Does naloxone reverse buprenorphine?
Buprenorphine has a much higher binding affinity for the mu-opioid receptor compared with naloxone. Buprenorphine has a longer elimination half-life than naloxone. The half-life of buprenorphine is between 24 and 42 hours, depending on the patient. Comparatively, the half-life of naloxone is only 2 to 12 hours. Therefore, buprenorphine binds to the mu receptor longer, and it also remains at the receptor site 4 to 12 times longer than naloxone. Naloxone reversal of buprenorphine therefore would not be effective, especially at moderate to high doses of buprenorphine. The good news is, the higher the dose of buprenorphine, the higher the antagonist properties become.