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Product name: Suboxone Oral Tablets
Generic Name: buprenorphine and naloxone
Brand Names: Bunavail, Suboxone, Zubsolv
Dosage Strength(s): 2mg/0.5mg, 8mg/2mg
Quantity: 100 – 750 Tablets
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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.
Do not cut, chew or swallow.
Avoid food or drinks until film dissolves. Give by sublingual (SL: under the tongue) or buccal (inside of cheek) administration.
Place additional films sublingually or buccally on opposite side from the first film if needed; should minimize overlapping.
Start when clear signs of withdrawal occur; individualize based on type and degree of opioid dependence.
Supervised induction (use SL route): Day 1: initially 2 mg/0.5 mg or 4 mg/1 mg; may increase in increments of buprenorphine 2 mg or 4 mg at 2-hr intervals, up to 8 mg/2 mg based on response; Day 2: a single dose up to 16mg/4mg.
Dependent on heroin or short-acting opioids: initiate induction with either Suboxone film or buprenorphine monotherapy (SL tabs) at least 6hrs after last opioid dose. Dependent on methadone or long-acting opioids: initiate buprenorphine monotherapy (SL tabs) for induction, then transition to once daily Suboxone.
Maintenance phase: (target dose): 16 mg/4 mg once daily; adjust in 2 mg/0.5 mg or 4 mg/1mg increments/decrements; (usual range): 4mg/1mg–24mg/6mg once daily. Switching between buprenorphine or buprenorphine/naloxone tabs and Suboxone films: start on same dosage as previously; may need dose adjustments between products; monitor for over- or under-dosing.
Switching between various Suboxone film strengths: systemic exposures may be different; monitor for over- or under-dosing. Hepatic impairment (severe): not recommended; (moderate): avoid use for induction. Concomitant use or discontinuation of CYP3A4 inhibitors or inducers: monitor closely and consider dose adjustments.
Increased risk of hypotension, respiratory depression, sedation with benzodiazepines or other CNS depressants (eg, non-benzodiazepine sedatives/hypnotics, anxiolytics, general anesthetics, tranquilizers, muscle relaxants, antipsychotics, alcohol, other opioids); manage concomitant use as clinically appropriate and closely monitor.
During or within 14 days of MAOIs: not recommended. Risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, 5-HT3 antagonists, mirtazapine, trazodone, tramadol, MAOIs, linezolid, IV methylene blue); monitor and discontinue if suspected.
Concomitant NNRTIs (eg, efavirenz, nevirapine, etravirine, delavirdine) or PIs (eg, atazanavir with/without ritonavir): monitor and reduce Suboxone dose, if needed. Potentiated by CYP3A4 inhibitors (eg, macrolides, azole antifungals, protease inhibitors). Antagonized by CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin). May antagonize diuretics; monitor. Paralytic ileus may occur with anticholinergics.
Common Side Effects of Suboxone
You should tell your doctor if any of the following side effects become severe or do not go away:
Difficulty falling asleep or staying asleep
Serious Side Effects of Suboxone
You should contact your doctor immediately if you experience any of the following serious side effects:
Itching, skin rash, or hives
Difficulty breathing or slowed breathing
Unusual bleeding or bruising
Loss of appetite
Pain in the upper right part of the stomach
Yellowing of the skin or eyes
Withdrawal Caused by Suboxone
In addition to these side effects, buprenorphine also causes withdrawal. If a person has been taking this medication for a long period of time and they no longer receive it, they suffer withdrawal symptoms similar to those suffered when stopping other forms of opiates.
Just like other opioids, buprenorphine interacts with the brain and body, affecting its chemical processes. Once removed, the body feels the absence of the drug, causing withdrawal. The severity of symptoms depends on the length, method, and amount of use. Common withdrawal symptoms include:
Nausea, vomiting, and diarrhea
Naturally, suffering from these withdrawal symptoms can worsen underlying mental disorders like depression. At times, withdrawal can become overwhelming, which sends patients spiraling into buprenorphine abuse and dependency.
There’s a huge debate swirling around the use of Suboxone for addiction treatment. The truth of the matter is that Suboxone helps thousands of people overcome their addictions. But there’s a flip side to this issue; Suboxone can also have a dark side that leads to further addiction and recovery hurdles.
No matter where you stand on the issue, it’s important to do your research and understand the facts before starting down this – or any other – treatment path.
Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.
Vigor Health Pharmaceuticals does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.
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