Suboxone vs. Belbuca: What’s the Difference?

Suboxone is a prescription medication that is FDA approved to treat opioid use disorder (OUD). If your doctor prescribes Suboxone, you’ll dissolve a film under your tongue or in your cheek, and your medication will keep cravings and withdrawal symptoms in check.

Belbuca shares a common active ingredient – Buprenorphine – with Suboxone. But it’s not FDA approved for OUD treatment. Instead, Belbuca is used to treat chronic pain.

Remember that prescription medications aren’t interchangeable. If you’re not sure what your prescription is for and how to use it, ask your doctor. 

What Is Suboxone?

Suboxone contains buprenorphine and naloxone. It is approved by the U.S. Food and Drug Administration (FDA) to treat OUD.

Buprenorphine is a partial opioid agonist, which means it occupies opioid receptors in the brain.[1] In doing so, it reduces cravings and prevents withdrawal symptoms associated with OUD.

To prevent patients from misusing Suboxone via injection or snorting, naloxone is added to the formulation.[2] Naloxone is an antagonist and prevents misuse by blocking opioids from occupying the receptor in the brain. If Suboxone is used in any other way than as prescribed, naloxone enters the bloodstream and stops the agonist aspect of buprenorphine from inducing a high.

Suboxone is available both as a sublingual film/strip or tablet. When applied beneath the tongue or between the cheek and gums, it dissolves in about 2-5 minutes. The effects of Suboxone can last for up to 72 hours.[3]

Although both Suboxone formulations are equally effective, there are a couple of key differences to keep in mind:

• Suboxone in tablet form is less expensive than films/strips.
• The strips dissolve faster than tablets, but both should be left in place for at least 2-5 minutes until they are completely absorbed.
• Some patients may prefer one flavor over the other, although this is a personal choice.

Suboxone Side Effects

Suboxone is safe to consume, but like many other medications, it can cause side effects.[4] These are the most common side effects:

• Headache
• Nausea
• Vomiting
• Constipation
• Excessive sweating
• Insomnia
• Swollen hands and legs
• Stomach pain
• Numbness in the mouth

It’s important to note that Suboxone may cause opioid withdrawal symptoms when consumed while there are other opioids in the system. Start the medication under the supervision of a health care provider to avoid withdrawal.

What Is Belbuca?

Belbuca is the brand name for a buprenorphine buccal film used to treat chronic pain. The term buccal film refers to the administration route.

Place the film/strip on the inner wall of the cheek or inside the mouth. It usually takes 5 minutes for the strips to dissolve completely, and the effects can last up to 27 hours.[5]

Belbuca is not approved by the FDA for the treatment of OUD. It is approved only for the treatment of chronic pain.

Belbuca Side Effects

It is possible to develop a physical tolerance to Belbuca or withdrawal symptoms when stopping it because it has an opioid effect. Although rare, people can develop an addiction to it as well. There are some notable side effects associated with Belbuca.[6]

Physical adverse effects include the following:

• Sleep disturbances
• Palpitations
• Dizziness
• Drowsiness
• Nausea, vomiting, and constipation
• Headaches
• Difficulty concentrating
• Low blood pressure
• Sweating

As with Suboxone, Belbuca may cause opioid withdrawal symptoms if consumed while there are other opioids in the system. Start using the medication while under the supervision of a health care provider to avoid withdrawal.

Suboxone vs. Belbuca

Suboxone and Belbuca contain buprenorphine, but they differ in several ways.

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Bicycle Health provides Suboxone therapy for opioid use disorder. Bicycle offers educational resources on Belbuca, Subutex and Sublocade, but does not currently offer those therapies.