Key facts
- Type: Opioid Use Disorder Treatment · Medically Assisted Treatment (MAT)
- ATC Code: N07BC01
- Kenya EML 2023: Listed
- Level of Use: Level 5-6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Controlled Medicine: MAT Programmes Only
Dispensed through licensed MAT programmes in Kenya.
What it treats
Which conditions is Buprenorphine / Buprenorphine-Naloxone used for?
Overview
What is Buprenorphine / Buprenorphine-Naloxone?
Buprenorphine is used as a treatment for opioid use disorder within licensed MAT programmes. It is often combined with naloxone in a combined formulation called Suboxone, which reduces the risk of the medicine being misused.
Compared to methadone, buprenorphine has a built-in safety advantage: because it is only a partial activator of opioid receptors, increasing the dose beyond a certain point produces no additional effect. This ceiling effect means taking a larger amount does not produce the dangerous breathing suppression that methadone can at high doses.
Both buprenorphine and buprenorphine-naloxone are listed in Kenya’s Essential Medicines List 2023.
How it works
What does it do in the brain?
Buprenorphine partially activates the same receptors that heroin and other opioids target. This partial activation is enough to prevent withdrawal symptoms and reduce cravings, but is not sufficient to produce the intense effects associated with heroin. The naloxone component deters injection misuse. If injected, naloxone immediately blocks all opioid effects.
Formulations in Kenya
How is it available?
Sublingual film or tablet Available through MAT programmes Dissolved under the tongue MAT programme facilities only
Availability across Africa
Where is it available in Africa and what is it called?
Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Uganda | Subutex, Suboxone | Available through select MAT programmes in Kampala. |
| Tanzania | Suboxone | Available through MAT programmes in Dar es Salaam. |
| South Africa | Suboxone, Subutex | Available in private addiction clinics and select public MAT programmes. |
| Nigeria | Suboxone | Available through select private addiction treatment centres in Lagos and Abuja. |
| Mauritius | Suboxone | Part of the national MAT programme; available as an alternative to methadone. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Headache
- Nausea
- Constipation
- Insomnia
- Sweating
- With long-term sublingual use, dental hygiene needs extra attention
Go to a doctor or emergency room straight away if you notice any of the following.
- If taken before a person is in sufficient withdrawal from opioids, buprenorphine can trigger sudden severe withdrawal. Your MAT team will assess readiness before giving the first dose.
- Breathing problems remain a risk if buprenorphine is combined with alcohol, benzodiazepines, or other sedating substances.
Who should not take it
Important warnings before starting
Tell your doctor about all your medical conditions, allergies, and other medicines before starting Buprenorphine / Buprenorphine-Naloxone.
- Taking the medicine before opioid withdrawal has adequately begun
- Severe liver disease
- Currently taking MAOIs
Special care needed
Situations that need extra attention
- The first dose is given only after the MAT team confirms you are in adequate withdrawal
- Never share buprenorphine with anyone
- Avoid alcohol and benzodiazepines during treatment
- If you are pregnant, continue MAT, it is the recommended approach
Pregnancy
Buprenorphine without naloxone is preferred during pregnancy. Continuing MAT is strongly recommended over attempting opioid withdrawal during pregnancy. Specialist care is available.
Breastfeeding
Low levels in breast milk. Breastfeeding is generally encouraged in stable patients. Discuss with your MAT team.
Other medicines
Medicines and substances that can interact with it
Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
- Alcohol and benzodiazepines: Significantly increases risk of breathing problems. Must be avoided.
- Certain HIV medicines and antifungals: Can raise buprenorphine levels. Your HIV doctor and MAT team need to coordinate.
- Rifampicin (TB treatment): Reduces buprenorphine levels and may trigger withdrawal. Must be managed alongside the MAT team.
Tests and follow-up
What your doctor will monitor
- Regular attendance at the MAT clinic
- Liver function tests at baseline and periodically
- HIV and hepatitis screening at enrolment
- Dental health for long-term users of sublingual formulations
Stopping this medicine
What happens if you stop taking it?
Stopping buprenorphine should be done gradually and only with MAT team support. Abrupt stopping leads to withdrawal and significantly increases the risk of opioid relapse.
In Kenya
What you should know about this medicine in Kenya
Buprenorphine-naloxone is available within Kenya’s established MAT programmes as an alternative to methadone. It offers a safer pharmacological profile and greater flexibility for take-home dosing as patients stabilise.
The combination formulation reduces diversion risk, which is important in settings where drug misuse is a concern.
Expanding access to MAT beyond current programme sites is a national health priority, given the significant burden of opioid use disorder particularly along the Kenyan coast.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- World Health Organization. (2009). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva: WHO.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.
- NACADA. (2017). National Guidelines for Medically Assisted Treatment in Kenya. Nairobi: NACADA/Ministry of Health.