How long does buprenorphine last?
MAIN POINTS: Buprenorphine is a complex medication, with varied half-life and duration based on mode of administration. It has both slow onset and long duration (24-48 hours). The rate of absorption is slower by the sublingual route, giving an average peak level at approximately 200 minutes after ingestion.
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Buprenorphine is a prescription drug that helps address cravings and delay withdrawal symptoms for those facing opiate and opioid addiction. In fact, buprenorphine is a semi-synthetic opioid used for the treatment of opioid or opiate addiction. Buprenorphine is also used to treat moderate acute pain. How does it work in the brain?
Buprenorphine is a partial receptor agonist and acts in a way that attaches to specific sites in the brain to inducing several effects. However, the binding process is not “perfect” and buprenorphine occupies central nervous system receptors without causing the euphoric effect of other stronger drugs. In fact, this is the reason why buprenorphine is used in opioid addiction treatment.
The main therapeutic effects of buprenorphine include:
- Pain relief.
- Reduced cravings for opiates or opioid class drugs.
- Suspension of opiate withdrawal symptoms.
Common, unwanted side effects of the drug also include:
- slower breathing
- slower heart rate
It’s pretty difficult to get high on buprenorphine. The medication has been designed to be fairly “abuse-proof.” The euphoric effects of buprenorphine will depend on the level of tolerance that your body has developed toward buprenorphine. People already dosing on buprenorphine DO NOT experience euphoric. Commonly, only opioid-naive people can even feel that they are getting high. Further, it is likely that the euphoric effects will wear off after 8 to 12 hours.
Pay attention though: this number would be different if you are chronically taking buprenorphine for recreational purposes. Many users will go that far and change buprenorphine for another painkiller on their own, without a doctor’s recommendation to do so, and then experience different effects than mentioned on the product label. Indeed, mixing buprenorphine with other painkillers or prescription drugs increases risk of overdose and death.
Here is a list of the most common buprenorphine effects which can accompany euphoria:
- difficulty breathing or swallowing
- difficulty falling asleep or staying asleep
- extreme tiredness
- lack of energy
- loss of appetite
- pain in the upper right part of the stomach
- skin rash
- slowed breathing
- stomach pain
- unusual bleeding or bruising
- upset stomach
- yellowing of the skin or eyes
Onset of Effects
How quickly buprenorphine works will vary by individual and mode of administration. However, when taken as prescribed, buprenorphine has a “balancing effect” on the brain and should take effect in the first days after initial dosing. The formulations used in prescriptions usually take the form of sublingual tablets or a film, both of which are designed to dissolve in the mouth.
Well documented prescribing protocols and variations in onset of effect are outlined in this 2005 article from the medical journal, Psychiatry written by University of Maryland School of Medicine physicians, Christopher Welsh, MDc and Adela Valadez-Meltzer, MD, PhD.
Duration of Effects
Buprenorphine has different performance and effects depending on the form that is administered. For example, buprenorphine has very poor bioavailability when administered orally, in the form of solution. On the other hand, buprenorphine sublingual tablets trigger moderate bioavailability. This is why doctors usually prescribe sublingual tablets in the form of Subutuex, or buccal film in the form of Suboxone.
Injection: Pharmacological effects of buprenorphine peak at 15 minutes and persists for 6 hours or longer when given intramuscularly. When given intravenously, the time to onset and peak effect are shortened.
Sublingual: Even though buprenorphine is rapidly absorbed from the oral mucosa, the absorption into the systemic is slower. The time to reach peak plasma concentration varies between individuals and can range from 40 minutes to 3.5 hours
It’s also helpful to know that buprenorphine is highly bound to plasma proteins. Because of an extensive first pass in metabolism, buprenorphine has both slow onset and long duration (24-48 hours). As mentioned earlier, the rate of absorption is slower by the sublingual route, giving an average peak level at approximately 200 minutes after ingestion.
The half life of a drug is the amount of time it takes for 1/2 of the drug to leave your system. Buprenorphine has a half-life of 24 to 60 hours, depending on the route of administration and whether it was used in combination with other drugs. What’s important to know is that buprenorphine has slow offset, and the half life of buprenorphine is greater than 24 hours (24-60 hours). This formula allows for once a day or every other day dosing when treating opiate addiction.
Additionally, buprenorphine has the ability to stay and bind the opiate receptors for over 24 hours, effectively disabling the receptors to make use of other stronger opiates less appealing. For these cases, user cannot not get high on drugs like heroin, morphine, codeine, hydrocodone, or oxycodone.
Injection: 1.2 – 7.2 hours with 0.3 mg (mean 2.2 hours)
Sublingual: 37 hours.
If you have been prescribed a dose of buprenorphine, you may be interested in how this medicine works and how long buprenorphine can remain in your system. Generally, buprenorphine is detectable in urine for up to 4 days after last use. To learn more about the most common forms of this medication, you can check out the FDA label for Suboxone and the FDA label for Subutex.
If You Miss a Dose
Q: What can you do if you miss a dose of buprenorphine?
A: The Medline Plus Consumer Guide to Buprenorphine suggests that if you miss a dose, you should take or apply the missed dose as soon as you remember it. IHowever, i you notice that it’s almost time for your next dose, you should skip the missed dose and continue your regular dosing schedule. Do not take or apply a double dose to make up for a missed one. Why? Because buprenorphine has a “ceiling effect” that will not make the medication more effective, even if you take it in larger doses. Taking double doses has little to no positive effect for controlling cravings .
We hope we’ve been able to address your questions about buprenorphine above. If you would like to know more about how long buprenorphine lasts, please ask us in the comments section below. We try to respond to all legitimate queries with a personal and prompt response.
Reference Sources: Daily Med: BUPRENORPHINE HCL AND NALOXONE HCL (buprenorphine and naloxone) tablet
Photo credit: Didier Jansen