Why do you have to let the drug Subutex dissolve under the tongue rather than swallow like other pills?

Question

The drug Subutex (and Suboxone) is used for treatment for opiate(narcotic) dependence; as is Methadone. However, with Methadone all one needs to do is swallow the pill, with Subutex and Suboxone it must be dissolved slowly under the tongue--sublingually. I don't like the taste and would prefer to simply swallow the pills, but the Dr. and pharmacist say allow it to dissolve slowly until gone under the tongue. Will I start to have withdrawals if I swallow the pill instead of allowing it to dissolve? Also, I'm taking a daily total of 8mgs...2mgs x 4per day. Is that the usual dosage? What are dosages that seem to work the best or are prescribed most frequently?

Answer 1

Usually when a medication is given sublingually it is because it cannot be given orally due to metabolism issues.

When a medication is given orally, it is absorbed through the walls of your GI tract and into the blood stream. The artery it is absorbed into goes directly to the liver, where most drugs are metabolized (inactivated). Some drugs are metabolized to such an extent that you might as well have not even taken the dose at all. This is called the "first pass effect."

If a drug is allowed to dissolve under the tongue, instead of going into your stomach like it seems it is, it is absorbed by a blood vessel under your tongue that does not go to the liver, so the drug doesn't have the "first pass effect" and it will be able to work in your body.

Answer 2

The slow dissolving under the tongue will help the Subutex work faster and more effeceintly. Sorry for the taste try sucking on a lime or lemon right after.

Answer 3

Subutex Pill

Answer 4

If you swallow the pill, it won't work. Sublingual administration is given to drugs which breakdown readily in the stomach or the liver. This administration allows the drug to directly absorb into the bloodstream. You'll get faster onset.

Answer 5

elyfant15 is correct. One of the side effects of Subutex is liver damage so bypassing the liver sublingually is important. The drug also contains Naloxone which block the effects of narcotics. This drug is included to keep addicts from injecting Subutex by causing bad withdrawal effects. This effect is also bypassed by taking Subutex sublingually. For patient information click on the following link:
http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm

Answer 6

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This is the case for some naturopathic remedies - Bach flower essences, for instance, are supposed to be squirted under the tongue. I believe it is so they can be absorbed into the body more efficiently.