Drugs Q & AMedicines

What are the Side Effects of Suboxone?

Suboxone is a combination medication that contains buprenorphine and naloxone. Buprenorphine is an opioid medication, sometimes called a narcotic. Naloxone blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse.

In combination, this medication is effective in reducing opioid misuse. It’s also effective for keeping people with opioid dependence in treatment over 24 weeks. (How well a drug such as Suboxone performs is partly

Suboxone is a controlled substance. It’s classified as a schedule three (III) prescription drug. This means that it has an accepted medical use, but it may cause physical or psychological dependence and may be abused.

The government has created special rules for how schedule III drugs can be prescribed by a doctor and dispensed by a pharmacist. Your doctor or pharmacist can tell you more.

What Are The Possible Side Effects Of Suboxone?

A major challenge in the use of Suboxone for blocking opioids is the problem of side effects.

The common side effects of Suboxone include:

•          Headache, nausea, vomiting, increased sweating, constipation, trouble sleeping (insomnia), pain, and swelling in the arms and legs (peripheral edema)

•          Signs and symptoms of withdrawal from opioids (such as shaking, stomach cramps, diarrhea, restlessness, irritability, anxiety, body aches, or runny nose)

•          Numbness of the mouth, redness of the mouth, and burning or painful tongue may occur with the Suboxone film

Rare/serious side effects

•          Orthostatic hypotension (low blood pressure when standing)

•          Changes in liver function or liver failure

•          Changes in adrenal gland function

•          Sleep-related breathing disorders

•          Allergic reactions

o          Avoid with known hypersensitivity (rashes, hives, itching) to buprenorphine, naloxone, or any of the ingredients with them

•          Overdose and death

o          Signs of overdose include pinpoint pupils, sedation, low blood pressure, and respiratory depression (slowed breathing)

o          This risk is higher when Suboxone is used IV or at the same time as sedatives (like benzodiazepines) or other depressants (like alcohol)

What are Suboxone side effects sexually?

Studies have shown that opioid dependence especially in men can lead to sexual dysfunctions in the short and long term. The medications used for long-term pharmacotherapy of opioid dependence such as Suboxone also affect sexual functioning.

Research has shown that Suboxone can cause:

  • Premature ejaculation
  • Erectile dysfunction
  • Loss/reduction in sexual desire

What are the long term side effects of suboxone?

Buprenorphine is a partial opioid agonist. Like other opioids, buprenorphine causes physical dependency when taken daily for a long period of time. This means that you may have withdrawal symptoms if Suboxone is stopped abruptly. Withdrawal symptoms when stopping Suboxone are usually not as severe as with other full opioids. Talk to your provider before stopping Suboxone.

What Other Medications May Interact With Suboxone?

There have been reports of respiratory depression (slowed breathing) and death in patients taking Suboxone with benzodiazepine medications such as alprazolam (Xanax®), clonazepam (Klonopin®), diazepam (Valium®), lorazepam (Ativan®), and temazepam (Restoril®). These medications should be taken exactly as prescribed. It is very dangerous to take Suboxone with benzodiazepines if you do not have a prescription.

The following medications may increase the effects of Suboxone:

•          Certain antibiotics such as clarithromycin (Biaxin®) and erythromycin (Ery-Tab®)

•          Certain antidepressants such as fluoxetine (Prozac®), phenelzine (Nardil®)

•          Antifungals, such as fluconazole (Diflucan®), ketoconazole (Nizoral®), and itraconazole (Sporanox®)

•          Certain HIV medications known as protease inhibitors: indinavir (Crixivan®), ritonavir (Norvir®), saquinavir (Fortovase®, Invirase®), and lopinavir/ritonavir (Kaletra®)

The following medications may decrease the effects of Suboxone:

•          Certain seizure medications such as phenobarbital, carbamazepine (Tegretol®), and phenytoin (Dilantin®)

•          The antibiotic rifampicin (Rifadin®)

•          The opioid “blocker” naltrexone (Revia®, Vivitrol®)

How Long Does It Take For Suboxone Strip To Work?

Suboxone will begin working shortly after taking one dose.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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