Suboxone

Generic Name: buprenorphine and naloxone (byoo PREH nor feen and NAH lox own)
Brand Name: Suboxone

What is Suboxone?

Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication. An opioid is sometimes called a narcotic.

Naloxone is an special narcotic drug that reverses the effects of other narcotic medicines.

Suboxone is used to treat narcotic (opiate) addiction.

Suboxone may also be used for purposes not listed in this medication guide.

Important information about Suboxone

Using this medicine improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from Suboxone. Follow all dosing instructions carefully.

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

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Never share Suboxone with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Suboxone. Check your food and medicine labels to be sure these products do not contain alcohol.

You should not breast-feed while using this medicine.

Do not give Suboxone to anyone under 18 years old without medical advice. The use of this medicine by a child can result in death. Seek emergency medical attention if a child has accidentally swallowed the medication.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how Suboxone will affect you.

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:

• asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;

• enlarged prostate, urination problems;

• liver disease;

• kidney disease;

• curvature of the spine that affects breathing;

• underactive thyroid;

• gallbladder disease;

• Addison's disease (an adrenal gland disorder);

• a history of mental illness, hallucinations, or psychotic episode;

• a history of drug or alcohol addiction; or

• a history of seizures, head injury, or brain tumor.

Buprenorphine may be habit forming. Never share Suboxone with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

FDA pregnancy category C. It is not known whether Suboxone will harm an unborn baby. Suboxone may cause addiction or withdrawal symptoms in your newborn if you take the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant.

See also: Suboxone pregnancy and breastfeeding warnings (in more detail)

Buprenorphine can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Do not give Suboxone to anyone under 18 years old without medical advice. The use of this medicine by a child can result in death. Seek emergency medical attention if a child has accidentally swallowed the medication.

How should I take Suboxone?

Take Suboxone exactly as directed by your doctor. Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. Your doctor may occasionally change your dose to make sure you get the best results.

Using buprenorphine improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from buprenorphine.

Before taking this medicine, drink a glass of water to moisten your mouth. Place the sublingual tablet or sublingual film under the tongue and allow it to dissolve. Do not chew the tablet or film, and do not swallow it whole.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Do not stop using Suboxone suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using Suboxone.

Never crush a tablet or dissolve a film to mix into a liquid for injecting the drug into your vein. This practice has resulted in death with the misuse of buprenorphine and similar prescription drugs.

Wear a medical alert tag or carry an ID card stating that you take Suboxone. Any medical care provider who treats you should know that you are being treated for narcotic addiction. Make sure your family members know you are using buprenorphine in case they need to speak for you during an emergency.

Store Suboxone at room temperature away from moisture and heat. Keep the sublingual film in the foil pouch until ready to use. After opening a pouch, you must use the medicine right away. Discard the empty pouch in a place children and pets cannot get to.

Keep track of the amount of medicine used from each new bottle. Buprenorphine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of buprenorphine can be fatal.

Overdose symptoms may include confusion, dizziness, pinpoint pupils, fainting, or slow breathing (breathing may stop).

What should I avoid while taking Suboxone?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Suboxone. Check your food and medicine labels to be sure these products do not contain alcohol.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how Suboxone will affect you.

Suboxone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Suboxone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, buprenorphine can slow your breathing. Death may occur if breathing becomes too weak.

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

• extreme drowsiness;

• loss of coordination, weakness or limp feeling;

• blurred vision, slurred speech, thinking problems;

• weak or shallow breathing;

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

• pounding heartbeats or fluttering in your chest; or

• withdrawal symptoms--diarrhea, vomiting, shaking or shivering, runny nose, watery eyes, muscle pain, and feeling very hot or cold.

Common Suboxone side effects may include:

• headache, mild dizziness;

• numbness or tingling;

• drowsiness, or sleep problems (insomnia);

• stomach pain, vomiting, constipation;

• redness, pain, or numbness in your mouth;

• feeling drunk; or

• trouble concentrating.

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.

See also: Suboxone side effects (in more detail)

What other drugs will affect Suboxone?

Taking Suboxone with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking Suboxone with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with Suboxone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Suboxone, especially:

• St. John's wort;

• an antibiotic--clarithromycin, erythromycin, nafcillin, rifabutin, rifapentine, rifampin, telithromycin;

• antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

• heart or blood pressure medication--nicardipine or quinidine;

• the hepatitis medications boceprevir or telaprevir;

• HIV or AIDS medicine--atazanavir, delavirdine, efavirenz, indinavir, nevirapine, saquinavir;

• a sedative--diazepam, alprazolam, lorazepam, temazepam, triazolam, Restoril, Valium, Xanax, and others; or

• seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, or primidone.

This list is not complete. Other drugs may interact with Suboxone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

• Your pharmacist can provide additional information about Suboxone.