When choosing to quit opioids and begin treatment with Suboxone, it’s helpful to understand the difference between Suboxone pills and strips, name brands and generics, and the basics of what you can expect when starting any formulation.
When starting medication-assisted treatment, Suboxone is a gold-standard medication that is readily available through a clinician near you. Once you begin Suboxone treatment, however, you may encounter different formulations of the medication. Your prescribing clinician is always the best expert to turn to in regards to your specific care. However, we’re here to explain the different formulations and types of Suboxone out there.
First, the Basics: What’s in Suboxone?
Suboxone is the common name brand used for the medication buprenorphine/naloxone. Buprenorphine/naloxone is an opioid with a strong binding capability, meaning it can knock other opioids out of the receptors in our brains when we’re struggling with opioid addiction. Buprenorphine doesn’t affect individuals to the same level as other opiates like methadone, oxycodone, or heroin. This means that Suboxone can help you get off other opioids, reduce withdrawal symptoms, and reduce cravings long-term. For more information on how Suboxone works, check out The Science of Suboxone, where we break down how opioids and medication like Suboxone both work in the brain.
The Emergence of Generic Suboxone Strips
Remember how Suboxone is the brand name for the drug buprenorphine/naloxone? This means Suboxone’s manufacturers (a company called Indivior) own this specific name, sort of like Kleenex company owns the name ‘Kleenex’ but that doesn’t keep us from asking for a ‘Kleenex’ when we’re really okay being passed any generic tissue.
Until recently, Suboxone was the only manufacturer of the strip formulation of buprenorphine/naloxone. Generic buprenorphine/naloxone was available as a tablet, which often helped individuals who needed to pay out of pocket purchase this life-saving medication at a lower cost.
Earlier this year, a Delaware Court ruled that Dr. Reddy’s could manufacture a generic version of the Suboxone strips (officially called a sublingual film). More choice in the marketplace should always benefit the consumer, but in this case it also caused more confusion. People on the name-brand Suboxone sublingual films suddenly found themselves switched to a generic version.
Generic Buprenorphine/Naloxone Strips vs Name Brand Suboxone Strips: What’s the Difference?
When I asked the expert medical team at Workit Health about the preference between name brand and generics, they’ve noted that they are the same formulations. Workit Health’s Head of Head of Medical Care, Dana Forman, FNP explained the Dr. Reddy’s strips and Suboxone strips this way: “The medication is both composed of the same two medications, buprenorphine and naloxone. The dosing is equivalent, meaning that an 8-2 mg of Suboxone (this is 8 mg of buprenorphine and 2 mg of naloxone) is the same as an 8-2 mg generic film. Also, the FDA requires that all generic drug company manufacturers prove through rigorous testing that the generic can be substituted for the brand and provide the same clinical benefit.”
As someone who is on medications myself, I’ve experienced the jarring effect of going to the pharmacy to pick up my usual prescription and receiving an unexpected generic package instead. It’s disorienting, and even more than that, some people insist that generics and brand names can cause different side effects, despite being similar formulations. Some people seem to dislike the Dr. Reddy’s generic strips, and some people seem to prefer them. So why do we all have such different reactions to similar formulations of medication?
A new book, Bottle of Lies, by Katherine Eban, argues that generic drugs might not be as well overseen as we’d like to think. This argument may resonant with anyone who has felt differently on a generic medication than they have on name brand. It’s important to note that whether Eban’s book is highlighting an actual issue or just hot air, we can be overly concerned about ensuring access to medication that helps us feel good and stay stable. Change to a system that has worked can be scary and unwelcome. If you are unhappy with a change in medication, speak honestly with your care team about your concerns.
Suboxone Strips vs. Suboxone Tabs: What’s Right For You?
In addition to generic sublingual films or name brand, buprenorphine/naloxone is also available in a tablet formulation. When are the Suboxone tablets (pills) a better alternative than the strips? Most notably, they can be a lower cost for those who must pay out of pocket for their medication. For some, taking a tablet feels more discreet than taking a strip, which can draw attention to the medication. Others might have a taste preference of the strip vs the tablet, but either one will need to dissolve in your mouth. Some also note that when you are ready to taper, you can cut the strips into much smaller and more precise amounts than the tablets (always taper your dose under the care of a medical provider, please).
But ultimately, both the strips and the tabs have similar results. A randomized controlled trial showed no difference in dose effects, levels of the medication in the participants systems, side effects, or treatment outcomes. Whether you and your care team determine Suboxone strips or tablets are right for you, both have the evidence and research behind them: Suboxone can reduce risk of relapse, overdose, and lower cravings.