Can Bunavail (buprenorphine/naloxone) be cut in half?

Note that the brand Bunavail has been discontinued but generic equivalents are available under the name buprenorphine/naloxone. We have kept a record of this question for interest purposes only.

• The manufacturer states that Bunavail film should not be cut in half
• However, people do report cutting the film in half, even though the manufacturer recommends against it
• Because the active ingredients (buprenorphine and naloxone) are spread evenly throughout the strip, cutting it should not affect how the ingredients normally release.

Bunavail is a combination buccal film containing buprenorphine and naloxone. Buccal means that it is placed between the upper gum and inner cheek.

Bunavail comes in three strengths:

• Bunavail 2.1mg buprenorphine/0.3mg naloxone
• Bunavail 4.2mg buprenorphine/0.7mg naloxone
• Bunavail 6.3mg buprenorphine/1mg naloxone.

The strips are bi-layered with a medication side and a backing that encourages the absorption of buprenorphine and naloxone through the inner cheek into the bloodstream. Because of this delivery system, more medication is absorbed directly into the bloodstream, rather than being swallowed.

The manufacturer of Bunavail, BioDelivery Sciences International, Inc., has not done any testing on how cutting or tearing the film subsequently affects the absorption of Bunavail.

There is a concern that cutting or tearing the film may affect how much buprenorphine or naloxone (the active ingredients of Bunavail) is absorbed. It could also mean that more buprenorphine and naloxone is swallowed, rather than absorbed into the bloodstream through the inner cheek. Any buprenorphine and naloxone that is swallowed are ineffective.

However, it does appear that some doctors do prescribe a half dose of Bunavail and ask their patients to cut the strip in half. The easiest way to do this is to fold the strip in half and then use scissors to cut it. Because the active ingredients are spread evenly throughout the strip, it should not affect how Bunavail works.

How do you use Bunavail buccal film?

To use Bunavail buccal film:

• Wet the inside of the cheek with the tongue.
• Apply the side that has the active ingredients (this will be marked BN2, BN4, or BN6) to the wet area and hold in place for 5 seconds. The strip should stick upon contact.
• The backing of the strip ensures nearly all the Bunavail is absorbed into the bloodstream, through the cheek. The strip has a citrus-blend flavor.
• The time that it takes for each strip to dissolve varies depending on strength, but it is usually within 15 to 30 minutes. You should not eat or drink while the strip is dissolving; however, you can still talk while it is in place.
• There should be no residual film to remove afterward; however, if any is remaining after 30 minutes, you can remove it from your mouth and dispose of it safely. It is likely to just be the backing strip which contains no active ingredients.

Coadministration with liquids reduced the absorption of buprenorphine by 59% and naloxone, by up to 76%, which is why the film should be allowed to dissolve in the mouth without water or food.