The drug company that made Bunavail, BioDelivery Sciences International, Inc., announced that it was discontinuing Bunavail in the United States in March 2020. This was a marketing decision. Given the competition with other similar drugs on the market, the company decided to concentrate on its other products instead. Bunavail was not discontinued due to side effects or lack of effectiveness.

What are the alternatives?

Bunavail is a combination of buprenorphine and naloxone. Other brands and a generic version of buprenorphine/naloxone are still available.

Available brands of buprenorphine/naloxone that are approved by the FDA include:

• Suboxone
• Zubsolv

In 2018, the FDA announced the first generic version of buprenorphine/naloxone, as an absorbable film placed under the tongue.

How does buprenorphine/naloxone work?

Buprenorphine/naloxone is taken as a tablet or film dissolved in your mouth. It is used to treat opioid use disorder (OUD). People with this disorder abuse opioid drugs, such as hydrocodone, morphine and fentanyl. Using medication along with counseling and psychological support for OUD is called medication-assisted treatment (MAT) and is a pathway out of addiction.

Once a person starts MAT and is stable, buprenorphine/naloxone helps reduce the risk of OUD in the future. This is called maintenance therapy.

• Buprenorphine is a weak opioid. It does not cause the same pleasurable effects as stronger opioids. It blocks the effect of these drugs by attaching to receptors in your brain so that other drugs can’t bind to them. It reduces withdrawal symptoms and reduces opioid drug cravings. Taking buprenorphine/naloxone as prescribed lowers your risk of relapse.
• Naloxone is added to buprenorphine only to prevent abuse of buprenorphine. Buprenorphine becomes more powerful if it is injected into the bloodstream and may be abused in this way. Naloxone is not activated if the combination medicine is dissolved in the mouth as prescribed, but if it is injected, the naloxone will block the effect of the buprenorphine. As an opioid antagonist, naloxone blocks the ability of opioids to bind to your brain cells. For this reason, naloxone is sometimes used alone to reverse an emergency opioid overdose.