How long does it take for Suboxone to start working?
Suboxone starts to work quickly—about 20 to 60 minutes after you take the first dose. The medication should reach peak effect around 100 minutes (1 hour and 40 minutes) after you take the first dose.
Suboxone is a combination of the drugs buprenorphine and naloxone, and it's used as a treatment for opioid dependence. You can take Suboxone 12-24 hours after you last used opioids. That's because your body must already be in opioid withdrawal for Suboxone to work properly. Suboxone is typically prescribed after taking buprenorphine alone for a day or two, but sometimes treatment may begin with Suboxone.
Suboxone is available as a film or a tablet, and both are dissolved under the tongue. The combination of buprenorphine and naloxone is also sold under the brand names Zubsolv and Bunavail. Generic equivalents are also available. The dosages range from 2 mg buprenorphine and 0.3 mg naloxone to 24 mg buprenorphine and 6 mg naloxone. There is no demonstrated clinical advantage to dosages higher than that.
Day 1 of treatment typically starts with buprenorphine alone or a low dose of Suboxone. Dosages may be increased until they effectively reduce withdrawal symptoms. You may be given gradually higher doses of the medication approximately every 2 hours, depending on how well the acute withdrawal symptoms are controlled. Most people feel much better at the end of the first day.
A single daily dose of up to 16 mg/4 mg is usually recommended on day 2 and the following days. The effects of Suboxone can last for 28-37 hours after it is dissolved under the tongue. That means the right dose can be enough to last you throughout an entire day without needing another dose.
The length of treatment with Suboxone can vary from days to months, or even years. It is often more successful when maintained long-term, so sometimes treatment with Suboxone is indefinite. As long as the medication is beneficial and not causing any complications, it is usually recommended that you continue taking it.
Don't stop taking Suboxone without checking with your doctor.
- Government of British Columbia. Opioid use disorder induction handout. Undated. Available at: https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/oud-induction-handout.pdf. [Accessed March 22, 2021].
- National Health Service Ayrshire & Arran. Suboxone. May 2016. Available at: https://www.nhsaaa.net/media/1932/20160628suboxone.pdf. [Accessed March 22, 2021].
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- Velander JR. Suboxone: Rationale, science, misconceptions. Ochsner J. 2018;18(1):23-29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
- Substance Abuse and Mental Health Services Administration (SAMHSA). Buprenorphine. Last updated March 12, 2021. Available at: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. [Accessed March 22, 2021].
- U.S. National Library of Medicine. Buprenorphine sublingual and buccal (opioid dependence). Last updated December 15, 2020. Available at: https://medlineplus.gov/druginfo/meds/a605002.html. [Accessed March 22, 2021].
- Substance Abuse and Mental Health Services Administration (SAMHSA). Advisory: Sublingual and transmucosal buprenorphine for opioid use disorder: Review and update. March 2016. Available at: https://store.samhsa.gov/product/Advisory-Sublingual-and-Transmucosal-Buprenorphine-for-Opioid-Use-Disorder-/SMA16-4938. [Accessed March 22, 2021].
- Food and Drug Administration (FDA). Suboxone (buprenorphine and naloxone) sublingual film. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. [Accessed March 22, 2021].
- Zoorob R, Kowalchuk A, Mejia de Grubb M. Buprenorphine therapy for opioid use disorder. Am Fam Physician. 2018;97(5):313-320. https://pubmed.ncbi.nlm.nih.gov/29671504/
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