Suboxone

Generic name: Buprenorphine And Naloxone (oral/sublingual)
Dosage form: buccal film, sublingual film, sublingual tablet.
Drug class: Narcotic analgesic combinations

Usage of Suboxone

Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication, sometimes called a narcotic. Naloxone blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse.

Suboxone is used to treat narcotic (opiate) addiction.

Suboxone is not for use as a pain medication.

Suboxone side effects

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.

Suboxone can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

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

any problems with your teeth or gums;

weak or shallow breathing, breathing that stops during sleep;

a light-headed feeling, like you might pass out;

confusion, loss of coordination, extreme weakness;

blurred vision, slurred speech;

liver problems - upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

high levels of serotonin in the body - agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea;

low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or

opioid withdrawal symptoms - shivering, goose bumps, increased sweating, feeling hot or cold, runny nose, watery eyes, diarrhea, muscle pain.

Serious breathing problems may be more likely in older adults and those who are debilitated or have wasting syndrome or chronic breathing disorders.

Common Suboxone side effects may include:

dizziness, drowsiness, blurred vision, feeling drunk, trouble concentrating;

withdrawal symptoms;

tongue pain, redness or numbness inside your mouth;

nausea, vomiting, constipation;

headache, back pain;

fast or pounding heartbeats, increased sweating; or

sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Suboxone

You should not use Suboxone if you are allergic to buprenorphine or naloxone (Narcan).

To make sure Suboxone is safe for you, tell your doctor if you have ever had:

tooth problems, including a history of cavities;

breathing problems, sleep apnea;

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 head injury, brain tumor, or seizures; or

alcoholism or drug addiction.

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 opioids may need medical treatment for several weeks.

Ask a doctor before using Suboxone if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

Relate drugs

How to use Suboxone

Usual Adult Dose for Opiate Dependence - Induction:

INDUCTION: For those Dependent on Heroin or Other Short-acting Opioid Products: -INITIAL DOSES should begin when objective signs of moderate opioid withdrawal appear and not less than 6 hours after the patient last used opioids to avoid precipitating an opioid withdrawal syndrome: Suboxone Sublingual Film: Day 1: up to 8 mg/2 mg sublingually; administer as an initial dose of 2 mg/0.5 mg or 4 mg/1 mg with titration in 2 or 4 mg increments of buprenorphine at approximately 2-hour intervals Day 2: 16 mg/4 mg sublingually as a single dose Comments: -Patients dependent on heroin or other short-acting opioid products may be inducted with combination buprenorphine/naloxone or buprenorphine monotherapy; to avoid precipitating withdrawal during induction, initiation should occur when clear signs of withdrawal are evident, preferably when moderate objective signs of opioid withdrawal appear, and no sooner than 6 hours after last use of heroin or other short-acting opioid. -Suboxone sublingual tablets are not indicated for induction therapy; Suboxone sublingual film for sublingual or buccal use should only be administered sublingually for induction to minimize exposure to naloxone. -For patient's dependent on methadone or long-acting opioid products, buprenorphine monotherapy should be used during the induction phase as naloxone may be absorbed in small amounts and could precipitate or prolong withdrawal during induction. -Maintenance treatment begins on day 3. Use: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support.

Usual Adult Dose for Opiate Dependence - Maintenance:

MAINTENANCE Treatment: -Doses of buprenorphine/naloxone should be adjusted to a level that holds the patient in treatment and suppresses opioid withdrawal signs and symptoms; doses should be titrated to clinical effectiveness as rapidly as possible as gradual titration may lead to higher drop-out rates. SUBOXONE Sublingual Film and Sublingual Tablets: -Progressively adjust in increments/decrements of 2 mg/0.5 mg or 4 mg/1 mg to a level that holds the patient in treatment and suppresses opioid withdrawal signs and symptoms -Recommended target dose: 16 mg/4 mg sublingually (film, tablet) or buccally (film) once a day; dose range 4 mg/1 mg to 24 mg/6 mg -Maximum dose: 24 mg/6 mg per day Comments: -Following induction, maintenance therapy is provided to hold a patient in treatment and suppress opioid withdrawal signs and symptoms; there is no maximum recommended duration for maintenance treatment and some patients may require treatment indefinitely. -There are multiple buprenorphine/naloxone products available for maintenance treatment; these products are not bioequivalent and dose adjustments may be necessary when switching products; e.g., Zubsolv 4.2 mg/0.7 mg buccal film provides equivalent buprenorphine exposure as Suboxone 8 mg/2 mg sublingual tablet. Use: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support.

Warnings

Suboxone can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Taking Suboxone during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What other drugs will affect Suboxone

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");

medicines for motion sickness, irritable bowel syndrome, or overactive bladder;

other opioids - opioid pain medicine or prescription cough medicine;

a sedative like Valium - diazepam, alprazolam, lorazepam, Xanax, Klonopin, Ativan, and others;

drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or

drugs that affect serotonin levels in your body - a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may interact with buprenorphine and naloxone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Disclaimer

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