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Suboxone
Suboxone is a combination medication containing buprenorphine and naloxone, used to treat opioid dependence. Buprenorphine is a partial opioid agonist, which helps reduce opioid cravings and withdrawal symptoms, while naloxone is an opioid antagonist that blocks the effects of opioids, preventing misuse of the medication. Suboxone is used as part of a comprehensive treatment plan for opioid addiction, typically including counseling and behavioral therapy, and it helps individuals reduce their dependence on opioids while minimizing the risk of relapse.
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Frequently Asked Questions
How long does it take for Suboxone to start working?
Suboxone begins to reduce opioid withdrawal symptoms and cravings within 30 to 60 minutes of the first dose. The full effect may take 1 to 2 hours.
Can Suboxone cause withdrawal symptoms?
Yes, Suboxone can cause withdrawal symptoms if stopped abruptly or if taken inappropriately. It is important to taper off the medication under medical supervision.
Can I drive while taking Suboxone?
Suboxone can cause drowsiness or dizziness, especially when first starting treatment. Avoid driving or operating heavy machinery until you know how the medication affects you.
Can Suboxone be misused?
Yes, Suboxone contains buprenorphine, which is an opioid. It can be misused, although the inclusion of naloxone helps reduce the potential for abuse. Use Suboxone only as prescribed by your healthcare provider.
How long should I take Suboxone?
The length of time on Suboxone varies for each individual. Some may need it for a few months, while others may require long-term treatment. Always follow your healthcare provider's recommendations.
Comprehensive Drug Guide
How Does Suboxone Work?
- Buprenorphine: A partial opioid agonist that binds to opioid receptors in the brain but produces a weaker effect than full opioid agonists like heroin or oxycodone. This helps reduce cravings and withdrawal symptoms without producing the intense "high" associated with opioid abuse.
- Naloxone: An opioid antagonist that blocks the effects of opioids. Naloxone is included to prevent misuse of the medication; if Suboxone is injected, naloxone will block the opioid effects, making it less likely to be abused.
Together, buprenorphine and naloxone help individuals manage opioid dependence by reducing cravings and withdrawal symptoms, allowing them to focus on recovery.
Common Dosages
- 2 mg buprenorphine / 0.5 mg naloxone (sublingual film or tablet)
- 8 mg buprenorphine / 2 mg naloxone (sublingual film or tablet)
Typical Dosing
- Induction phase (initiating treatment): Suboxone is typically started under medical supervision. The usual initial dose is 2 mg buprenorphine / 0.5 mg naloxone, with additional doses based on the patient's withdrawal symptoms. Total daily doses may be adjusted based on the severity of opioid dependence.
- Maintenance phase: The typical maintenance dose ranges from 8 mg to 24 mg buprenorphine per day, depending on the individual's response and needs.
Suboxone is administered sublingually (under the tongue). The film or tablet should be allowed to dissolve completely without chewing or swallowing.
Typical Dosing
FDA Approved Indications
- Maintenance treatment of opioid dependence in adults and adolescents aged 16 years and older as part of a comprehensive treatment plan, including counseling and behavioral therapy.
Who Shouldn't Take Suboxone?
- Known hypersensitivity to buprenorphine, naloxone, or any component of the formulation.
- Severe respiratory depression or other conditions where significant respiratory impairment exists.
- Acute alcohol intoxication, as combining alcohol with Suboxone increases the risk of respiratory depression.
Advice From The Pharmacist
- Take Suboxone as prescribed. Place the sublingual film or tablet under the tongue and allow it to dissolve completely. Do not chew, swallow, or cut the film, as this may reduce its effectiveness.
- Avoid consuming alcohol or using other sedatives while taking Suboxone, as this increases the risk of serious side effects, including respiratory depression.
- Store Suboxone safely and securely, as it is a controlled substance with potential for misuse. Keep it out of reach of children and pets.
- Do not abruptly stop taking Suboxone without consulting your healthcare provider, as this may lead to withdrawal symptoms. Tapering off the medication gradually is usually recommended.
- Carry identification or a medical card indicating that you are taking Suboxone in case of emergencies, as it can affect how other medications or treatments, especially pain medications, are administered.
Side Effects of Suboxone
Common Side Effects
- Nausea or vomiting
- Headache
- Sweating
- Constipation
- Drowsiness
- Dizziness
Uncommon/Severe Side Effects
- Respiratory depression: Especially when combined with alcohol, sedatives, or other opioids.
- Liver problems: Symptoms include yellowing of the skin or eyes (jaundice), dark urine, or stomach pain.
- Allergic reactions: Rash, itching, or difficulty breathing.
- Dependence and withdrawal: While Suboxone helps reduce opioid withdrawal symptoms, it can still lead to dependence if not used as directed.
Risks and Warnings of Suboxone
- Respiratory depression: Suboxone can cause severe respiratory depression, especially when combined with alcohol, sedatives, or other central nervous system depressants. Avoid using these substances while on Suboxone.
- Misuse and addiction: Although Suboxone is used to treat opioid addiction, it is still an opioid and can be misused. It is important to follow your healthcare provider’s instructions closely and use the medication only as prescribed.
- Withdrawal symptoms: Stopping Suboxone suddenly can cause opioid withdrawal symptoms. It is important to taper off the medication under medical supervision.
- Neonatal opioid withdrawal syndrome: Babies born to mothers taking Suboxone during pregnancy may experience withdrawal symptoms after birth. This condition requires medical treatment.
Interactions with Suboxone
Common Drug Interactions
- Alcohol and CNS depressants: Combining Suboxone with alcohol, benzodiazepines (e.g., diazepam, lorazepam), or other sedatives can increase the risk of severe respiratory depression, coma, or death.
- Other opioids: Taking additional opioids with Suboxone can reduce the medication’s effectiveness and increase the risk of overdose.
- Certain medications for mental health: Some antipsychotics, antidepressants, and sedatives can interact with Suboxone, increasing the risk of side effects like drowsiness or respiratory depression.
Alternatives to Suboxone
- Methadone: A full opioid agonist used to treat opioid dependence, typically administered in a clinical setting.
- Vivitrol (naltrexone): An opioid antagonist used to treat opioid and alcohol dependence; available as a monthly injection.
- Zubsolv: Another combination of buprenorphine and naloxone, used similarly to Suboxone but available in different strengths and formulations.
- Probuphine: An implantable form of buprenorphine that provides long-term opioid dependence treatment.
