Suboxone

By Medically reviewed by hellodoktor

Generic Name: Suboxone Brand Name(s): Suboxone and Suboxone.

Uses

What is Suboxone® (buprenorphine and naloxone) used for?

Suboxone® is commonly used to treat narcotic (opiate) addiction.

Suboxone® is not used as a pain medication.

How should I take Suboxone® (buprenorphine and naloxone)?

This medicine can slow or stop your breathing. Never use Suboxone® in larger amounts, or for longer than prescribed.

This medicine may be addictive. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Misuse of narcotic medicine can cause addiction, overdose, or death, especially in a child or other people using the medicine without a prescription. It is against the law to sell or distribute Suboxone®.

Use dry hands when handling a Suboxone® sublingual tablet or film. Drink a glass of water to moisten your mouth. Place the sublingual tablet or sublingual film under the tongue and allow it to dissolve. Place the buccal film in your mouth against the inside of your cheek and allow it to dissolve. Do not chew or cut the tablet or film, and do not swallow it whole.

Do not stop using Suboxone® abruptedly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Never crush or break a Suboxone® tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death.

How do I store Suboxone® (buprenorphine and naloxone)?

Suboxone® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Suboxone® in the bathroom or the freezer. There may be different brands of Suboxone® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Suboxone® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Suboxone® (buprenorphine and naloxone)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Suboxone® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Some medicines can interact with buprenorphine and naloxone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

It is not known whether this medicine will harm an unborn baby. If you use Suboxone® while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is unknown whether opioid effects on fertility are permanent.

Buprenorphine and naloxone can pass into breast milk and may cause drowsiness or breathing problems in the nursing baby. Tell your doctor if you are breast-feeding.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Suboxone® (buprenorphine and naloxone)?

Some common side effects of Suboxone®:

  • Dizziness
  • Drowsiness
  • Blurred vision
  • Feeling drunk
  • Tongue pain
  • Redness or numbness inside your mouth
  • Constipation
  • Mild nausea
  • Vomiting
  • Headache
  • Back pain
  • Swelling in your hands or feet
  • Fast or pounding heartbeats
  • Increased sweating
  • Increased sweating
  • Sleep problems (insomnia)

Call your doctor at once or seek emergency medical attention if you have:

  • Weak or shallow breathing, feeling like you might pass out
  • Confusion, loss of coordination, extreme weakness
  • Blurred vision, slurred speech
  • Adrenal gland problems – nausea, vomiting, loss of appetite, dizziness, feeling weak or tired
  • High levels of serotonin in the body – agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting
  • Liver problems – nausea, upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
  • Withdrawal symptoms – diarrhea, vomiting, shaking or shivering, runny nose, watery eyes, muscle pain, and feeling very hot or cold

Like other narcotic medicines, Suboxone® can slow your breathing. Death may occur if breathing becomes too weak.

While Suboxone® is used in the treatment of addiction, the drug itself can lead to tolerance and dependence. Suddenly stopping use of Suboxone can elicit unpleasant withdrawal effects, and prove much more difficult to quit than thought. Other side effects that may occur during a period of active use or withdrawal include:

  • Constipation (during use)
  • Diarrhea (during withdrawal)
  • Arthralgia, or joint pain (during withdrawal)
  • Insomnia
  • Irritability
  • Jitteriness
  • Pinpoint pupils (during use)
  • Dilated pupils (during withdrawal)

Get emergency medical help if you have signs of an allergic reaction to Suboxone®: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Suboxone® (buprenorphine and naloxone)?

Suboxone® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Other narcotic medications – opioid pain medicine or prescription cough medicine
  • Drugs that make you sleepy or slow your breathing – a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine
  • Drugs that affect serotonin levels in your body – medicine for depression, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting

Does food or alcohol interact with Suboxone® (buprenorphine and naloxone)?

Suboxone® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Suboxone® (buprenorphine and naloxone)?

Suboxone® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Any type of breathing problem or lung disease
  • Enlarged prostate, urination problems
  • Liver or kidney disease
  • Abnormal curvature of the spine that affects breathing
  • Problems with your gallbladder, adrenal gland, or thyroid
  • A history of drug abuse, alcohol addiction, or mental illness
  • A history of head injury, brain tumor, or seizures

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of Suboxone® (buprenorphine and naloxone) for an adult?

On Day 1, an induction dosage of up to 8 mg/2 mg Suboxone® sublingual film is recommended. Clinicians should start with an initial dose of 2 mg/0.5 mg or 4 mg/1 mg buprenorphine/naloxone and may titrate upwards in 2 or 4 mg increments of buprenorphine, at approximately 2-hour intervals, under supervision, to 8 mg/2 mg buprenorphine/naloxone based on the control of acute withdrawal symptoms.

On Day 2, a single daily dose of up to 16 mg/4 mg Suboxone® sublingual film is recommended.

What is the dose of Suboxone® (buprenorphine and naloxone) for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Suboxone® (buprenorphine and naloxone) available?

Suboxone® is available in the following dosage forms and strengths:

  • Sublingual tablets, sublingual film: buprenorphine hydrochloride 2mg, naloxone hydrochloride 0.5mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Suboxone®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 12, 2017 | Last Modified: September 12, 2019

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