• Suboxone®

• Partial opioid agonist that blocks other opioids from attaching to receptors in the brain
• A partial agonist produces less effect than a full agonist when it binds to opioid receptors

• Tablets: sublingual pills
  • Buprenorphine 2mg/naloxone 0.5mg;
  • Buprenorphine 8mg/naloxone 2mg

• Film: Sublingual
• Patch:

• SUBOXONE can decrease cravings and relieve withdrawal symptoms
• Clinical researches have found Buprenorphine effective for:
  • Suppressing symptoms of opioid withdrawal
  • Reducing cravings for opioids
  • Reducing illicit opioid use

• Using buprenorphine together with following medications can lead to serious side effects such as respiratory distress, coma, or even death
  • Zolpiden
  • Benzodiazepines
  • Alcohol
• Using buprenorphine together with sertraline may increase side effects such as dizziness, drowsiness, and difficulty concentrating

Buprenorphine or buprenorphine and naloxone may cause side effects:

1. headache
2. difficulty falling asleep or staying asleep
3. mouth numbness or redness
4. tongue pain
5. blurred vision
6. stomach pain
7. constipation
8. vomiting
9. back pain

What is Precipitated withdrawal?

• Precipitated withdrawal can occur when buprenorphine is administered to a patient dependent on opioids
• Due to Buprenorphine’s high affinity at the mu receptor it displaces opioids from the mu receptors, without activating the receptor to an equivalent degree, resulting in a net decrease in agonist effect, thus precipitating a withdrawal syndrome.
• To avoid precipitated withdrawal you should start suboxone no earlier than 12 hours from the last use of short acting opioids (Heroin, Crushed OxyContin®, Percocet®, Vicodin®, Oxycodone®) and no earlier than 24 hours after the last use of long acting opioids (Methadone).

If you experience any of these symptoms call your doctor and 9-1-1 or go to emergency, immediately:

1. hives
2. skin rash
3. itching
4. difficulty breathing or swallowing
5. swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
6. slowed breathing
7. upset stomach
8. blurred vision
9. slurred speech
10. confusion
11. unusual bleeding or bruising
12. pain in the upper right part of the stomach
13. yellowing of the skin or eyes
14. dark-colored urine
15. light-colored stools

Risk of overdose:

• Suboxone, was involved in 30,135 emergency room visits in 2010, up from 3,161 visits in in 2005 (SAMHSA 2013).
• Over half of the hospitalizations were for non-medical use of buprenorphine – with some users taking the drug to get high.

• Elizabeth H. Crane, Ph.D, MPh Emergency Department Visits Involving Buprenorphine. The CBHSQ Report. 2013.

This document is prepared by the “Mental Health for All” team. This document is provided for information purposes only and does not necessarily represent endorsement by or an official position of the Essentials of Medicine. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.