How do buprenorphine-naloxone troches work?

Troches (lozenges) are a compounded alternative to standard sublingual Suboxone film or tablets, prepared by a compounding pharmacy. They dissolve slowly in the mouth, between the cheek and gum.

How they work: Buprenorphine is a partial opioid agonist that activates the same brain receptors as opioids but with a ceiling effect that reduces overdose risk. Naloxone is added as an abuse deterrent.

Troches vs. standard film:

  • Designed to dissolve slowly over 15–30 minutes between the cheek and gum
  • May be preferred by patients who find sublingual film uncomfortable
  • Absorption is similar to film, though timing may vary

How to use: Place the troche between your cheek and gum. Do not chew or swallow. Let it dissolve completely. Do not eat or drink while dissolving. Do not use opioids within 12–24 hours before your first dose — doing so may cause precipitated withdrawal.

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