Belbuca (buprenorphine): Side Effects, Dosage, Uses and More

What Is Belbuca (Buprenorphine)?

Belbuca is a strong pain medication that contains the opioid buprenorphine. Belbuca is used when other pain medications, including non-opioids, are ineffective. Belbuca is a dissolvable film placed in the lining of the cheek, making it easy to use.

Buprenorphine is often used as a treatment for opioid use disorder and pain. Although buprenorphine is an opioid like oxycodone and hydromorphone, it works differently and is safer. Buprenorphine is a partial agonist of opioid receptors, meaning it has a ceiling effect. Even if someone attempts to increase their dosage, it won’t increase the effects beyond a certain point.

Some of the common side effects of Belbuca can include:

• Nausea and vomiting
• Constipation
• Headache
• Dizziness
• Sleepiness

As with other narcotics, there is a potential for overdose with Belbecua. If you suspect someone has taken too much Belbuca, you should call 911 and give naloxone (Narcan) if it’s available.

What Does Belbuca Look Like?

Belbuca is a dissolvable film that’s small, square and yellow. When someone is prescribed Belbuca, it adheres to the buccal mucosa and should be fully dissolved within around 30 minutes. Belbuca requires more frequent dosing than something like Butrans. For example, Butrans is usually prescribed to be taken every 24 hours. Belbuca is typically taken every 12 hours for around-the-clock pain management. There are many Belbuca dosages available. These dosages include:

• 75 mcg
• 150 mcg
• 300 mcg
• 450 mcg
• 600 mcg
• 750 mcg
• 900 mcg

Is Belbuca Addictive?

Belbuca can be addictive and, therefore, is a Schedule III controlled substance. That said, buprenorphine doesn’t have the same risk of misuse as full opioid agonists like oxycodone. Any euphoria a person might experience will be milder than what they would experience with other prescription opioids or heroin, lowering the risk of misuse and addiction. 

Belbuca manufacturers include certain warnings with the drug. First, patients are instructed to apply it exactly as instructed by the prescribing healthcare provider and not to change the dose. People who use Belbuca should also avoid chewing, swallowing, snorting or injecting the drug, as this leads to an uncontrolled delivery of buprenorphine and can cause an overdose.

We understand the weight of addiction and its far-reaching effects. We’d like to help, so contact The Recovery Village to learn more.

Symptoms of Belbuca Abuse

Belbuca misuse is possible, but the risk is lower than other opioids. Buprenorphine, as a partial opioid agonist, has milder effects than other opioids. That’s why buprenorphine can be used as a medication-assisted treatment option for people who misuse or are dependent on other opioids. Buprenorphine doesn’t tend to produce the intense euphoric high people desire when they misuse opioids. There’s also a ceiling effect with buprenorphine. Beyond a certain point, the effects of buprenorphine aren’t going to increase by taking more, at least not significantly. Despite some of the features of Belbuca that make the misuse potential lower, the risk still exists to an extent. Before someone is prescribed Belbuca for pain, their doctor should review any history of substance misuse. Symptoms of Belbuca misuse can include:

• Taking a larger dose than advised by a medical provider
• Taking Belbuca more often than instructed by a physician
• Using Belbuca without a prescription
• Using it in other ways than how it should be used, such as liquefying the buprenorphine and injecting it
• Using Belbuca to get certain effects, such as euphoria or relaxation

Side Effects of Belbuca Abuse

While Belbuca may have milder overall effects than full opioid agonists, many of the drug’s side effects are similar to other prescription narcotics. Some possible side effects of Belbuca misuse can include addiction and dependence. Other physical side effects of Belbuca can include:

• Insomnia or sleep disturbances
• Strange sleep patterns
• Heart palpitations
• Dizziness
• Excessive drowsiness
• Nausea, vomiting and constipation
• Headaches or migraines
• Changes in behavior
• Attention problems
• Lowered blood pressure
• Sweating

Belbuca Withdrawal Timeline and Symptom Duration

Certain factors affect how long the Belbuca withdrawal timeline might last. For example, the length of time someone used Belbuca and whether they used it by prescription or misused it is relevant. The dosage can also determine the withdrawal timeline. For the most part, Belbuca withdrawal symptoms can start within 30 hours after the last dose. Withdrawal symptoms from Belbuca typically last around 10 days. Peak withdrawal symptoms usually occur within three to eight days after the last dose of buprenorphine. Some people may experience ongoing withdrawal symptoms that last for months. These symptoms tend to be psychological, such as depression, anxiety or insomnia.

Managing Symptoms of Belbuca Withdrawal

For people going through opioid withdrawal, including Belbuca withdrawal, symptoms aren’t typically fatal. However, the symptoms of Belbuca withdrawal can be uncomfortable and difficult. Rather than stopping cold turkey or trying to go through Belbuca withdrawal without medical help, experts recommend people seek professional help. A medical professional may advise patients to taper off Belbuca slowly, which can reduce or eliminate withdrawal symptoms. It’s not uncommon for people to experience recurring use after going through opioid detox, which must be addressed with professional help and guidance. Recurrence of use after detox is dangerous because people’s tolerance will have diminished, increasing their risk of overdose.

Can You Overdose on Belbuca?

Belbuca, in binding to opioid receptors even partially, can cause central nervous system depression. That central nervous system depression can cause a fatal overdose in some cases. That’s why it’s important for people to take Belbuca exactly as prescribed. Buprenorphine medications have a ceiling effect. This means that up to a certain point, even if someone continues using more, they won’t achieve more effects. For example, if someone attempted to get high using Belbuca, they might try to take a large dose. They could experience some mild euphoria, but eventually, taking more wouldn’t increase the desirable effects but could cause a deadly overdose. Some of the risk factors for a Belbuca overdose can include:

• Chewing the film or trying to inject the medication
• Using Belbuca in any way other than prescribed
• Using Belbuca without a prescription
• Using multiple film doses at one time
• Using Belbuca without an existing opioid tolerance
• Using Belbuca only to get high
• Taking Belbuca with another opioid medication or heroin
• Combining Belbuca and other central nervous system depressants like alcohol, benzodiazepines or prescription sleep aids

Belbuca vs. Suboxone

Belbuca is not the only buprenorphine-containing drug available for pain and opioid withdrawal symptoms. Another popular buprenorphine-based product is Suboxone. While both drugs contain the active ingredient buprenorphine, key differences set them apart.

What Is Suboxone?

Like Belbuca, Suboxone is an opioid that contains buprenorphine. It is also a Schedule III controlled substance that can be prescribed for pain or opioid withdrawal symptoms. However, unlike Belbuca, Suboxone also contains naloxone, which is included to make Suboxone safer than alternatives like Belbuca. This is because naloxone is an opioid reversal agent. When a person takes Suboxone by mouth as prescribed, the naloxone component is inert. However, if someone tries to abuse Suboxone by dissolving and injecting the drug, the naloxone component becomes active, blocking buprenorphine’s effects. Because of this extra layer of safety provided by Suboxone, experts prefer it to Belbuca for opioid use disorder.

Suboxone’s side effects include:

• Numbness in the mouth
• Tongue pain
• Red mucous membrane in the mouth
• Headache
• Nausea or vomiting
• Sweating
• Constipation
• Withdrawal symptoms
• Insomnia
• Swelling

Differences Between Belbuca and Suboxone

Belbuca and Suboxone are similar drugs in some ways but have important differences. Understanding their similarities and differences is key to being able to help determine which medication may be better for you:

Frequently Asked Questions About Belbuca

Does Belbuca Interact With Alcohol?

Belbuca and alcohol used together can increase the likelihood of side effects and their severity. Common side effects of mixing alcohol and Belbuca can include low blood pressure and overdose risk. Someone who’s mixed alcohol and Belbuca may experience impaired motor function and coordination, impaired thinking and judgment and changes in mood and behavior. Memory problems and blackouts may more likely happen when someone combines two substances, like alcohol and Belbuca.

How Long Does Belbuca Stay in Your Urine, Hair And Blood?

Belbuca can show up on drug tests. However, buprenorphine might not be tested for on a standard drug screening because the metabolite it leaves behind is different from other misused opioids. A drug test might have to specifically look for buprenorphine for it to show up on the screening. In a urine test, Belbuca and its breakdown products could show up for 14 days. In a hair test, a 1.5-inch hair sample should show if Belbuca was used in the past 90 days. Blood tests usually show if Belbuca was used 15–150 hours after the last dose.

Belbuca Addiction Treatment

Whether someone uses Belbuca for pain and becomes addicted or as a MAT, treatment may be needed. If someone requires treatment for Belbuca addiction symptoms, specific options are available. What’s important for people to realize is that addiction doesn’t have to continue being their reality. There is a way out — reach out to The Recovery Village for more information.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more