Belbuca vs. Suboxone: What Is the Difference?


Belbuca is a potent prescription pain medication that contains buprenorphine in a buccal film form (that is meant to be placed against the cheek).

It is used for managing intense pain that requires continuous, long-term opioid treatment and does not go away with other pain relievers.

Suboxone is an FDA-approved oral drug used to treat opioid addiction. It contains a combination of buprenorphine and naloxone.

Both Belbuca and Suboxone use the same active ingredient, but they differ in their uses, side effects, and dosages.

Read on to understand the similarities and differences between both drugs.

Belbuca vs Suboxone: How Do They Work?

Belbuca and Suboxone work similarly because they have the same active ingredient—buprenorphine. Here’s a closer look.


Belbuca contains buprenorphine, a partial opioid agonist. This means it binds to the same receptors in the brain as opioids, but it activates them weakly compared to illegal drugs.

When Belbuca is administered as a buccal film (placed inside the cheek), buprenorphine is absorbed through the lining of the mouth so it goes right into the bloodstream.

From there, it binds to mu-opioid receptors in the brain and spinal cord, which reduces pain perception.

Partial activation of opioid receptors produces pain relief but with a ceiling effect. This means there’s a limit to how much pain relief Belbuca can provide.

Plus, buprenorphine binds strongly but detaches slowly from opioid receptors. The slow detachment contributes to its long-lasting pain relief effects.

The drug is designed as a last-resort treatment for pain that is not controlled by other painkillers, such as severe cancer pain.


Suboxone contains a combination of two active ingredients—buprenorphine and naloxone.

The goal of the buprenorphine in this formulation is to reduce opioid drug cravings and withdrawal symptoms without causing the same level of euphoria (happiness) or respiratory depression as drugs of abuse.

As for naloxone, it’s an opioid antagonist that blocks opioid receptors and prevents any drugs containing them from activating them.

When Suboxone is taken as prescribed (placed under the tongue), naloxone has minimal effect because it is poorly absorbed through the lining of the mouth.

But if an opioid use disorder patient attempts to misuse Suboxone by injecting it into a vein, naloxone becomes active.

It blocks the effects of buprenorphine and causes withdrawal symptoms in opioid-dependent individuals, preventing addiction to Suboxone.

Belbuca vs Suboxone: Precautions to Take

Since both drugs contain buprenorphine, there are several necessary precautions to consider before using either of them. These include:

1. Pregnancy concerns

Buprenorphine use during pregnancy can lead to life-threatening withdrawal symptoms in your newborn baby.

The condition is called neonatal opioid withdrawal syndrome, where newborns experience fever, sweating, poor feeding, difficulty breathing, and high-pitched crying.

2. Breastfeeding concerns

Buprenorphine is not recommended for breastfeeding mothers because it may pass into breast milk.

3. Household environment

If you live in a household with small children or people who have a history of abusing street or prescription drugs, take extra precautions to store Belbuca and Suboxone securely and out of reach.

4. Drug interactions

Buprenorphine can interact with other prescription drugs, over-the-counter medications, and herbal supplements.

Tell your doctor about all the medications and supplements you take before starting Belbuca or Suboxone to avoid serious side effects.

4. Drinking alcohol

Combining buprenorphine with alcohol can be dangerous and potentially fatal. The combination may lead to excessive drowsiness, dizziness, or lightheadedness.

Belbuca vs Suboxone: Side Effects

Here’s a look at how the side effects of Belbuca and Suboxone compare.


Common side effects of Belbuca include:

  • Constipation
  • Nausea
  • Vomiting
  • Headache
  • Dizziness
  • Drowsiness

More serious side effects that should prompt you to seek immediate medical attention include:

  • Slow/shallow breathing, including breathing that stops during sleep (sleep apnea)
  • Slow heartbeat or weak pulse
  • Feeling lightheaded, like you might pass out
  • Chest pain or trouble breathing
  • Severe constipation
  • Mental/mood changes (such as agitation, confusion, or hallucinations)
  • Difficulty urinating


Suboxone has similar side effects to Belbuca due to the presence of buprenorphine.

The naloxone component of Suboxone doesn’t cause side effects when taken by mouth as it’s not absorbed by the body through this route.

If someone attempts to inject Suboxone intravenously, naloxone triggers opioid withdrawal symptoms, including:

  • Watery eyes
  • Runny nose
  • Excessive swearing
  • Goosebumps
  • Excessive yawning
  • Tremors
  • Diarrhea
  • Restlessness

Belbuca vs Suboxone: Dosage

Belbuca and Suboxone come in different doses.


The dosage of Belbuca is measured in micrograms (mcg). It is available in the form of a square yellow dissolvable film in the following dosages:

  1. 75 mcg
  2. 150 mcg
  3. 300 mcg
  4. 450 mcg
  5. 600 mcg
  6. 750 mcg
  7. 900 mcg


Suboxone dosage is measured in milligrams (mg) of buprenorphine.

It comes in four different strengths, either as a sublingual film or tablet, with a buprenorphine-to-naloxone ratio of 4:1.

These strengths include:

  1. 2 mg buprenorphine/0.5 mg naloxone
  2. 4 mg buprenorphine/1 mg naloxone
  3. 8 mg buprenorphine/2 mg naloxone
  4. 12 mg buprenorphine/3 mg naloxone

Belbuca vs Suboxone: Which One’s Better for Pain Management?

Belbuca and Suboxone are approved for different purposes, despite sharing the same active ingredient.

Belbuca comes as a buccal film and is used to provide steady relief from severe, long-term pain unresponsive to other medications.

Suboxone, on the other hand, contains both buprenorphine and naloxone and is meant to manage opioid dependence by reducing cravings and withdrawal symptoms.

That said, it’s also sometimes used for long-term, chronic pain management, although this is an off-label use.

If your healthcare provider prescribes Suboxone for this purpose, only then is it okay to use it, and according to the instructions from a healthcare professional.

Frequently Asked Questions

Is Belbuca a Strong Pain Killer?

Yes, Belbuca is a strong prescription opioid pain medication for long-term pain. It’s reserved for severe cases due to addiction risks and side effects.

What Is the Difference Between Buccal and Sublingual Suboxone?

Buccal drugs dissolve against the cheek’s inner lining, while sublingual drugs dissolve under the tongue.

Access Medication-Assisted Opioid Addiction Treatment Today

At Curednation, we provide easily accessible addiction treatment plans customized to suit your requirements by skilled healthcare professionals.

If you wish to consult a knowledgeable addiction specialist about medication-assisted treatment, schedule an appointment today.


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