Bunavail

Buprenorphine Post
compchat57
Posts: 35

Postby compchat57 » Sat Jul 12, 2014 7:03 am

@adavid,

What happens to the patch after the bup is absorbed. Does it dissolve and swallowed ?


adavid
Posts: 64

Postby adavid » Sat Jul 12, 2014 7:03 am

What tastes bad in Suboxone is the bup itself. The Bunavail patch has the bup painted on only one side - the side that goes against the cheek. The inert backing prevents the bup from getting on the tast buds on the tongue. The pt does not taste the bup.
Bunavail has been my product of choice for some two years. Legitimate looking patients are all uniformly happy with it. The unhappy ones are always those sporting many red flags.

Bunavail is not just another Zubsolv. It has very strong anti-abuse properties. This is very important since now both Subutex and Suboxone Film are widely used for their euphoric potential.

entjwb
Posts: 180

Postby entjwb » Sat Jul 12, 2014 7:03 am

Actually the delivery system of Bunavail has the advantage of almost or none lost in the saliva. With the sublingual delivery a lot of the medication will be in the saliva and may not be absorbed. The bioavailability varies a lot because can be dependent on the amount of saliva produced to dilute the medication. That is probably the reason the lesser dose can be used with same effects.

edibill
Posts: 101

Postby edibill » Sat Jul 12, 2014 7:03 am

By what mechanism would it decrease constipation?

rickbennettmd
Posts: 90

Postby rickbennettmd » Sat Jul 12, 2014 7:03 am


This buccal film preparation (Bunavail),posted by Dr. Passer, certainly is presented as an extremely convenient dosing form. It appears the patient simply places the patch in the cheek and immediately resumes normal activity.

Another new preparation to ponder, joining the also recently introduced Probuphine 6-month subcutaneous implantable preparation.

Interesting that the marketers tout the following:

1) bioavailability of this preparation is 100% -- 2 fold -- greater than the bioavailability of Suboxone preparations ("As a result of the improved absorption of buprenorphine with BUNAVAIL, which is the direct result of the BEMA technology, plasma concentrations of buprenorphine comparable to Suboxone can be achieved with half the dose."

2) constipation rate is 33% that of Suboxone preparations: "In addition, approximately 40% of patients taking sublingual tablets or film experienced constipation while on those medications. After switching to Bunavail, constipation resolved in more than two-thirds of the patients."

I would guess that most of us will be skeptical of these claims until very good, industry-independent studies are presented. In my experience, Zubsolv's claims of more efficient drug delivery are not actually borne out clinically.

I again disagree with the marketing plan, utilized also by Zubsolv, that has produced a pleasant tasting drug preparation. As has been discussed, this discards the less-than-pleasant-taste safeguard of Suboxone against accidental consumption and overdose in children. And what therapist wants to contribute to the administration reinforcement conditioning of an opiate preparation?

The cost of the preparation will largely determine it's utilization in the vast majority of our patients, as we all recognize.

That being said, Bunavail may indeed ultimately prove to be a significantly improved tool in our therapy.


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