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Key Information



Britoflex (Subutex, Buprenorphine, Lofexdine, Naltrexone)


17-(cyclopropylmethyl)-alpha-(1,1-dimethylethyl)-4,5-epoxy- 18,19-dihydro-3-hydroxy-6-methoxy-alpha-methyl-6,14- ethenomorphinan-7-methanol


Bupe, subs, subbies, orange guys


These are a semi-synthetic opiate (the term opiate describes any of the narcotic opioid alkaloids found as natural products in the opium poppy plant).  If you stop taking heroin, they can prevent or reduce the unpleasant withdrawal symptoms. Many people stay on them long-term, but some people gradually reduce the dose and come off drugs altogether. You should not take any street drugs or much alcohol when you are taking these.  If you take these, you are unlikely to get withdrawal symptoms if you stop heroin (or the withdrawal symptoms are much less severe). 


These are a tablet which you put under the tongue. The tablet dissolves over 3-7 minutes and is absorbed straight into the bloodstream from the mouth. (The tablets do not work if you swallow them into the stomach).   Because of its opioid agonist effects, these opiates are abusable, particularly by individuals who are not physically addicted to opioids

HEALTH RISKS (long term) which includes withdrawal & tolerance:

These are an opioid partial agonist. This means that, although these are opioids, and thus can produce typical opioid agonist effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone. At low doses they produce sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The agonist effects can increase linearly with increasing doses of the drug until at moderate doses they reach a plateau and no longer continue to increase with further increases in dose - the “ceiling effect.” Thus, these carry a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, in high doses and under certain circumstances,  these can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream.


Many GPs will refer users to a community drug team to be assessed. Following assessment, the community drug team may prescribe these. Some GPs work in a 'shared care' arrangement and will prescribe whatever is recommended by a community drug team. Some GPs who are specially trained may assess and prescribe these without the need for referral.

  1. Lofexidine (Britloflex) is a treatment which is used to relieve the symptoms of withdrawal in patients undergoing Heroin or opiate detoxification. 
  2. Lofexidine (Britloflex) is not an opiate like Heroin and is non-addictive.
  3. Lofexidine (Britloflex) was launched in 1992 specifically for symptomatic relief in patients undergoing opiate withdrawal programmes.
  4. It is approved in the United Kingdom, but is still undergoing clinical trials in the United States.
  5. It is effective in reducing the symptoms associated with opiate withdrawal or "cold turkey" such as chills, sweating, stomach cramps, diarrhoea, muscle pain, runny nose and eyes.
  6. When you stop taking opiates, the body doesn't like this a lot. The withdrawal symptoms are caused by some parts of the brain becoming more irritated and alert. The brain produces more noradrenaline to become more alert and it is this that causes sweating, cramps and pain.  Lofexidine (Britloflex) blocks the effects of this extra noradrenaline and reduces the withdrawal effects ("Cold Turkey") you then get. When your body has got used to not having opiates, the effects stop and you can stop taking Lofexidine (Britloflex).   Lofexidine (Britloflex) only helps make the cold turkey easier. It doesn't have much effect long-term.  
  7. Lofexidine  (Britloflex) works to restore natural levels of norepinephrine and endorphins to pre-opiate addiction levels.
  8. Lofexidine (Britloflex) does not reduce blood pressure to the same extent as Clonidine, but is otherwise similar to Clonidine.
  9. For people with a high risk or history of hypotension, Lofexidine  (Britloflex) is an ideal choice. 
  10. It acts on alpha-adrenoceptors in the brain to reduce impulses in the sympathetic nervous system. 
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