingredients from being swallowed. Although you cannot eat or drink while the film is in your mouth, you can still speak and the film has a citrus-like taste.

Suboxone is a sublingual tablet or film that is placed under the tongue and allowed to dissolve. Although most is absorbed directly into the bloodstream under the tongue, some of the active ingredients are swallowed instead while Suboxone is dissolving. You cannot eat, drink, or talk while Suboxone is dissolving.

Do Bunavail and Suboxone work in the same way?

Yes, they do. Both Bunavail and Suboxone contain the ingredients buprenorphine and naloxone.

Buprenorphine is an opioid (narcotic) that has a unique and complex mechanism of action, which includes incomplete binding to “mu” opioid receptors and complete binding to “kappa” opioid receptors. Opioid receptors have three main effects:

• Decreasing pain
• Reducing breathing (respiratory depression)
• Producing euphoria (feelings of intense happiness or excitement).

The way buprenorphine binds means it can satisfy opioid cravings without producing strong feelings of euphoria or causing significant respiratory depression. Also, while it is bound to opioid receptors, other opioids (such as heroin or oxycodone) cannot bind. It stays on receptors for about three days, which makes it a good choice for use in opioid addiction treatment programs.

Naloxone is present in these combination products to discourage misuse. Naloxone is a very strong blocker of “mu” opioid receptors and will precipitate people into opioid withdrawal if drug misusers attempt to convert the film or sublingual tablet into an injectable form. Naloxone has poor absorption when taken sublingually.

Both Bunavail and Suboxone belong to the class of medicines known as combination opioid/opioid antagonists.