Methadone and Subutex (buprenorphine) are both medications used for the treatment of opioid use disorder. But sometimes, one medication may be preferred over another.
Preferences for methadone versus buprenorphine (the generic equivalent of Subutex) do occur.
Learn more about using Subutex during medication-assisted treatment
What To Do Before Switching From Methadone To Subutex
Methadone and Subutex are both drugs that must be approved for use by a doctor. Before switching, you’ll need the approval of your healthcare provider.
Before switching to Subutex, you’ll need to:
- talk to your healthcare provider
- discuss the potential benefits of switching to Subutex
- share why you want to switch to Subutex
- discuss potential risks of switching medications
Discussing all of the possible benefits and risks of switching from methadone to buprenorphine can help you make an informed decision about your treatment.
If you have specific questions about what the switch to Subutex might look or feel like, your doctor should be able to offer answers based on your medical and substance use history.
How To Switch From Methadone To Subutex
Changing the amount of methadone you’re taking prior to getting medical consultation is not recommended.
Before switching to Subutex, you’ll need to taper off methadone and get a prescription from a doctor for Subutex.
Your doctor can help you create a plan for safely making the transition from methadone to buprenorphine.
Steps for switching to Subutex:
1. Tapering Your Methadone Dosage
To transition to buprenorphine, you’ll need to gradually taper the amount of methadone you are taking to either a very low dose or abstinence.
Why is this necessary? Buprenorphine, the primary ingredient in Subutex, doesn’t interact well with other opioids.
If methadone is still in your system when you take Subutex, this could trigger severe symptoms of acute opioid withdrawal.
For this reason, it’s highly recommended that a person is abstinent from methadone for 36 to 72 hours before taking Subutex.
If abstinence is not an option for you, most clinics recommend getting on as low a dose of methadone as possible.
2. Begin Taking Subutex
Your first dose of Subutex can be taken 36 to 72 hours after your last dose of methadone, once you are demonstrating clear signs of moderate withdrawal.
Taking Subutex before the methadone has left your bloodstream could cause precipitated withdrawal, a severe form of opioid withdrawal syndrome.
Your healthcare provider can help you determine an appropriate dosage for you to begin and adjust this dosage over the first week of treatment with Subutex.
3. Continue Taking Subutex For Maintenance
Buprenorphine products like Subutex and Suboxone (with added naloxone) can be taken as maintenance medications, in conjunction with behavioral therapy and drug counseling.
After initial stabilization, your doctor can help you find the most effective dosage for you. The average range for dosing is 4 mg to 24 mg each day, taken in a single daily dose.
Buprenorphine can be taken for opioid use disorder for as long as it provides benefits for the patient taking it. Buprenorphine may be taken for weeks, months, or years into recovery.
Switching From Methadone To Subutex FAQs
Find answers to some of the most frequently asked questions about transitioning from methadone to Subutex.
Is Methadone The Same As Subutex?
No. Methadone is an opioid full agonist. Like Subutex, it is slow-acting. Unlike Subutex, a partial agonist, methadone fully activates opioid receptors in the brain.
Subutex only partially activates the same receptors, which reduces its euphoric effects and its effects on the respiratory system.
How Long Does It Take To Taper Off Methadone?
The amount of time it takes to taper off methadone will depend on how high a dose you are taking, overall health status, and other personal factors.
Tapering off methadone may take anywhere from a few days to a few weeks.
Methadone doses should be reduced gradually to prevent opioid cravings and other uncomfortable symptoms.
Are There Side Effects From Transitioning To Buprenorphine From Methadone?
Withdrawal symptoms will need to be present before taking the first dose of Subutex. Generally, it’s recommended that you make this transition in a medically supervised setting.
Making the switch from methadone to buprenorphine can be uncomfortable, and can carry a risk for relapse to opioid use without a strong support system.
Why Do People Switch From Methadone To Subutex?
Reasons for switching medications for medication-assisted treatment can vary.
Common reasons for wanting to switch to buprenorphine include:
- side effects of methadone
- methadone interactions with other medications
- being able to take buprenorphine at home
- not having to visit a clinic daily for methadone
How Long After Using Methadone Can I Take Subutex?
You’ll need to wait until methadone is out of your bloodstream before taking Subutex. On average, this will take 36 to 72 hours.
For some, this may be longer, depending on how long you’ve been taking methadone, liver function, age, and the amount of methadone last taken.
Can You Take Subutex While On Methadone?
Subutex and methadone shouldn’t be mixed. Taking Subutex with methadone could cause acute symptoms of opioid withdrawal, such as excessive vomiting, diarrhea, and pain.
This is known as precipitated withdrawal. Precipitated withdrawal could make for an uncomfortable few days. In severe cases, this could require medical treatment.
Find Help Switching From Methadone To Subutex Today
Making the switch from methadone to Subutex is possible with medical guidance and support. If you or a loved one is looking to switch medications, we may be able to help.
Call our helpline today for more information about switching MAT medications, or to find a treatment center that offers Subutex treatment near you.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Providers Clinical Support System — PSSC Guidance Transfer from Methadone to Buprenorphine
https://pcssnow.org/wp-content/uploads/2014/03/PCSS-MATGuidanceTransferMethadonetoBup.Casadonte.pdf - U.S. Food & Drug Administration (FDA) — SUBUTEX (buprenorphine sublingual tablets)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020732s018lbl.pdf - U.S. National Library of Medicine — Transferring Patients From Methadone to Buprenorphine: The Feasibility and Evaluation of Practice Guidelines
https://pubmed.ncbi.nlm.nih.gov/29509558/
