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Buprenorphine and Naloxone Dosage

Buprenorphine and naloxone comes in the form of tablets or film that are dissolved under the tongue once daily. Your dosage of buprenorphine and naloxone will depend on several factors, such as the type and dose of other opioids you have been taking. Do not suddenly stop taking this drug or increase your dosage without your healthcare provider's approval.

An Introduction to Your Dosage of Buprenorphine and Naloxone

The dose of buprenorphine and naloxone (Suboxone®) your healthcare provider recommends will vary, depending on a number of factors, including:
 
  • The type and dose of opioids you have been taking
  • How you respond to the medication
  • Other medications you are taking
  • Other medical conditions you may have.
 
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
 

Buprenorphine and Naloxone Dosing Guidelines

When you are first stopping other opioids and starting treatment with a buprenorphine product, a healthcare provider will usually prescribe Subutex® (a similar medication that does not contain naloxone), rather than buprenorphine and naloxone. Using buprenorphine and naloxone in this situation is likely to cause severe opioid withdrawal symptoms.
 
Your healthcare provider will individualize your Subutex dosage, based largely on how you respond to the medication. Typically, Subutex is started at least four hours after your last dose of other opioids, preferably after withdrawal symptoms start to appear. If you take this medicine too soon, it might actually worsen withdrawal symptoms.
 
Often, by the third day you can be switched to buprenorphine and naloxone. This drug is typically a good option for use outside of a treatment center, as it is less likely to be abused (see What Is Buprenorphine and Naloxone Used For? for more information about buprenorphine and naloxone versus Subutex).
 
Because the naloxone component of the drug essentially has no effect when buprenorphine and naloxone is used as directed, you can be switched to exactly the same dose, based on the buprenorphine content. For instance, if you were using 8 mg of Subutex, you can be switched to buprenorphine and naloxone 8 mg/2 mg, which contains 8 mg of buprenorphine and 2 mg of naloxone.
 
Your healthcare provider should adjust your dosage until you find an amount that adequately reduces your withdrawal symptoms. For most people, this daily dose is usually between 4 mg and 24 mg of the buprenorphine content.
 
If you switch from the tablets to the film, you and your healthcare provider should be watchful for any signs of overdose or toxicity. The sublingual film is generally absorbed into the bloodstream more effectively than the tablets.
 
Buprenorphine and naloxone lasts long enough that you can use it just once a day. It has a half-life of 24 to 42 hours (based on the buprenorphine content), meaning that it takes 24 to 42 hours for the level of buprenorphine to drop by 50 percent in your blood. This means it may take several days, or even a week or longer, to be mostly out of your system.
 
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Buprenorphine and Naloxone Drug Information

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