Subutex and Suboxone

[Sistersteel]

Why is this medication prescribed?

Buprenorphine (Subutex) and buprenorphine and naloxone (Suboxone) are used to treat opioid dependence (addiction to opioid drugs, including heroin and narcotic painkillers). Buprenorphine is in a class of medications called opioid partial agonist-antagonists, and naloxone is in a class of medications called opioid antagonists. Buprenorphine alone and the combination of buprenorphine and naloxone prevent withdrawal symptoms when someone stops taking opioid drugs by producing similar effects to these drugs.

How should this medicine be used?

Buprenorphine and the combination of buprenorphine and naloxone come as sublingual tablets to taken under the tongue. They are usually taken once a day. To help you remember to take buprenorphine or buprenorphine and naloxone, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take buprenorphine or buprenorphine and naloxone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
You will start your treatment with buprenorphine, which you will take in the doctor's office. Your doctor will start you on a low dose of buprenorphine and will increase your dose for several days before switching you to buprenorphine and naloxone. Your doctor may increase or decrease your buprenorphine and naloxone dose until the medication works properly.
Place the tablets under your tongue until they melt. This should take 2 to 10 minutes. If you are taking more than two tablets, either place them all under your tongue at the same time or place them under your tongue 2 at a time. Do not chew the tablets or swallow them whole.
Do not stop taking buprenorphine and naloxone without talking to your doctor. Stopping buprenorphine and naloxone too quickly can cause withdrawal symptoms. Your doctor will tell you when and how to stop taking buprenorphine and naloxone.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking buprenorphine or buprenorphine and naloxone,

tell your doctor and pharmacist if you are allergic to buprenorphine, naloxone, or any other medications.
do not take antidepressants ('mood elevators'), narcotic pain killers, sedatives, sleeping pills, or tranquilizers while taking buprenorphine or buprenorphine and naloxone.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetaminophen (Tylenol, others); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); carbamazepine (Tegretol); cholesterol-lowering medications (statins); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); dexamethasone (Decadron); diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S., E-Mycin, Erythrocin); ethosuximide (Zarontin);fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir); iron products; isoniazid (INH, Nydrazid); medications for anxiety, mental illness, and seizures; methotrexate (Rheumatrex); metronidazole (Flagyl);nefazodone (Serzone); niacin (nicotinic acid); oral contraceptives (birth control pills); phenobarbital (Luminal, Solfoton); phenytoin (Dilantin); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); troglitazone (Rezulin); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you drink large amounts of alcohol and if you have or have ever had adrenal problems such as Addison's disease; benign prostatic hypertrophy (BPH, enlargement of the prostate gland); difficulty urinating; head injury; hallucinations (seeing things or hearing voices that do not exist); a curve in the spine that makes it hard to breathe; gallbladder disease; stomach conditions; and thyroid, kidney, liver, or lung disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking buprenorphine or buprenorphine and naloxone, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking buprenorphine or buprenorphine and naloxone.
you should know that buprenorphine or buprenorphine and naloxone may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
remember that alcohol can add to the breathing difficulties that can be caused by this medication.
you should know that buprenorphine or buprenorphine and naloxone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking buprenorphine or buprenorphine and naloxone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

What special dietary instructions should I follow?

Talk to your doctor about drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?


Buprenorphine or buprenorphine and naloxone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

headache
stomach pain
constipation
vomiting
difficulty falling asleep or staying asleep
sweating


Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

hives
skin rash
itching
difficulty breathing or swallowing
slowed breathing
upset stomach
extreme tiredness
unusual bleeding or bruising
lack of energy
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
flu-like symptoms


Buprenorphine or buprenorphine and naloxone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html (http://www.fda.gov/MedWatch/index.html)] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Buprenorphine or buprenorphine and naloxone can be a target for people who abuse prescription medications or street drugs. Keep your medication in a safe place to protect from theft. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

pinpoint pupils
extreme drowsiness
dizziness
blurred vision
slowed breathing


What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to buprenorphine and naloxone.
In case of an emergency, you or a family member should tell the treating doctor or emergency room staff that you are taking buprenorphine or buprenorphine and naloxone.
Do not inject buprenorphine or buprenorphine and naloxone sublingual tablets. Severe reactions may happen, including withdrawal symptoms.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names


Suboxone®



Subutex®

[cobra]

Well, they gave me suboxone in rehab for a week and I don';t know if I could'av went through the withdrawls w/o it. On the other hand, I've seen countless addicts relapse then go to a doc and get put on suboxone and can never wing themselves off. LOL, who'd thought, huh?

[Sistersteel]

Well, they gave me suboxone in rehab for a week and I don';t know if I could'av went through the withdrawls w/o it. On the other hand, I've seen countless addicts relapse then go to a doc and get put on suboxone and can never wing themselves off. LOL, who'd thought, huh?

What was your DOC cobra?

[newgoal300]

similar to methadone in use i guess but, they can both be addictive and do get you high if abused. unfortunately i am aware of both of these down sides

[cobra]

What was your DOC cobra?

MORE!! lol, nah, namely Oxycontin, that's what brought me to my bottom. I dabbled in most things though, although I've never smoked crack or meth. NOT SAYIN I'm better than that by NO MEANS, just have always been more 'chill' I guess you could say.

[SonOfPluto]

On a milligram basis, suboxone is is a very strong agonist of opiate receptor. It has a half life of like 2 1/2 days, so its ideal to taper off. However, the withdrawals from it can horrible, every bit as bad as vicodin or even worse. Years back, I was in rehab and they put me on it for 5 days and then just took me off it without a taper. When I went to bed the following night all I could do was sweat and shake like a leaf, my legs wanted to kick out all the time. I told the asswipes to put me back on a small dose so I could effectively finish out the last several days off the program and they refused, so I just checked myself out and the doctor wrote me a small script for a taper. I completed the program anyways, but at those places they try to keep you there for as long as your insurance will pay. After coming off the taper, I couldn't sleep for several days until I had my doctor write me a script for clonidine and requip. The requip was a godsend for the restless legs, and I couldn't understand why they weren't prescribing it at the hospital.

[Chi-town1984]

Im just getting over a heroin addiction, just had an overdose not too long ago, woke up in a back of an ambulance, paramedics shot me, well to be honest im not sure if they injected with the NARCAN or now i know they have the inhalent form of narcan. When i woke up in the ambulance i didnt know what the hell was going on. Scary shit....BUT a real eye opener, and a wake up call from GOD. Sad cuz i threw away four years of bodybuiding cuz of that shit, well.....i trained for almost 5 years actually up until a year ago this month, so i stopped lifting for a year cuz i started using. It hasnt been too long since ive been sober, but i dont wanna go to rehab cuz i dont have the money for that shit, fuckin expensive. I HAVE THE WILL POWER TO DO IT ON MY OWN, getting back into training and eating good is my rehab. Just gotta take it one day at a time.

[Sistersteel]

Im just getting over a heroin addiction, just had an overdose not too long ago, woke up in a back of an ambulance, paramedics shot me, well to be honest im not sure if they injected with the NARCAN or now i know they have the inhalent form of narcan. When i woke up in the ambulance i didnt know what the hell was going on. Scary shit....BUT a real eye opener, and a wake up call from GOD. Sad cuz i threw away four years of bodybuiding cuz of that shit, well.....i trained for almost 5 years actually up until a year ago this month, so i stopped lifting for a year cuz i started using. It hasnt been too long since ive been sober, but i dont wanna go to rehab cuz i dont have the money for that shit, fuckin expensive. I HAVE THE WILL POWER TO DO IT ON MY OWN, getting back into training and eating good is my rehab. Just gotta take it one day at a time.

I hate to be the barer of bad news...but no you can't do it on your own my friend. That's just the way it is. You have no control over your disease. The meetings are free ...find one today. God bless.

[irishpride]

I hate to be the barer of bad news...but no you can't do it on your own my friend. That's just the way it is. You have no control over your disease. The meetings are free ...find one today. God bless.
agreed..famous last words from many people.and when i say last words, i really mean last words..12 step programs are always available and free and they work, the only reason i no many do utilize them is ego..they dont like the stigma or "its not for them" , "they werent that bad" or "they're not like those people" but when you sit down close your mouth and open your ears your all very much alike..sure there are differences of opinion and people you may not like but a addict is still an addict and there is the common ground you can use..i thought i was to young when i went to my first meeting and that i had plenty of runs left in me, but i was damn wrong.i really wish i didnt have to listen to my overinflatted ego and continue on that horrible path..i live a great life today and wasted many years but again i ended up in the right place and it was my time..

[R.I.P.]

man those two drugs sound evil to me. i know alot of young people in my area that have used it. some of them shot it and /or snorted that shit. i guess it's a good thing for some. i'll try not to be too judgemental but from what my friends have told me sounds kinda like mean shit.

[Ryan Wacht]

I hate to be the barer of bad news...but no you can't do it on your own my friend. That's just the way it is. You have no control over your disease. The meetings are free ...find one today. God bless.

If he really wants to kick for good, he'll do it, regardless if he goes to meetings or not. I know this from experience. What's most important is that he deals with whatever issues he may have that led him into addiction in the first place. Don't get me wrong, I think AA and NA are awesome for a lot of people, but not necessarily for everyone.

[R.I.P.]

If he really wants to kick for good, he'll do it, regardless if he goes to meetings or not. I know this from experience. What's most important is that he deals with whatever issues he may have that led him into addiction in the first place. Don't get me wrong, I think AA and NA are awesome for a lot of people, but not necessarily for everyone.


addiction is a disease that is progressive and fatal.it is much easier to kick and stay off the junk with help than by yourself. i did marijuana maintenance until the coke man called then i was smoking it up.if he can kick god bless him but 1 out of 100 or some such number stay clean a year with help. what do you think the odds are without. never ever tell someone that is asking for help they can do it on their own. it's dangerous to the addict , yes withdrawals are dangerous.if you did it without meetings then maybe you were never an addict.

[jalsmiley]

i also did it on my own...and like the last person i not saying aa or na is bad...i say if you feel faulty at all try it out, it def works for some...i did not ever try either of them but beat heroin addiction on my own. it may be dangerous to tell someone they can do it without meetings but guys, dont tell a guy determined to beat this that he gonna fail and it cant be done when it can be!! that is more dangerous. give him options and let him know people with similar experiences are right here to help with what we can and good luck be strong

[Ryan Wacht]

addiction is a disease that is progressive and fatal.it is much easier to kick and stay off the junk with help than by yourself. i did marijuana maintenance until the coke man called then i was smoking it up.if he can kick god bless him but 1 out of 100 or some such number stay clean a year with help. what do you think the odds are without. never ever tell someone that is asking for help they can do it on their own. it's dangerous to the addict , yes withdrawals are dangerous.if you did it without meetings then maybe you were never an addict.

I was trying to give him encouragement. And yeah I was an addict, but it took a lot of loss and grief to turn me around. I also had to deal with a lot of regret, that I still struggle with to this day. However he decides to kick his addiction, what's important is that he succeeds, not so much how he goes about doing it.

[Ryan Wacht]

i also did it on my own...and like the last person i not saying aa or na is bad...i say if you feel faulty at all try it out, it def works for some...i did not ever try either of them but beat heroin addiction on my own. it may be dangerous to tell someone they can do it without meetings but guys, dont tell a guy determined to beat this that he gonna fail and it cant be done when it can be!! that is more dangerous. give him options and let him know people with similar experiences are right here to help with what we can and good luck be strong


Totally agree!

[R.I.P.]

i hope both of you multiple years of serenity.

[Sistersteel]

This is a Narcotics Anonymous based discussion forum. Kindly reserve all discussions on alternate approaches for the designated forums. I don't want to see anyone who has never gone through a 12 step based recovery program advising struggling addicts on how to go about getting sober.

No. He cannot do it on his own. Just because someone is not actively using does mean he is sober. Sobriety and abstinence are two different things. If someone had enough sense to comprehend the magnitude of the mess they were in, enough to actively DO something about it without help, then they were highly unlikely to have been addicted in the first place.

Having a bad habit and having a drug addiction are not the same thing either.

SS

[R.I.P.]

bump sister bump

[irishpride]

This is a Narcotics Anonymous based discussion forum. Kindly reserve all discussions on alternate approaches for the designated forums. I don't want to see anyone who has never gone through a 12 step based recovery program advising struggling addicts on how to go about getting sober.

No. He cannot do it on his own. Just because someone is not actively using does mean he is sober. Sobriety and abstinence are two different things. If someone had enough sense to comprehend the magnitude of the mess they were in, enough to actively DO something about it without help, then they were highly unlikely to have been addicted in the first place.

Having a bad habit and having a drug addiction are not the same thing either.

SS
damn i couldnt have said it better myself... looking back on it i gave up drinking and drugs 1000 or more times and each time with moderate success but never for ever and thje attitude was always stilll there and the actions were as well..it was way way easier (for myself) to put down the drink/drugs than to alter my way of thinking..they told me you only have to change one thing, and that one thing is EVERYTHING (and the old you) i always laugh when they say no major changes in the first year because you just made the most major decision you ever could..to be a better you..i know what there saying but it still is funny..besides what on earth is worse than sittng around with an ative addict/drunk? sitting with a dry addict or drunk..thats fucking terrible..what i was told and i always say to the newcomers is give us (the rooms) 6months to a year and if you dont like what is happening and offering and what you see, you can have your old life back for free when ever you want...

[OMEGA]

best way to come off Opiods is to COME OFF FOREVER

the crash may last 2 weeks or at worst 2 months but when you come out the other side you will "forget" that class of drug and never do it again

all other 'treatments' only delay your bodies and spirits ability to fight the demon

just crash and be done with it.

if the crash hinders your work take a sick leave if you can

if you can then at last chance tell boss and family to give you 2 weeks to whether the worst of it.

the truth will set you free, NO DRUG will

[LookImDancinCrazy!]

.....and naloxone is in a class of medications called opioid antagonists.


Wondering how this is any different than Naltrexone. I suspect this is just a product that is just a slight tweak to an old drug that is about to go off patent.

[Ryan Wacht]

Wondering how this is any different than Naltrexone. I suspect this is just a product that is just a slight tweak to an old drug that is about to go off patent.

I think they're pretty much the same drug.