If you've been prescribed Suboxone® (buprenorphine/naloxone) for opioid use disorder (OUD) treatment, you probably have some questions. Even if you know the basics of what Suboxone is, you might still be wondering what it means for you, from changes you can expect in your body to the right way to take the medication (important safety information).
Proper Suboxone dosage isn’t just about remembering to take it every day. How can you be sure you're getting the right amount? Can your dosage needs change over time? We’re here to break down these important details so you can be certain that your medication routine is the right one for you.
How Suboxone helps with OUD
Suboxone is a combination medicine approved by the United States Food and Drug Administration (FDA) for OUD treatment. It consists of two primary ingredients: buprenorphine, which activates opioid receptors, and naloxone, which blocks the action of opioids at the receptors. However, the naloxone in the Suboxone films and tablets is not bioavailable so long as the medication is taken sublingually, meaning the film or tablet is placed under the tongue for a quicker absorption into the bloodstream.
Suboxone is commonly prescribed as a medication for addiction treatment (MAT) for OUD patients because it helps reduce uncomfortable opioid withdrawal symptoms, including:
- Muscle cramps
- Sweating
- Chills
- Nausea
- Vomiting
- Abdominal cramping
- Diarrhea
- Anxiety
A basic Suboxone dose guide
Suboxone comes in various strengths, each with its own ratio of buprenorphine and naloxone. Suboxone films are dissolved in the mouth, either under the tongue or inside the cheek. Don’t eat or drink anything, and don’t brush your teeth. You must wait for the film to dissolve fully to ensure that the naloxone in the dose is not bioavailable.
Suboxone films come in the following strengths:
- 2 mg of buprenorphine and 0.5 mg of naloxone
- 4 mg buprenorphine and 1 mg naloxone
- 8 mg buprenorphine and 2 mg naloxone
- 12 mg buprenorphine and 3 mg naloxone
The medication takes effect 30 to 60 minutes after ingestion when administered sublingually. The maximum impact is noticed about 4 hours after taking it. Exactly how long the medication stays in your body depends on traits like your weight, metabolic rate, and medical history.
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Determining the correct Suboxone dosage
So, what's the correct Suboxone dosage for you? This depends on various factors, including your history of opioid use, body composition, and sensitivity to medications. You'll have to consult a healthcare provider for an individual dosage recommendation.
Most OUD treatment plans start with an induction process, which means Suboxone is given at a lower dosage to help the body build tolerance to eventually reach a therapeutic dose. This may be administered after the patient has ceased their current opioid use; the process of Suboxone is conducted specifically to avoid any precipitated withdrawal. The dosage may then be steadily increased in increments until an effective dosage is reached.
There are also alternative approaches, such as microdosing. This involves starting a person on smaller doses of Suboxone while they're still using opioids. The ratio of substances is then adjusted over time, so that the dose of Suboxone is gradually increased while opioid use is decreased. In other instances, healthcare providers may recommend macro-dosing, which means starting with a big dose and then dialing down.
As you can see, the approaches for Suboxone induction are highly variable. That's why it's so important to get a personalized treatment plan from a qualified healthcare provider that's tailored to your distinct needs.
After the induction period is over, the maintenance period begins. This is when the patient's Suboxone dose is stabilized.
Signs your Suboxone dose may be too low
If your Suboxone dosage is insufficient, you won't get the full benefits of the medication, which can impede your OUD treatment's success. Recognizing the signs that your Suboxone dose is low can help. If you notice these symptoms, talk to the healthcare provider who prescribed your Suboxone:
- Sweating
- Abdominal cramps
- Diarrhea
- Nausea
- Vomiting
- Tremors
- Anxiety
- Pain
- Cravings for opioids
You may notice that a lot of these symptoms are identical to the OUD withdrawal symptoms mentioned above. This is because Suboxone is supposed to control those withdrawal symptoms, so when you aren't getting enough, they're likely to appear.
The goal when prescribing Suboxone for OUD is to prescribe the lowest possible dosage that is still effective. You don't want a dose that's too low, or you risk experiencing withdrawal symptoms, which can increase your likelihood of returning to prior use.
On the other hand, there's no point in taking an excessively high dose because the medication has a ceiling effect. Once you pass a certain threshold, taking more won't make it more effective, as dosing is different for each patient. It’s crucial to speak with your healthcare provider to ensure you’re receiving the best dose and treatment that best suits your needs.
Professional guidance for your Suboxone treatment
Suboxone has been proven as an effective and safe means of helping to treat OUD, especially when administered as part of a MAT program. However, it's critical that Suboxone is prescribed by a qualified healthcare professional according to each patient's unique needs. The right dose for one patient may not be right for another.
If you think you may benefit from MAT, we can help. Ophelia offers online opioid addiction treatment. If you’re a good candidate for this treatment, we’ll send a Suboxone prescription to your local pharmacy, and you’ll have regular virtual visits with your care team to monitor your progress.
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