Is it possible to overdose on Belbuca (buprenorphine)?

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Last updated: April 3, 2025View editorial policy

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From the Guidelines

Yes, it is possible to overdose on Belbuca (buprenorphine buccal film), and it is crucial to take this medication exactly as prescribed to minimize the risk of overdose and other serious adverse effects. Belbuca is a potent opioid medication used for pain management, and taking more than prescribed can lead to a potentially life-threatening overdose. According to the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1, buprenorphine products approved for the treatment of pain are not included in the table of morphine milligram equivalent doses due to their partial μ-receptor agonist activity and resultant ceiling effects compared with full μ-receptor agonists. However, this does not mean that buprenorphine is without overdose risk.

Some key points to consider when taking Belbuca include:

  • Always taking the medication exactly as prescribed by your healthcare provider
  • Never increasing your dose without medical supervision
  • Storing Belbuca securely away from others to prevent accidental ingestion or misuse
  • Disposing of unused medication properly to prevent environmental contamination and misuse
  • Avoiding combinations with other central nervous system depressants like alcohol, benzodiazepines, or other opioids, as these can dangerously suppress breathing

Signs of Belbuca overdose include extreme drowsiness, pinpoint pupils, slowed or stopped breathing, bluish lips or skin, unconsciousness, and in severe cases, death. If you suspect someone is overdosing on Belbuca, call 911 immediately. Naloxone (Narcan) can reverse opioid overdose effects, but Belbuca overdoses may be particularly difficult to reverse because buprenorphine binds strongly to opioid receptors 1.

From the FDA Drug Label

Clinical Presentation The manifestations of acute overdose include pinpoint pupils, sedation, hypotension, respiratory depression, and death. Treatment of Overdose In the event of overdose, the respiratory and cardiac status of the patient should be monitored carefully When respiratory or cardiac functions are depressed, primary attention should be given to the re-establishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. Naloxone may be of value for the management of buprenorphine overdose. Yes, it is possible to overdose on Belbuca (buprenorphine). The key symptoms of an overdose include:

  • Pinpoint pupils
  • Sedation
  • Hypotension
  • Respiratory depression
  • Death Treatment for overdose involves careful monitoring and supportive measures, including the use of naloxone 2.

From the Research

Overdose on Belbuca

  • Belbuca is a brand name for the medication buprenorphine, which is used to treat pain and opioid use disorder.
  • According to the studies, buprenorphine has a ceiling effect on its cardio-respiratory depressant effect, meaning that it may have a wider safety margin compared to other opioid drugs 3.
  • However, it is still possible to overdose on buprenorphine, and respiratory depression can occur, especially when taken in large doses or combined with other substances 4, 5.

Risk of Respiratory Depression

  • Respiratory depression is a serious side effect of opioid overdose, and buprenorphine is no exception.
  • Studies have shown that buprenorphine can cause respiratory depression, especially in pediatric patients and when taken in large doses 4, 5.
  • The frequency of respiratory depression was found to be around 11% in both adult and pediatric patients who took buprenorphine orally, either alone or with other substances 4.

Treatment of Overdose

  • Naloxone is a medication that can be used to reverse opioid-induced respiratory depression, including buprenorphine overdose 6, 7, 5.
  • However, the effectiveness of naloxone may vary depending on the dose and type of opioid taken, as well as the individual's response to the medication 7.
  • In cases of buprenorphine overdose, naloxone may be administered to reverse respiratory depression, but it is essential to monitor the patient closely and adjust the treatment as needed 6, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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