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Step-by-Step Guide on How to Effectively Take Suboxone

Taking Suboxone correctly is easy, and it’s a necessary step to stay safe while taking the medication.

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When used correctly, Suboxone can help to prevent relapse and overdose on opioid drugs and limit the experience of cravings and withdrawal symptoms during recovery from opioid addiction.[1] When used incorrectly, the naloxone component of the drug can be activated, causing the user to go into precipitated withdrawal, which is characterized by extreme opioid withdrawal symptoms.[2]

If you have questions about your Suboxone dose and how to take it, contact your prescribing doctor. If you are concerned that you are having an adverse reaction to your prescription, contact emergency medical help.

How to Properly Take Suboxone Depending on the Form Used

Suboxone is available for prescription in two forms: sublingual film strips and sublingual tablets.[3]

Both forms of the medication are designed to dissolve in the mouth—not to be swallowed. This aids in the faster absorption of the medication into the bloodstream. 

Suboxone Sublingual Film Strips

Suboxone sublingual film strips are dissolved by placing it under the tongue for up to 10 minutes until it is fully dissolved.[4]

Steps to Take Suboxone Sublingual Film

Follow these steps to safely take Suboxone film strips:

  • Make sure your hands are dry before opening the package or touching the film.
  • Open the package as directed right before you want to take the medication. 
  • If you have been instructed to cut the film to manage your dose, do as your doctor ordered.[5]
  • Place the film under the tongue.
  • Allow the film to dissolve completely, which can take up to 10 minutes. 
  • If you are taking supportive medications, take those as needed.[6]

Standard Doses of Suboxone Buccal Film

The dose of Suboxone taken each day will vary from person to person and according to their phase of treatment. Initially, doses generally start low and are adjusted as needed, ranging from 2 mg buprenorphine/0.5 mg naloxone to 12 mg buprenorphine/3 mg naloxone per day.[7]

Suboxone Sublingual Tablets

Suboxone sublingual tablets are similar in function and purpose to the sublingual film. They are also placed under the tongue to dissolve.[8]

How to Take Suboxone Sublingual Tablets

Follow these steps to effectively take Suboxone sublingual tablets:

  • Before touching or taking the tablet, make sure your hands are clean and dry. 
  • Put the tablet under your tongue, and allow it to dissolve completely without chewing or swallowing it. 
  • If more than one tablet is needed for a dose, place all tablets under the tongue at one time or two tablets at a time if all won’t fit.
  • The process of dissolution takes approximately four to eight minutes.

Standard Doses of Suboxone Sublingual Tablets

Like the film strips, the dosage for tablets is determined based on individual needs and where someone is in their process of recovery. In most cases, dosing starts with 2 mg buprenorphine/0.5 mg naloxone and is increased as needed.[9]

Tips for All Forms of Suboxone 

No matter what form of Suboxone you take, it is important to follow these steps: 

  • Be consistent, and take the medication at the same time each day. 
  • Avoid eating or drinking anything while you are waiting for the film or tablet to dissolve. 
  • Do not alter the medication in any way, including attempts to crush and inject tablets.
  • Communicate with your doctor about any issues or questions you may have or if you would like to adjust your dose. 

What to Expect When Starting Suboxone

When initiating Suboxone to manage an opioid use disorder and transition into active recovery, most people start by taking buprenorphine alone. Though buprenorphine is one of the active ingredients in Suboxone, the naloxone in the medication can make it a poor choice too early in the detox process. 

In most circumstances, the person is advised to wait about 24 hours after last opioid use before taking any medication. Then, they are advised to take buprenorphine alone before beginning a low dose of Suboxone.[10] 

This period of time is called the induction phase. It begins with a consultation and assessment and continues as the person stops taking their drug of choice and embarks on the medication regimen provided by their doctor. This process is tailored to each individual.

This chart breaks down what to expect as you begin to take Suboxone:[3-8,11]

TimelineWhat to Expect
Day 1: InductionYou’ll likely start taking Suboxone under the supervision of your doctor once mild to moderate withdrawal symptoms appear. This usually happens within 12 to 24 hours of your last dose of opioids. Because the goal is to find the minimum dose required to reduce withdrawal symptoms without causing sedation or respiratory depression, the first day’s dose may be low, but it may be later increased if needed.
Days 2-3: AdjustmentIf needed, your doctor may increase your dose based on your response on the first day. The goal is to alleviate withdrawal symptoms and cravings without triggering a euphoric high or any serious side effects.
Days 4-7: StabilizationYou and your doctor will continue to work on finding the right dose for your maintenance period of recovery if this is not addressed fully in the first few days. During this time, your withdrawal symptoms and cravings should decrease considerably, though you may experience some side effects as your body adjusts to the medication, such as mild headaches, nausea, or constipation.
Beyond week 1: MaintenanceOnce you feel stable in recovery, you will continue on this dose as you enter maintenance or the long-term phase of recovery. The length of this phase varies widely from person to person, ranging from several months to years depending on the progress in recovery, overall health, and unique personal needs and goals for treatment.

Tips and Considerations When Taking Suboxone 

  • Do not try to take Suboxone on your own even if you find that it is available on the street. It is important to follow the dosing schedule carefully and have medical supervision throughout the process. 
  • Though Suboxone is available on an outpatient basis, it is not designed to be the sole source of support in recovery from opioid addiction. Therapy, alternative health measures, and lifestyle changes are recommended.[12]
  • Even when you are stable in the maintenance phase of recovery, it is important to continue to check in regularly with the prescribing physician and share any questions, concerns, or requests to alter the dose. 
  • If side effects become an issue at any point, especially if your health status changes and you are diagnosed with a co-occurring medical condition or new medications, check in with your prescribing physician.[13]

Starting a Suboxone regimen is a big step in recovery and a great way to transition out of active opioid abuse. A comprehensive medication-assisted treatment (MAT) plan can help to reduce the risk of death due to opioid overdose or accident while under the influence. 

If you have questions about your dose or your experience with Suboxone, reach out to your doctor. If you don’t have a prescription for Suboxone, reach out for help today.

Updated April 6, 2024
Resources
  1. Velander JR. Suboxone: Rationale, science, misconceptions. The Ochsner Journal. 2018;18(1):23-29.
  2. Sivils A, Lyell P, Wang JQ, Chu XP. Suboxone: History, controversy, and open questions. Frontiers in Psychiatry. 2022;13.
  3. Poliwoda S, Noor N, Jenkins JS, et al. Buprenorphine and its formulations: a comprehensive review. Health Psychology Research. 2022;10(3).
  4. Highlights of Prescribing Information for Suboxone Sublingual Film. US Food and Drug Administration. Published March, 2021. Accessed March 26, 2024.
  5. Reindel K, Deangelis M, Ferrara A, Conn K, Phillips E. An exploratory study of Suboxone (buprenorphine/naloxone) film splitting. International Journal of Pharmaceutical Compounding. 23:258-263.
  6. Suboxone microdosing instruction. University of Colorado School of Medicine. Accessed March 26, 2024.
  7. Highlights of prescribing information. Suboxone. Revised December 2023. Accessed March 26, 2024.
  8. Highlights of prescribing information Suboxone sublingual tablets. U.S. Food and Drug Administration. Revised October, 2019. Accessed March 26, 2024.
  9. Hydrochloride B, Naloxone, Dihydrate H. SUBOXONE ® sublingual tablets consumer medicine information. New Zealand Medicines and Medical Devices Safety Authority. Revised July, 2021. Accessed March 26, 2024.
  10. Buprenorphine quick start guide. Substance Abuse Mental Health Services Administration. Accessed March 26, 2024.
  11. Practice profile: Buprenorphine maintenance treatment – CrimeSolutions, National Institute of Justice. Accessed March 26, 2024.
  12. Deyo Svendsen M, Cabrera Svendsen M, Walker J, Hodges A, Oldfather R, Mansukhani MP. Medication-assisted treatment for opioid use disorder in a rural family medicine practice. Journal of Primary Care & Community Health. 2020;11.
  13. Savage SR, Kirsh KL, Passik SD. Challenges in using opioids to treat pain in persons with substance use disorders. Addiction Science & Clinical Practice. 2008;4(2):4-25.
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