Suboxone Side Effects
Suboxone, which contains buprenorphine and naloxone as its two active ingredients, may cause a number of side effects.[2] These side effects generally lessen as a person gets used to the medication.
Physical symptoms of Suboxone use may include nausea, headache, and constipation. Psychological effects include anxiety and depression. There are also potential behavioral changes, like agitation and cravings for more opioids.
These side effects can vary in severity based on a number of factors, such as the nature and degree of OUD, the person’s overall health and lifestyle, environmental factors, and many other factors.
This chart breaks down the various potential side effects of Suboxone:[1-3]
| Type of Side Effect | Physical | Mental | Behavioral | Sexual |
| Nausea | X | |||
| Headache | X | |||
| Drowsiness | X | |||
| Insomnia | X | |||
| Anxiety | X | |||
| Depression | X | |||
| Irritability | X | X | ||
| Mood Swings | X | X | ||
| Agitation | X | X | ||
| Cravings | X | X | X | |
| Fatigue | X | X | X | |
| Constipation | X | |||
| Sweating | X | |||
| Changes in Libido | X | |||
| Erectile Dysfunction | X |
Physical Side Effects
Some of the physical side effects of Suboxone include, but are not limited to, nausea, headache, drowsiness, insomnia, constipation, sweating, fatigue, and changes in libido.[3]
Psychological Side Effects
The psychological side effects of Suboxone include anxiety, depression, irritability, mood swings, and cravings for more Suboxone or other opioids. Without treatment and therapy, these psychological side effects of Suboxone can impact mood and overall mental health, affecting daily functioning and quality of life.[2]
Behavioral Side Effects
Some of the behavioral side effects of Suboxone overlap with the psychological side effects. Agitation and irritability may manifest in behavioral differences. For some people, cravings may motivate compulsive drug-seeking behaviors. The presentation of behavioral side effects of Suboxone can harm interpersonal relationships.
Sexual Side Effects
Sexual side effects of Suboxone will vary according to sex.
Men
Erectile dysfunction (ED), or difficulty achieving or maintaining an erection, is a common complaint among men taking Suboxone.[4] They may experience decreased libido (reduced sex drive) as a result of lower testosterone levels. Some men may encounter delayed ejaculation and difficulty reaching orgasm.
Women
Similar to the effect in men, Suboxone can dampen sexual desire among women taking the medication.[5] This may take the form of difficulty achieving orgasm or a decrease in vaginal lubrication during sex, leading to a reduced quality of sex and intimacy between partners. Some women may struggle with irregular menstrual cycles because of their Suboxone intake.
Both Sexes
Additionally, both male and female patients can experience a decrease in sexual spontaneity due to Suboxone’s effects on mood and energy levels (related to the psychological and behavioral side effects noted above).[6]
Short vs. Long-term Effects of Taking Suboxone
Many side effects of Suboxone may be temporary, and they fade within a few days or weeks of taking the medication. This chart breaks down potential short-term and long-term side effects:[1]
| Short-Term Effects | Long-Term Effects |
| Reduce opioid withdrawal symptoms | Physical dependence |
| Pain relief | Tolerance development (primarily an issue for those opioid naïve) |
| Mild euphoria for people who are opioid naïve | Liver damage (with prolonged use and more likely for those with existing liver issues) |
These effects vary, depending on individual factors like dose, frequency of use, and overall health status.
Short-term effects of Suboxone use primarily involve alleviation of opioid withdrawal symptoms, such as nausea, muscle aches, and cravings, which helps in the early stages of addiction treatment. Additionally, Suboxone provides pain relief, which can be beneficial as a way of inducing comfort and stability during the initial phases of recovery. These short-term effects are crucial for managing the acute challenges of opioid withdrawal
Long-term use of Suboxone may lead to physical dependence and tolerance, requiring higher doses for the same (potentially diminishing) effect.[7] Prolonged use may also result in psychological dependence, where individuals feel unable to function without the medication.
Additionally, there is a risk of respiratory depression, liver damage, and hormonal imbalances with extended use. These issues are more likely for those with pre-existing liver issues, health conditions, and mental health issues.
How to Manage Side Effects
Suboxone is an evidence-based treatment for OUD. If you are experiencing side effects, tell your treatment team. If they persist beyond a week or are particularly severe, they may adjust your dose, introduce alternative therapies, or otherwise change your treatment plan to help you cope.
- Suboxone: Highlights of prescribing information. U.S. Food and Drug Administration. Accessed March 31, 2024.
- Buprenorphine/naloxone versus methadone for the treatment of opioid dependence: A review of comparative clinical effectiveness, cost-effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health; 2016. Accessed March 31, 2024.
- Mental health medications. National Alliance on Mental Illness. Published 2020. Accessed March 31, 2024.
- Ghosh A, Mattoo S, Subodh B, et al. Sexual dysfunction in men on buprenorphine – naloxone-based substitution therapy. Indian Journal of Psychiatry. 2020;62(1):66.
- Zamboni L, Franceschini A, Portoghese I, Morbioli L, Lugoboni F. Sexual functioning and opioid maintenance treatment in women. Results from a large multicentre study. Frontiers in Behavioral Neuroscience. 2019;13.
- Ghadigaonkar DS, Murthy P. Sexual dysfunction in persons with substance use disorders. Journal of Psychosexual Health. 2019;1(2):117-121.
- Woody GE, Poole SA, Subramaniam G, et al. Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth. JAMA. 2008;300(17).
