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What is Suboxone?

Suboxone is a prescription drug containing both buprenorphine and naloxone. It helps treat dependence on opioid medications. 

Suboxone is available for use as an oral film that you can place under your tongue (sublingual) or in the center of the gums and cheek (buccal). The film is meant to dissolve in the mouth.

Suboxone consists of two drugs: buprenorphine and naloxone in variable strengths:

  • 2 Mg buprenorphine / 0.5 mg naloxone
  • 1 Mg naloxone / 4 mg buprenorphine
  • 8 Mg buprenorphine / 2 mg naloxone
  • 3 Mg naloxone / 12 mg buprenorphine

Suboxone effectively reduces opioid misuse and helps keep people with opioid dependence in medical treatment over a time of 24 weeks.

Important Information

Suboxone is a controlled substance under schedule three (III) prescription drugs. It clearly states that Suboxone has an accepted medical use, but it may cause psychological and physical dependence and become a drug of abuse.

The doctor or pharmacist may prescribe schedule III category drugs like Suboxone only under unique rules set by the government.

Suboxone has opioid effects, and long period use of this drug can cause physical and psychological dependence. Suboxone dependence can cause drug-seeking and drug-craving behavior, leading to misuse or abuse. 

What to know before taking Suboxone?

Taking high doses of Suboxone can cause coma, severe breathing problems, and death. These adverse effects of Suboxone are more likely to occur if someone misuses or abuses Suboxone. 

Breathing problems due to Suboxone are more likely to occur in people who already have a breathing problem, such as COPD- chronic obstructive pulmonary disease. 

Before taking Suboxone, you should know that some people who take Suboxone for several weeks can face a reduction in cortisol hormone levels. This medical condition is known as adrenal insufficiency, and the symptoms may include:

  • Vomiting 
  • Nausea
  • Loss of appetite
  • Diarrhea
  • Dizziness
  • Fatigue and weakness
  • Depression
  • Low blood pressure

Both mild and severe liver damage has been taking place in people getting treatment with Suboxone. In some cases, liver damage may happen due to a hepatitis infection or other causes. However, Suboxone may have also been the cause. 

During the treatment with Suboxone, your medical healthcare provider may perform some blood tests to check the functioning of your liver. If you have liver damage symptoms, you need to stop taking Suboxone. Signs of liver damage may include fatigue, stomach pain, and yellowing of the whites of your eyes or the skin.

How to take Suboxone?

It would be best if you took Suboxone according to the medical prescription. Your Suboxone dosage will depend upon your age, the severity of your medical condition, your initial response to the treatment with Suboxone, other medical conditions you have (if you have any), and other medications you are taking.

Usually, your doctor will start your treatment with the lowest effective dose and adjust it overtime to decide the proper dosage for you.

Suboxone contains naloxone that helps prevent abuse of this medication. Because of this component, you could have severe withdrawal symptoms if you abuse Suboxone. Naloxone is an opioid antagonist medicine that blocks the effects of opioid drugs. 

Using the Suboxone film in the cheek or under your tongue would not cause any severe withdrawal symptoms because the film does not release as much naloxone into the system. 

However, using the film could cause unpleasant withdrawal symptoms if you take it while you still have some other opioids in your system. 

If you have a physical or psychological dependence on Suboxone and you suddenly stop taking it, you could face mild withdrawal signs such as headache, nausea, and muscle aches. You can avoid these effects by gradually tapering the dose of the medicine before you stop taking it altogether. 

Suboxone dosage

Induction dosage:

  • Initial treatment with Suboxone takes place in the doctor’s office or clinic.
  • Starting with the lowest effective dose, your medical healthcare provider may give you 2 mg buprenorphine / 0.5 mg naloxone or 1 mg naloxone / 4 mg buprenorphine.
  • The maximum dosage for the first few days is 8 mg buprenorphine / 2 mg naloxone.

Maintenance dosage:

  • When you reach an accurate Suboxone dosage that keeps you stable,  the doctor will continue your treatment with the same dose during the maintenance phase.

Maximum dosage:

  • The maximum regular dose during the maintenance phase is 8 mg naloxone / 32 mg buprenorphine.

Overdose

Taking too much Suboxone can increase the risk of several side effects. Symptoms of a Suboxone overdose may include:

  • Nausea
  • Headache
  • Diarrhea
  • Vomiting
  • Anxiety
  • Stomach pain
  • Sweating
  • Anxiety
  • Weakness or fatigue
  • Chills
  • Decreased touch sensation
  • Dizziness
  • Trouble breathing
  • Burning tongue
  • Coma
  • Death 

In an overdose, seek guidance from your medical healthcare provider or call the Poison helpline at 1-800-222-1222. But if you are having severe symptoms, go to the nearest emergency room or call 911 right away.

What to avoid while using Suboxone?

Avoid alcohol consumption, driving any vehicle, or performing any activity that requires alertness until you know how this medicine will affect you. 

Suboxone side effects

Suboxone may cause mild or severe side effects. The following list consists of side effects of taking Suboxone, but these are not all possible side effects, and others may occur. 

For further information regarding possible side effects of this drug or suggestions on dealing with such troubling side effects, consult any of your medical healthcare providers.

Common side effects of Suboxone that does not require instant medical help may include:

  • Headache
  • Depression 
  • Anxiety
  • Sweating
  • Trouble sleeping (insomnia)
  • Constipation
  • Weakness or fatigue
  • Nausea
  • Burning tongue
  • Back pain
  • Redness in the mouth
  • Opioid withdrawal symptoms such as abdominal cramps, body aches, and rapid heart rate

Some of these more common side effects may go away within a couple of weeks or few days. If they are more severe or persist for a more extended period, consult your medical healthcare provider.

Severe side effects from Suboxone are rare, but they can occur. Contact your medical healthcare provider right away if you have severe side effects. Call 911 if you feel you are dealing with life-threatening withdrawal symptoms or if you think you have a medical emergency.

Severe side effects of Suboxone may include:

  • Abuse and dependence
  • Severe allergic reaction
  • Coma 
  • Breathing problems
  • Liver damage
  • Adrenal insufficiency (or any other hormone problems)
  • Severe withdrawal symptoms

Severe allergic reactions or health issues, including anaphylaxis, may occur in some people taking Suboxone. Symptoms of such an allergic reaction can include skin rash, trouble breathing, or swelling of your lips, throat, tongue.

Call the doctor or local Poison control center right away if you have an allergic reaction. If the symptoms are severe after having a Suboxone overdose, go to the nearest emergency room or call 911. 

What drugs can interact with Suboxone?

Interaction of Suboxone with other drugs such as opioids, benzodiazepines like Valium, Ativan, or Xanax, or alcohol can cause coma, breathing problems (severe), and death.