Buprenorphine (Subutex)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Buprenorphine

What it is

Buprenorphine is an opioid that only partly activates the mu opioid receptor while binding it very tightly, so its effect levels off at higher doses. It is used as maintenance treatment for opioid dependence (often combined with naloxone, as Suboxone), and as patches or injections for pain. It is sold as Subutex, Butrans and other names.

How genes come into it

Buprenorphine is broken down by CYP3A4 and by UGT enzymes such as UGT2B7. Studies have looked at these, at the opioid receptor genes OPRM1 and OPRD1, and at COMT, mostly for how well treatment for opioid dependence worked and for withdrawal in newborns, with mixed results. There is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Buprenorphine. Upload your DNA file to see which of these rows apply to you.

Rated evidence (22 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

OPRD1 rs678849: Level 3. Efficacy: Opioid-Related Disorders. 3.

OPRD1 rs529520: Level 3. Efficacy: Opioid-Related Disorders. 2.

CYP3A4 rs2740574: Level 3. Dosage: Opioid-Related Disorders. 2.

COMT rs4680: Level 3. Toxicity: Neonatal Abstinence Syndrome. 1.

Metabolism (4 findings)

Studies of how quickly the body processes this medication.

OPRM1 rs2075572: Genotypes CC + CG is associated with increased concentrations of buprenorphine in people with Opioid-Related Disorders as compared to genotype GG.

UGT2B7 rs7439366: Genotype CC is associated with decreased concentrations of buprenorphine in people with Opioid-Related Disorders as compared to genotype CT.

UGT2B7 rs7662029: Genotype GG is associated with decreased concentrations of buprenorphine in people with Opioid-Related Disorders as compared to genotypes AA + AG.

OPRM1 rs562859: Genotypes CT + TT is associated with increased concentrations of buprenorphine in people with Opioid-Related Disorders as compared to genotype CC.

Response (42 findings)

Studies of how well it worked in people carrying a variant.

rs11782370: Allele T is associated with increased response to buprenorphine in people with Opioid-Related Disorders as compared to allele C.

rs13169373: Allele T is associated with increased response to buprenorphine in people with Opioid-Related Disorders as compared to allele C.

rs62368105: Allele G is associated with increased response to buprenorphine in people with Opioid-Related Disorders as compared to allele A.

rs6973474: Allele T is associated with increased response to buprenorphine in people with Opioid-Related Disorders as compared to allele C.

Dosing (4 findings)

Studies of how much of the drug people needed or tolerated.

ABCB1 rs1045642: Allele A is associated with decreased dose of buprenorphine, dihydrocodeine, fentanyl, hydromorphone, methadone, morphine, oxycodone, piritramide, tilidine or tramadol in people with Pain as compared to allele G.

COMT rs4680: Allele A is not associated with dose of buprenorphine, dihydrocodeine, fentanyl, hydromorphone, methadone, oxycodone, piritramide, tilidine or tramadol in people with Pain as compared to allele G.

CYP3A4 rs2740574: Genotype CT is associated with increased dose of buprenorphine in people with Opioid-Related Disorders.

OPRM1 rs1799971: Genotype G is not associated with dose of buprenorphine, dihydrocodeine, fentanyl, hydromorphone, methadone, morphine, oxycodone, piritramide, tilidine or tramadol in people with Pain as compared to genotype A.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Alfenta (Opioids)

Codeine (Opioids)

Demerol (Opioids)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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