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Is Bunavail safe?

Yes, Bunavail is generally a safe medication.

Bunavail is used in medication-assisted treatment (MAT) to help people reduce or quit the use of heroin or other opiates, such as pain relievers like morphine.

This article provides you with information about the safe use of Bunavail in treatment, plus its side effects. Additionally, some of you may be wondering if Bunavail is safe for long-term treatment, or not.

We’ll review and answer these questions here. Then, we invite your questions about the safe use of Bunavail at the end. In fact, we try to answer ALL legitimate questions personally and promptly.

Bunavail safety

Bunavail was approved by the Food and Drug Administration (FDA) for the maintenance treatment of drug dependence, to be used as part of a complete treatment plan which include counseling and psychosocial support. The main ingredients found in Bunavail are buprenorphine and naloxone.

Bunavail is a controlled substance (CIII) because it contains buprenorphine, which can be a target for people who abuse prescription medicines or street drugs. When taken as prescribed, buprenorphine is safe and effective. It is not known if Bunavail is safe or effective in children and should not be used when you are pregnant or breastfeeding.  Additionally, prescription is limited under the Drug Addiction Treatment Act and is available only with a certified doctor’s prescription.

How does Bunavail (buprenorphine) work? Bunavail works in the body by helping:

  1. Diminish the effects of physical dependency to the opiate or opioid you’re addicted to. It helps minimize withdrawal symptoms and cravings.
  2. Increase safety precautions in cases of overdose.
  3. Lower the potential for misuse.

To be more specific, we’ll explain a little more about drug dependence. When you use a narcotic medicine for a long time, it becomes habit-forming, causing mental or physical dependence. Physical dependence may lead to withdrawal side effects if the narcotic is stopped suddenly.

Severe withdrawal side effects can usually be prevented when a person is switched to Bunavail. It acts on the central nervous system (CNS) to help prevent the withdrawal side effects.

Can taking Bunavail cause serious side effects?

Bunavail may cause side effects and you should consult your doctor if any of these symptoms appear and do not go away:

  • back pain
  • blurred vision
  • constipation
  • difficulty falling asleep or staying asleep
  • headache
  • mouth numbness or redness
  • stomach pain
  • tongue pain
  • vomiting

Further, these are some of the more serious side effects:

  • confusion
  • dark-colored urine
  • lack of energy
  • light-colored stools
  • loss of appetite
  • upset stomach
  • yellowing of the skin or eyes
  • blurred vision
  • difficulty breathing or swallowing
  • extreme tiredness
  • hives
  • itching
  • nausea
  • pain in the upper right part of the stomach
  • skin rash
  • slowed breathing
  • slurred speech
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • unusual bleeding or bruising

If you feel faint, dizzy and confused, or if your breathing gets much slower than is normal for you, then you should call your doctor right away or get emergency help because these can be signs of an overdose or other serious problems.

SPECIAL PRECAUTIONS: An overdose, and even death, can happen if you take Bunavail at the same time that you are using:

  • alcohol
  • benzodiazepines
  • sedatives
  • tranquilizers

NOTE HERE: Do not inject (“shoot-up”) Bunavail because:

1. Injecting Bunavail may cause life-threatening infections and other serious health problems.

2. Injecting Bunavail may cause serious withdrawal symptoms such as:

  • anxiety
  • cramps
  • cravings
  • diarrhea
  • pain
  • sleep problems
  • vomiting

How much Bunavail is safe to take?

Most Bunavail buccal film prescriptions are prescribed as a single daily dose of buprenorphine/naloxone. The recommended daily dose for maintenance is 8.4 mg/1.4 mg. Dosage should be adjusted using increments/decrements of 2.1/0.3 mg Bunavail buccal film units. Maintenance doses range from 2.1/0.3 mg to 12.6/2.1 mg Bunavail per day. Doses above this range have not been shown to provide a clinical advantage.

Bunavail safety instructions

This medication comes in the form of buccal film. Your health caregiver should show you how to use Bunavail. When taking Bunavail film rinse your mouth with water to moisten it. Place the side of the film with the text (BN2, BN4, or BN6) against the inside of your cheek. If your doctor told you to use more than 1 film, place the second film inside your other cheek. Do not place more than 2 films inside of 1 cheek at a time. Do not move or touch the film. Do not eat or drink anything until the film is completely dissolved.

When taking a sublingual (under the tongue) film, drink some water to help moisten your mouth. Place the film under your tongue. If your doctor told you to use more than 1 film, place the second film on the opposite side from the first one. Do not move the film after you place it under your tongue. If you are supposed to use more than 2 films, use them the same way, but do not start until the first 2 films are completely dissolved.

When taking a sublingual tablet, place the tablet under your tongue. If your doctor told you to use more than 1 tablet, place all of the tablets in different places under your tongue at the same time. You can use 2 tablets at a time until you have taken all of the medicine, if that is easier for you. Let the tablets dissolve completely in your mouth. Do not eat or drink anything until the tablets are completely dissolved.

Do not break, crush, chew, or cut the film or tablet.

NOTE HERE: Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
You must let the medicine dissolve. Never swallow the film or tablet. Your body may not absorb enough of the medicine if you swallow it.

NOTE ALSO: Do not switch from Bunavail to other medicines that contain buprenorphine without talking with your doctor. Also, talk to your doctor about drinking grapefruit juice while taking or using this medicine.

For additional safety, have these rules in mind:

  1. Bunavail is not for occasional or “as needed” use.
  2. Never give your Bunavail to anyone else. It can cause death or harm them.
  3. Selling or giving away this medicine is against the law.

Who should not take Bunavail?

People allergic to buprenorphine or naloxone. Before taking Bunavail, tell your doctor if you:

  • Are breastfeeding or plan to breastfeed. Bunavail can pass into your breast milk and may harm your baby.
  • Are pregnant or plan to become pregnant. It is not known if Bunavail will harm your unborn baby. If you take Bunavail while pregnant, your baby may have symptoms of withdrawal at birth. Talk to your doctor if you are pregnant or plan to become pregnant.
  • Have Addison’s disease.
  • Have adrenal gland problems.
  • Have a curve in your spine that affects your breathing.
  • Have a head injury or brain problem.
  • Have a history of alcoholism.
  • Have an enlarged prostate gland (men).
  • Have problems urinating.
  • Have gallbladder problems.
  • Have liver or kidney problems.
  • Have low thyroid (hypothyroidism).
  • Have mental problems such as hallucinations.
  • Have trouble breathing or lung problems.
  • Have any other medical condition.

Is Bunavail safe for long term use?

Bunavail contains an opioid that can cause physical dependence. After a long term use you could become sick with uncomfortable withdrawal signs and symptoms because your body will become used to this medicine. We recommend not to stop taking Bunavail without talking to your doctor first.

How to come off Bunavail safely?

If you plan to come off Bunavail, do not stop using this medicine suddenly. Ask your doctor to slowly decrease your dose before you stop it completely. This process is called “tapering”. The most effective and safest way to taper is under a physician and pharmacist’s supervision.

Bunavail safety questions

If you still have questions about Bunavail safety or use, please leave them here. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular question, we will refer you to someone who does.

Reference Sources: PBM: Buprenorphine / Naloxone Buccal Film (Bunavail) C-III National PBM Abbreviated Drug Review
SAMHSA: Buprenorphine
NCBI: Buprenorphine/Naloxone (Into the mouth)
FDA:Bunvail Medication guide
FDA: Bunavail label
Medline Plus: Buprenorphine Sublingual and Buccal

Photo credit: DailyMed

Leave a Reply

3 Responses to “Is Bunavail safe?
Tracy
2:34 am March 20th, 2016

I started the Bunavail on Thursday. After the first dose I became very dizzy vomiting and extremely tired. It’s now Saturday night and the right side of my neck is swollen, chipmunk style! I’m getting concerned and am too scared to take benadryl. Definitely asking to change to something else on Monday!! Anyone had their glands swell??

R Johnson
9:15 pm April 29th, 2016

Buprenorphine treatment is a good option for those who are struggling with opiate addiction and seeking long term recovery. It should be viewed as one component of a comprehensive program for care, which should also include counseling, education and holistic healthcare.

Melody
11:37 am September 1st, 2018

Started using Bunavail mid June after 1st using Subsolve May 1-mid June/stopped due to the “menthol flavor” which BURNED intensely under tongue causing massive blistsering. The Bunavail films also “burm” on cheeks immedidately when starting dissolving, left on for 30 min 2 xs daily. The most serious issues (1) blurred vision getting worse (2) teeth affected/crumbling to gumline which NO the teeth were NOT in this horrific condition (age 71) however due to the opidiod pain meds prescribed,the side effect of opidios causing brittle bones also in concert w/Vit D defenency due to Dr/2009 told me to “say OUT of sunlight 100% due to the massive # of BP meds taken” Result? Vit D defencency. Take supplements/eat rare foods that contain Vit D. But now? the teeth problem from the films is so massive I now have Sept 27 appointments in adjoining state with (1) oral surgeon who is ALSO and MD (2) dentist who will do the dentures after oral surgery. The dentist seen in my town here read ALL med conditions and firmly states I MUST have an MD because of the severity of my conditions so he made appointments with highly regraded oral surgeron who is also MD + the dentist and told ALL conditions + the loss of teeth. He also saw the Bunavail film before usage with the “blue ink” and the SHELLAC + multiple sodium components. I have 1 kidney and sodium is highly restricted. Using 2 xs daily the dissolved “gunk” inside cheek is “scraped off: with a warmed paper towel over and over then toothbrush removes “gunk” that has slid on top and sides and inbetween teeth. I was referred to the Interention Pain Clinic by primary care because HE prescribed pain meds for chronic pain conditions for 20 yrs (serious bone conditions throughout entire body) that contained opioids. Bunvail also contains opioid. Started program May 1. Ive been told that my “oral surgeon” will need to contact the Pain clinic Dr to “discuss which meds will be used for pain for the oral surgery and the nurse stated YES I will be expected to continue use of the Bunavail fillm or a “complimentary opioid” will be used during the oral surgery + denture fixing and insertion. I will meet with new oral surgeon/dentist Sept 27 so at this time I do NOT know anything more. I will have my monthly meeting mid Sept with the pain clinic Dr and will find out more about what will happen to me with this massive oral surgery situation. My overall health has been drastically affected as blurred vision, daily headaches, earaches, racing heart, shallow breathing ( have scoliosis bending the upper spine) along with other massive arthritic areas throughout body from head to toes. As has been explained to me NO I am NOT a “true addict” but a patient prescribed opidiod containing pain meds for chronic pain conditions. I was NOT told that the pain meds contained opidios nor any info regarding addiction possibilities. I was simply given a new pain med and told “this will insure your pain will now be controlled and return at least a part of quality of life for you.” That was 2014. 2/14//2018 was told ‘oops” now I will refer you to this pain clinic and you MUST go and get help to get the opdiods out of your body and when I asked the pain clinic dr “how long will I be on these meds”………answer “it took years for to build up in your body and it will take years to get the Os out.” I am also told each visit that “you cant stop this program any time you want: I have NEVER said one word about stopping! and added last visit “I can help you find a doctor to help you”……NEVER said one word about wanting another Dr either!” And when I reveal the “side effects: ie blurred vision, etc? NEVER are those side effects discussed. I will be 72 this yr and I never expected the end of my life would be filled with this much negativity and this much agony and yes pain that I have continued to have…..and yes I am concerned about taking “blue ink” and shellac 2 xs a day…….back in the 1950s shellac was used as a paint “shining” “sealer” and one had to use it with extreme ventilation! Now? I have this dissolving in my already medically condemned body? oh yes lets not forget that once the film is place on cheek and the burning starts….the heart beat also races HARD.and this morning? the left arm got numb from shoulder to finger tips! I had 1 heart attack age 40/stress. And now? I feel that heart race 2 xs daily with this film dissolving!