Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Are The Side Effects Of Taking Second Dose Of Suboxone?
Question: For an individual with a dependence on opioid analgesics (typically 70mg Oxycodone daily), what should be expected after the initial dose of Suboxone in terms of side effects, assuming the indicated period of time elapsed between ingestion of the final Oxycodone dose and the first Suboxone to avoid precipitated withdrawal?
Brief Answer:
you need to be in withdrawal.
Detailed Answer:
going up on narcotics does not feel bad; going lower on them does. The most important feature is to be far enough out from the oxycodone that one is solidly into withdrawal otherwise the suboxone WILL produce withdrawal.
Assuming one has not taken any narcotic for at least 12 hrs and better if 24 hrs (assuming ONLY short acting drugs like oxycodone) or 2-3 days if long acting (methadone), and that one is having pain/shivers/nausea then the suboxone will lower the symptoms. The suboxone guides from 2-5 years ago are a bit wrong in advising to start at 2 mg doses of suboxone. Typically people seeking suboxone have already established what dose is appropriate for them (usually 16 mg a day sometimes slightly more or less) and that should be the initial dosing. This would end the withdrawal. Although the 'high' from suboxone is small as these things go, it's effects on pain are quite significant. So, if someone has pain (lumbar disk, cervical spine, etc.) then the usual dose of suboxone will be more or less adequate for pain control and withdrawal control. Suboxone stays in the system for most of 24 hrs but it's levels dwindle between 16-24 so typically it requires twice a day dosing.
It's total effectiveness is less than 70 mg oxycodone equivalent a day but not a lot less and it is quite good at stopping withdrawal and fairly good at stopping cravings.
typically, it's pretty good. Haven't had many people on that LOW a dose of oxycodone before starting suboxone.
you need to be in withdrawal.
Detailed Answer:
going up on narcotics does not feel bad; going lower on them does. The most important feature is to be far enough out from the oxycodone that one is solidly into withdrawal otherwise the suboxone WILL produce withdrawal.
Assuming one has not taken any narcotic for at least 12 hrs and better if 24 hrs (assuming ONLY short acting drugs like oxycodone) or 2-3 days if long acting (methadone), and that one is having pain/shivers/nausea then the suboxone will lower the symptoms. The suboxone guides from 2-5 years ago are a bit wrong in advising to start at 2 mg doses of suboxone. Typically people seeking suboxone have already established what dose is appropriate for them (usually 16 mg a day sometimes slightly more or less) and that should be the initial dosing. This would end the withdrawal. Although the 'high' from suboxone is small as these things go, it's effects on pain are quite significant. So, if someone has pain (lumbar disk, cervical spine, etc.) then the usual dose of suboxone will be more or less adequate for pain control and withdrawal control. Suboxone stays in the system for most of 24 hrs but it's levels dwindle between 16-24 so typically it requires twice a day dosing.
It's total effectiveness is less than 70 mg oxycodone equivalent a day but not a lot less and it is quite good at stopping withdrawal and fairly good at stopping cravings.
typically, it's pretty good. Haven't had many people on that LOW a dose of oxycodone before starting suboxone.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. Last follow up - how often are there adverse reactions to Suboxone that are not related to withdrawal? Buprenorphine is likely to be well tolerated I'd Oxycodone is, but do you find that the narcan/ nalaxone in Suboxone often produces rough side effects?
Brief Answer:
not related to withdrawal... no, not common
Detailed Answer:
Naloxone is emerging as an interesting drug in combination with narcotics:
1) It has some role in lowering addictive behaviors and is FDA approved for such in alcoholism and weight management.
2) it seems to lower the incidence of narcotic associated nausea and itching (?!?)
http://europepmc.org/abstract/med/0000
(among many other papers).
It just doesn't have many adverse effects outside of it's interaction with narcotic drugs also taken at the same time.
not related to withdrawal... no, not common
Detailed Answer:
Naloxone is emerging as an interesting drug in combination with narcotics:
1) It has some role in lowering addictive behaviors and is FDA approved for such in alcoholism and weight management.
2) it seems to lower the incidence of narcotic associated nausea and itching (?!?)
http://europepmc.org/abstract/med/0000
(among many other papers).
It just doesn't have many adverse effects outside of it's interaction with narcotic drugs also taken at the same time.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
