Buprenorphine/naloxone (Suboxone, Zubsolv)

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If you or someone else has severe breathing problems, collapses, or cannot be woken, call 999 immediately.
For urgent non-emergency advice, contact NHS 111 or your opioid treatment service.

Current UK Shortage Status

What has happened

• Buprenorphine/naloxone (Suboxone®) 2mg/500microgram and 8mg/2mg sublingual tablets were discontinued on 5 January 2026.
• Buprenorphine/naloxone (Zubsolv®) sublingual tablets in strengths 0.7mg/0.18mg, 1.4mg/0.36mg, 5.7mg/1.4mg, 8.6mg/2.1mg and 11.4mg/2.9mg are available as short-dated stock only. Future supply to the UK has not been confirmed.
• Buprenorphine (Subutex®) tablets have also been discontinued.

Alternatives that remain available

• Branded and generic buprenorphine sublingual tablets (2mg and 8mg)
• Buprenorphine oral lyophilisate 2mg and 8mg (Espranor®)

What patients should do today

• Do not stop taking your medication without speaking to your prescriber, pharmacist or opioid treatment service.
• If you are concerned about supply, contact your treatment team as soon as possible. Changes between products must be led by your prescriber.
• Do not borrow, share, split or change doses without clinical guidance.

*Source: CPE Medicine Supply Notification MSN/2026/002, accessed 13 May 2026 — https://cpe.org.uk/our-news/medicine-supply-notification-buprenorphine-naloxone-suboxone-2mg-500microgram-and-8mg-2mg-sublingual-tablets/*

Plain-English Summary

Buprenorphine/naloxone is a combination medicine used to treat dependence on opioid drugs such as heroin or morphine. It is taken as part of a supervised programme that includes medical, social and psychological support. In the UK it has been available as Suboxone and Zubsolv. Suboxone tablets have been discontinued, and future UK availability of Zubsolv is uncertain.

What Is Buprenorphine/naloxone Used For?

Buprenorphine/naloxone is used as substitution treatment for opioid drug dependence. It is prescribed for adults and adolescents aged 15 years and over who have agreed to treatment and are receiving medical, social and psychological support.

Substitution treatment aims to reduce or stop the use of non-prescribed opioids, reduce cravings, and help people stabilise their lives. It is not a standalone cure — the support programme around it is essential.

*Source: EMA EPAR — Suboxone, accessed 13 May 2026 — https://www.ema.europa.eu/en/medicines/human/EPAR/suboxone*

How It Works

The medicine contains two active ingredients:

• Buprenorphine is a partial opioid agonist. It acts on the same brain receptors as opioids like heroin or morphine, but its effects are weaker. It reduces withdrawal symptoms and cravings without producing the same level of intoxication.
• Naloxone is an opioid antagonist (blocker). When the medicine is taken correctly (dissolved under the tongue), naloxone has little effect. If someone tries to dissolve and inject the medicine, naloxone counteracts the opioid effects and can cause withdrawal symptoms.

This combination is designed to help people stay in treatment while reducing the risk of the medicine being misused by injection.

*Sources: EMA EPAR — Suboxone, accessed 13 May 2026 — https://www.ema.europa.eu/en/medicines/human/EPAR/suboxone; EMA EPAR — Zubsolv, accessed 13 May 2026 — https://www.ema.europa.eu/en/medicines/human/EPAR/zubsolv*

Products and Strengths Mentioned in Official Sources

CPE-confirmed UK supply facts (MSN/2026/002)

Discontinued:

• Suboxone® 2mg/500microgram sublingual tablets
• Suboxone® 8mg/2mg sublingual tablets

Short-dated UK stock available (future supply unconfirmed):

• Zubsolv® 0.7mg/0.18mg sublingual tablets
• Zubsolv® 1.4mg/0.36mg sublingual tablets
• Zubsolv® 5.7mg/1.4mg sublingual tablets
• Zubsolv® 8.6mg/2.1mg sublingual tablets
• Zubsolv® 11.4mg/2.9mg sublingual tablets

Alternatives that remain available:

• Buprenorphine sublingual tablets (2mg and 8mg) — branded and generic
• Buprenorphine oral lyophilisate 2mg and 8mg (Espranor®)

EMA product-authorisation background

The EMA European Public Assessment Reports describe additional strengths and formulations that have been authorised in the EU, but these may not all have been marketed or currently available in the UK:

• Suboxone was also authorised as sublingual films in strengths including 16mg/4mg.
• Zubsolv is additionally authorised at 2.9mg/0.71mg.

Zubsolv and Suboxone are not interchangeable. The EMA states that some Zubsolv strengths produce different blood levels of the active substances compared with Suboxone, so switching between them requires medical supervision.

*Sources: CPE MSN/2026/002, accessed 13 May 2026 — https://cpe.org.uk/our-news/medicine-supply-notification-buprenorphine-naloxone-suboxone-2mg-500microgram-and-8mg-2mg-sublingual-tablets/; EMA EPAR — Suboxone, accessed 13 May 2026; EMA EPAR — Zubsolv, accessed 13 May 2026*

Brand and Generic Names

• Suboxone — combination brand (buprenorphine/naloxone)
• Zubsolv — combination brand with different tablet strengths
• Espranor — buprenorphine alone (oral lyophilisate), listed by CPE as an alternative
• Buprenorphine — generic mono-product tablets are also available

*Sources: EMA EPARs; CPE MSN/2026/002*

Invention and Approval History

Buprenorphine itself has been used in the EU since the mid-1990s for opioid addiction. The addition of naloxone was developed as a strategy to reduce misuse by injection.

• Suboxone received a European marketing authorisation on 26 September 2006 (CHMP opinion 27 July 2006).
• Zubsolv received a European marketing authorisation on 10 November 2017 as a hybrid medicine referencing Suboxone.
• In the UK, NICE Technology Appraisal 114 (published 24 January 2007) recommended methadone and buprenorphine as treatment options for opioid dependence.

*Sources: EMA EPAR — Suboxone, accessed 13 May 2026; EMA EPAR — Zubsolv, accessed 13 May 2026; NICE TA114, accessed 13 May 2026 — https://www.nice.org.uk/guidance/ta114/chapter/1-Recommendations*

How Medicines of This Type Are Made

Official patient information sources do not usually describe the proprietary manufacturing processes for specific medicines. The clinically relevant detail is how the active ingredients work (see "How It Works" above). If you need information about how a specific product is manufactured, ask your pharmacist or contact the marketing authorisation holder.

UK Suppliers and Marketing Authorisation Holders

The following marketing authorisation holder information comes from the EMA European Public Assessment Reports. UK-specific marketing authorisation or distribution arrangements should be confirmed with the MHRA or the product supplier:

• Suboxone: Indivior Europe Limited, Dublin, Ireland
• Zubsolv: Accord Healthcare S.L.U., Barcelona, Spain

In the UK, these medicines are supplied through specialist addiction services and pharmacies. Because they are controlled drugs, they are subject to stricter prescription and dispensing rules than ordinary medicines. Any change of product or supplier must be handled by your prescriber and pharmacy team.

*Sources: EMA EPAR — Suboxone; EMA EPAR — Zubsolv*

Common Side Effects

Side effects are usually mild and often improve as treatment continues. The most common (may affect more than 1 in 10 people) include:

• Insomnia (difficulty sleeping)
• Constipation
• Nausea (feeling sick)
• Sweating
• Headache
• Withdrawal syndrome (especially if started too soon after last opioid use)

With Zubsolv specifically, common side effects also include excessive sweating and pain.

*Sources: EMA EPAR — Suboxone, accessed 13 May 2026; EMA EPAR — Zubsolv, accessed 13 May 2026*

Serious Side Effects and When to Get Urgent Help

Call 999 immediately if you or someone you know has:

• Severe difficulty breathing or very shallow breathing
• Extreme drowsiness or inability to wake
• Blue lips or fingernails
• Swelling of the face, lips or tongue, difficulty breathing, or a severe rash (possible severe allergic reaction)

Contact your prescriber or opioid treatment service urgently if you develop:

• Yellowing of the skin or eyes
• Severe vomiting or persistent diarrhoea
• Seizures (fits)

Product information says this medicine may not be suitable for people with severe breathing problems, severe liver disease, acute alcohol intoxication or delirium tremens, or those also taking naltrexone or nalmefene. Your prescriber will assess whether it is appropriate for you.

*Sources: EMA EPAR — Suboxone; EMA EPAR — Zubsolv*

Interactions and Cautions

Sedatives and alcohol: Taking buprenorphine/naloxone with benzodiazepines, other tranquillisers, sedatives, or alcohol can cause severe drowsiness, breathing problems, coma or death. Tell your clinician about any sedatives you are taking.

Other medicines to tell your prescriber about:

• Naltrexone or nalmefene (product information says these must not be used together)
• Certain antifungal or antibiotic medicines
• Medicines that affect liver enzymes
• Other opioids or painkillers

General cautions:

• Liver function should be checked before starting and monitored during treatment.
• The medicine can cause dependence, which is why it is prescribed under supervision.
• Keep all supplies in a safe place, away from children and anyone for whom it is not prescribed. Accidental ingestion of opioid medicines can be fatal.

*Sources: EMA EPAR — Suboxone; GOV.UK/DHSC — Oral methadone and buprenorphine: recommendations, accessed 13 May 2026 — https://www.gov.uk/government/publications/medicine-choices-in-opioid-substitution-treatment/oral-methadone-and-buprenorphine-recommendations*

Pregnancy, Breastfeeding, Driving and Alcohol

Pregnancy: The UKTIS/Medicines in Pregnancy information below refers to buprenorphine alone, not specifically the buprenorphine/naloxone combination. Buprenorphine can be used in pregnancy under medical supervision. Current evidence does not suggest it harms the baby's development, though more research is needed. If buprenorphine is used around the time of delivery, the baby may be jittery, have feeding problems, or need temporary help with breathing. These issues usually settle within a few days. Do not stop or change your dose without speaking to your doctor — withdrawal can be harmful to both you and the baby. If you are taking buprenorphine/naloxone specifically, ask your specialist for combination-specific advice.

Breastfeeding: Small amounts of buprenorphine pass into breast milk. The amount is usually very low and side effects in breastfed infants are rare, but babies should be monitored for drowsiness, breathing problems or poor weight gain. Discuss breastfeeding with your specialist, especially if you are taking the buprenorphine/naloxone combination.

Driving: Buprenorphine can cause drowsiness and slow reaction times. Do not drive or operate machinery if you feel drowsy, dizzy, or less alert than usual. Ask your prescriber or pharmacist for advice about your specific situation and any legal obligations related to driving while taking this medicine.

Alcohol: Drinking alcohol while taking buprenorphine/naloxone increases the risk of dangerous sedation and breathing problems. Avoid alcohol unless your clinician has told you otherwise.

*Sources: EMA EPAR — Suboxone; Medicines in Pregnancy (UKTIS) — Buprenorphine, accessed 13 May 2026 — https://www.medicinesinpregnancy.org/leaflets-a-z/buprenorphine/; GOV.UK/DHSC Orange Book supplement*

Missed Doses and Stopping Suddenly

If you miss a dose or are unsure what to do, contact your prescriber, pharmacist or opioid treatment service. Do not take a double dose to make up for a missed one unless your patient information leaflet or clinician specifically tells you to.

Do not stop buprenorphine/naloxone suddenly without speaking to your prescriber. Stopping suddenly can cause withdrawal symptoms. If you and your clinician agree to reduce or stop treatment, this is usually done gradually.

*Note: Specific missed-dose instructions should be confirmed with your patient information leaflet or clinical team.*

Monitoring and Check-Ups

While taking buprenorphine/naloxone you should have:

• Regular clinical reviews with your prescriber or keyworker
• Random drug tests to check for non-prescribed substance use
• Liver function tests before starting and periodically during treatment
• Reviews of your dispensing arrangement

NICE guidance recommends daily supervised consumption for at least the first 3 months. The 2024 DHSC guidance allows more flexibility for buprenorphine depending on individual risk assessment. Your treatment team will decide what is appropriate for you.

*Sources: EMA EPAR — Suboxone; NICE TA114; GOV.UK/DHSC Orange Book supplement 2024*

What to Ask a Pharmacist or GP During Supply Issues

If your usual buprenorphine/naloxone product is unavailable, ask your prescriber or pharmacist:

1. What prescriber-led options are available? CPE lists buprenorphine sublingual tablets and Espranor as alternatives that remain available.
2. Is Zubsolv in stock, and is the strength different from my previous medicine? Zubsolv and Suboxone are not interchangeable — any switch requires medical supervision and your dose may need adjusting.
3. Will my supervision or pharmacy arrangements change? Different products may have different supply arrangements.
4. Do I need a new prescription? Controlled-drug rules mean product changes usually require a new prescription from your prescriber.

*Sources: CPE MSN/2026/002; EMA EPAR — Zubsolv*

Related Medicines a Clinician May Discuss

If buprenorphine/naloxone is unavailable or unsuitable, your clinician may discuss:

• Buprenorphine alone (sublingual tablets or Espranor oral lyophilisate)
• Methadone — the other main opioid substitution medicine recommended by NICE
• Long-acting buprenorphine injections — newer formulations that may be introduced under updated guidance
• Naltrexone — an opioid blocker used after detoxification to prevent relapse

Your treatment team will choose the best option based on your medical history, stability, and preferences.

*Sources: NICE TA114; GOV.UK/DHSC Orange Book supplement 2024*

Frequently Asked Questions

Is Suboxone discontinued in the UK?

Yes. Suboxone 2mg/500microgram and 8mg/2mg sublingual tablets were discontinued on 5 January 2026, according to DHSC/CPE MSN/2026/002.

Is Zubsolv still available in the UK?

Short-dated stock of certain Zubsolv strengths is available, but future supply to the UK has not been confirmed. Contact your prescriber or pharmacist to check current stock.

Can my pharmacist substitute buprenorphine/naloxone with a different brand?

No. Buprenorphine/naloxone products are not interchangeable without prescriber supervision. Any change must be led by your treatment team.

What should I do if I only have a few doses left?

Contact your prescriber, pharmacist or opioid treatment service as soon as possible. Do not stop taking your medication or change your dose without clinical guidance.

What alternatives are available?

According to CPE MSN/2026/002, branded and generic buprenorphine sublingual tablets (2mg and 8mg) and buprenorphine oral lyophilisate 2mg and 8mg (Espranor) remain available.

Official Sources and Correction Route

This article is based on:

• CPE Medicine Supply Notification MSN/2026/002 — https://cpe.org.uk/our-news/medicine-supply-notification-buprenorphine-naloxone-suboxone-2mg-500microgram-and-8mg-2mg-sublingual-tablets/ (accessed 13 May 2026)
• EMA European Public Assessment Report — Suboxone — https://www.ema.europa.eu/en/medicines/human/EPAR/suboxone (accessed 13 May 2026)
• EMA European Public Assessment Report — Zubsolv — https://www.ema.europa.eu/en/medicines/human/EPAR/zubsolv (accessed 13 May 2026)
• NICE Technology Appraisal 114 — Methadone and buprenorphine for the management of opioid dependence — https://www.nice.org.uk/guidance/ta114/chapter/1-Recommendations (accessed 13 May 2026)
• GOV.UK / DHSC — Oral methadone and buprenorphine: recommendations (2024 Orange Book supplement) — https://www.gov.uk/government/publications/medicine-choices-in-opioid-substitution-treatment/oral-methadone-and-buprenorphine-recommendations (accessed 13 May 2026)
• UKTIS / Medicines in Pregnancy — Buprenorphine — https://www.medicinesinpregnancy.org/leaflets-a-z/buprenorphine/ (accessed 13 May 2026)

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