Monday September 26th 2016

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Is Suboxone safe?

Yes, Suboxone is generally a safe medication.

Suboxone is a prescription medicine used to treat adults who are addicted to the opiate or opioid class of drugs. It is used as part of a complete addiction treatment program that also includes counseling and behavioral therapy.

However, you may be wondering when and under what conditions is Suboxone safe to take? We review some of the major guidelines and principles when considering the safety of Suboxone here. Then, we invite your questions about the safe use of Suboxone at the end. In fact, we try to answer ALL legitimate questions personally and promptly.

Suboxone safety

Suboxone was approved for office-based treatment of opioid dependence under the Drug Addiction Treatment Act of 2000 (DATA). Since then, it has been prescribed to thousands of individuals to aid drug addiction recovery. How does it work?

Specifically, Suboxone is considered a “maintenance medication” and is intended to help people reduce or quit their use of heroin or other opiates, such as pain relievers. Suboxone helps with drug cravings and delays withdrawal. People recovering from opiate dependence who take Suboxone feel normal, and can’t get high. Additionally, when on Suboxone the brain delays withdrawal symptoms, making long term use of six months, or more, therapeutically beneficial.

Further, Suboxone is a combination of buprenorphine and naloxone. The naloxone is added to prevent abuse – it brings on withdrawal in people who abuse buprenorphine by injecting it.

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When is Suboxone most effective?

Suboxone is most effective when taken as perscribed by your doctor. The overall treatment of drug dependency with Suboxone is most effective in combination with counseling services, which can include different forms of behavioral therapy and self-help programs.

Can taking Suboxone cause serious side effects?

Yes, Suboxone can cause some side effects. If you experience any of the side effects listed below talk to your doctor.

  • back pain
  • blurred vision
  • constipation
  • decrease in sleep (insomnia)
  • disturbance in attention
  • dizziness
  • drug withdrawal syndrome
  • fainting
  • headache
  • intoxication (feeling lightheaded or drunk)
  • irregular heart beat (palpitations)
  • nausea
  • numb mouth
  • sleepiness
  • sweating
  • swollen and/or painful tongue
  • the inside of your mouth is more red than normal
  • vmiting

How much Suboxone is safe to take?

Suboxone comes in the form of a tablets and film. You should know that not all strengths and combinations of the Suboxone sublingual films are bioequivalent to Suboxone (buprenorphine and naloxone) sublingual tablets. Therefore, systemic exposure to buprenorphine and naloxone may be different when patients are switched from tablets to film or vice-versa.

You should always take Suboxone exactly as your doctor tells you. Your doctor may change your dose after seeing how it affects you. DO NOT change your dose unless your doctor tells you to change it and DO NOT take Suboxone more often than prescribed by your doctor. If you miss a dose of Suboxone you should take it as soon as you remember. If it is almost time for the next dose, you should skip the missed dose and take the next dose at the regular time.

Your doctor will likely start with an initial dose ratio of buprenorphine to naloxone of 2mg/0.5 mg or 4 mg/1 mg the first day, followed by a single daily dose of up to 16mg/4mg afterwards. Initial approval is limited to a 2-month period, to ensure that you are adherent to treatment and not continuing to abuse or misuse opioids, opiates, or other abusable drugs.

Who SHOULD NOT use Suboxone

Suboxone may be a great medicine for many, but still there are individuals who will not get their doctor’s clearance to initiate treatment. How does Suboxone make you feel? Generally, it helps stabilize cravings  to help you feel normal within a few days of dosing. However, some people may not be ideal candidates for this medication assisted treatment.

Your doctor should do a thorough examination before you are given Suboxone, to avoid any risks. For example, patients with organ damage may not be prescribed Suboxone. Before taking Suboxone film, tell your doctor if you are pregnant or breastfeeding, because Suboxone can pass into your breast milk. Additionally, treatment initiation may be postponed in individuals who haven’t abstained from their drug of choice long enough.

Here is a general (not exhaustive) list of conditions to avoid Suboxone:

DO NOT take Suboxone film if you are allergic to buprenorphine or naloxone as serious negative effects, including anaphylactic shock, have been reported.

DO NOT take Suboxone in combination with benzodiazepines or other medications that act on the nervous system (ie, sedatives, tranquilizers, or alcohol) it can extremely dangerous.

DO NOT take Suboxone if you have hepatic impairment and moderate hepatic impairment.

DO NOT mix Suboxone with alcohol because it can lead to loss of consciousness or even DEATH.

DO NOT take Suboxone film before the effects of other opioids (eg, heroin, hydrocodone, methadone,morphine, oxycodone) have subsided as you may experience withdrawal symptoms.

DO NOT drive, operate heavy machinery, or perform any other dangerous activities until you know how Suboxone film affects you. The buprenorphine from Suboxone sublingual film can cause drowsiness and slow reaction times during dose-adjustment periods.

DO NOT inject Suboxone because it may cause serious withdrawal symptoms such as:

  • anxiety
  • cramps
  • cravings
  • diarrhea
  • pain
  • sleep problems
  •  vomiting

Is Suboxone safe for long term use?

Generally, the initial approval period for Suboxone therapy is limited to a 2-month period. During this time your doctor or addiction professional should ensure that you are following treatment directions and not continuing to abuse or misuse opioids or other abusable drugs.

The quantity of prescribed medication will usually be limited to 62 tablets/films per month (16mg buprenorphine/day). Suboxone therapy is usually prescribed for a minimum of 6 months and a maximum of 12 months. However, the duration of Suboxone treatment depends greatly on your progress and dedication to the recovery process.

Does Suboxone cause physical dependence?

Yes, Suboxone causes dependence.

Suboxone contains buprenorphine, which is an opioid that can cause physical dependence. Therefore it’s not intended for occasional or “as needed” use. A physical dependence simply means that you are unable to stop using Suboxone without experiencing withdrawal effects.

Suboxone withdrawal is more likely to occur if you’ve been using the medication for a longer period of time, and even if you have always taken it as prescribed. These symptoms can vary in intensity depending on past use, they usually peak 2-5 days after the last dose and can persist for a week or two.

How to come off Suboxone safely?

DO NOT stop taking Suboxone without talking to your doctor first. It is recommended that you consult a doctor when withdrawing from Suboxone in order to assess your personal needs during withdrawal and to make sure you are withdrawing safely from the drug.

Generally, the best and safest way to discontinue Suboxone is to slowly reduce doses by following a teparing schedule over the course of several weeks. Your doctor can help you create a tapering schedule that will be tailored to your needs to make the withdrawal process as comfortable as possible. Most withdrawal side effects and discomfort can be treated, or at least managed, with the help of other prescription or over-the-counter medications.

DO NOT try to quit Suboxone cold turkey. You could become sick with uncomfortable withdrawal signs and symptoms because your body has become used to this medicine. The decision to discontinue therapy with Suboxone after a period of maintenance or brief stabilization should be made as part of a comprehensive treatment plan.

Suboxone safety questions?

If you have additional questions about Suboxone safety use, feel free to post them in the comments section below. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular enquiry, we will refer you to someone who does.

Reference Sources: Suboxone: Full perscribing information
FOOD AND DRUG ADMINISTRATION: Suboxone (buprenorphine HCl/naloxone HCl dihydrate, sublingual tablet) and Subutex (buprenorphine HCl, sublingual tablet)
FOOD AND DRUG ADMINISTRATION: Medication guide
ILLINOIS DEPRTMENT OF HEALTHCARE AND FAMILY SERVICE: Suboxone (buprenorphine/naloxone) tablets, films and buprenorphine tablets Prior Authorization Criteria
DAILYMED: Suboxone – buprenorphine hydrochloride and naloxone hydrochloride tablet

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