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Belbuca vs. Suboxone: Comparing OUD Medications

Belbuca and Suboxone have a lot in common. Both are prescription medications containing buprenorphine, and both are sold in a strip format. However, only Suboxone is U.S. Food and Drug Administration (FDA) approved for opioid use disorder (OUD). Belbuca is only FDA-approved for the treatment of chronic pain.

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Let’s dig deeper so you can understand how these medications work and who might use them. 

Understanding Belbuca & Suboxone

While both Belbuca and Suboxone contain the same active ingredient, these are very different medications that shouldn’t be used interchangeably. Learning more about how they work can help you see why this is the case. 

How Does Belbuca Work?

Belbuca is a prescription medication that contains buprenorphine. The FDA has approved this medication for people who have severe pain that hasn’t responded to other forms of treatment.[1]

Belbuca is delivered in a strip that melts away within a few minutes to provide pain relief for about 12 hours. Multiple strip strengths are available, ranging in potency from 75 mcg to 900 mcg. Doctors are encouraged to find the dose that works for their patients and to encourage those patients to take the dose on schedule. This medication isn’t designed for as-needed pain relief.[1]

Belbuca is a relatively new drug, and no generic versions are available. As a result, it can be expensive. Some insurance companies won’t cover this treatment, as other strong forms of pain control are available at a lower cost. 

All forms of buprenorphine can be addictive, as the drug causes euphoria. The effect is especially prominent in people who haven’t used opioids before. 

People taking Belbuca are encouraged to lock their drugs away, so their friends and family members won’t take the strips. However, people who use the drug for pain can get addicted to it too.[1]

How Does Suboxone Work? 

Suboxone is a prescription medication that contains both buprenorphine and naloxone. The FDA has approved this medication for people struggling with OUD. Doctors can prescribe it for at-home treatment.[2]

In people with OUD, Suboxone can ease drug cravings and help people stay in therapy for longer periods. At the proper dose, people don’t get high on Suboxone, but they can feel focused enough to work on their OUD and rebuild their lives.[2]

Suboxone contains naloxone as an abuse preventive. When people attempt to inject their doses, the naloxone is activated and blocks the action. At normal doses, people don’t even notice the naloxone.[2]

Suboxone comes in strengths ranging from 2 mg to 12 mg of buprenorphine. Most people take 16 mg once per day in the maintenance phase of treatment.[2]

A generic version of Suboxone was approved by the FDA in 2018.[3] With this step, the medication became much more affordable. Some insurance companies will only pay for the generic strips, meaning people who want the brand name must pay much more. 

Comparing Belbuca & Suboxone 

This chart makes the differences and similarities between Belbuca and Suboxone much easier to understand:[1-6]

Belbuca Suboxone 
Active IngredientBuprenorphineBuprenorphine 
FDA-Approved Use Severe pain Opioid use disorder 
Drug Schedule Schedule IIISchedule III 
Formats Available Buccal film Sublingual film 
Typical Dosage0.15 to 0.9 mg buprenorphine every 12 hours16 mg buprenorphine every 24 hours 
Common Side EffectsNausea, constipation, headache, vomiting, dizziness, and sedation Oral side effects, headache, nausea, vomiting, sweating, constipation, insomnia, pain, and swelling in the hands and feet 
Safety Concerns Respiratory depression, overdose, and neonatal withdrawal Withdrawal when used too early, respiratory depression, and neonatal withdrawal 
Addiction Potential Present Low, due to the addition of naloxone to each dose 
CostAround $460 for 60 strips Between $167 and $576 for 30 strips, depending on the strength 
Covered by Insurance?Not always The generic version is often covered, but the brand name may not be
Generic Available?No Yes
EfficacyIn studies of people with opioid experience and chronic low back pain, more people got better with Belbuca than they did with placebo In clinical trials, Suboxone was as effective as buprenorphine pills for people with OUD, and it didn’t come with more significant side effects 

Key Differences Between Belbuca & Suboxone 

Is Belbuca or Suboxone better for you and your medical condition? Digging deep into the differences between these medications can help you make an informed choice. 

These are a few of the top differences between Belbuca and Suboxone: 

Treatment Targets 

Belbuca is FDA-approved for people who have chronic pain that hasn’t responded to other forms of care and requires around-the-clock therapy. 

Suboxone is FDA-approved for people dealing with OUD. People who need help dealing with cravings that put their recovery at risk may benefit from buprenorphine’s ability to amend chemical imbalances caused by addiction

Where Films Are Placed

Belbuca is a buccal film, so it’s designed for placement inside your cheek right next to your teeth. Suboxone is more flexible, as it can be placed either inside the cheek or under the tongue. 

Abuse Potential 

Belbuca is weaker than Suboxone, so it should be less attractive as an abuse target. However, Suboxone has naloxone included as an abuse-deterrent. Belbuca doesn’t contain safety ingredients like this, so it could be easier to abuse. 

All forms of buprenorphine are capable of producing significant euphoria.[4] If you’re using either of these medications, it’s critical to only take them as your doctor directs. 

Strength

The strongest form of Belbuca available contains 900 mcg of buprenorphine.[1] The strongest form of Suboxone contains 12 mg of buprenorphine.[2] When compared head to head, Suboxone is a much stronger medication. 

Dosing Schedules 

People who use Belbuca are told to take the drug every 12 hours.[1] People who use Suboxone are told to take the drug every 24 hours.[2] 

Cost 

Suboxone is much less expensive than Belbuca, as it’s available in a generic format.[3] Generic drugs are often cheaper than their brand-name counterparts, even though they’re no less effective. Insurance companies may choose to cover the generics only, not the brand name. 

Choosing the Right Medication for Opioid Use Disorder

If you’re struggling with OUD, Suboxone is the only option FDA-approved for your treatment program. Belbuca is not indicated for this purpose. 

If you’re not interested in using Suboxone, or the medication somehow makes you feel sick, talk with your doctor. Together, you can find a medication that’s right for your treatment program.

Updated March 16, 2024
Resources
  1. Belbuca prescribing information. U.S. Food and Drug Administration. Published October 2015. Accessed February 28, 2024.
  2. Suboxone prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed February 28, 2024.
  3. FDA approves first generic versions of Suboxone sublingual film, which may increase access to treatment for opioid dependence. U.S. Food and Drug Administration. Published June 14, 2018.
  4. Buprenorphine. Drug Enforcement Administration. Published May 2022. Accessed February 28, 2024.
  5. Belbuca prices, coupons, and patient assistance programs. Drugs.com. Accessed February 28, 2024.
  6. Suboxone prices, coupons, and patient assistance programs. Drugs.com. Accessed February 28, 2024.
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