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Emergency Department Buprenorphine/Naloxone (Suboxone)

Home Dosing Information

​​​​​​​​​The Emergency Department gave you buprenorphine/naloxone (Suboxone) to help treat an opioid use disorder. It’s important for you to take this medicine.

You were given 6 doses of buprenorphine/naloxone to take with you.

What is buprenorphine/naloxone and how does it work?

Buprenorphine/naloxone (Suboxone) is a pill that has 2 medicines. The goal of this medicine is to help you use other opioids less, so you are safer and healthier.

Buprenorphine is a type of opioid (like morphine, heroin or methadone) but it works differently than other types of opioids. Buprenorphine helps treat withdrawal and can get rid of cravings more safely than other medicines. Once you get the right dose of buprenorphine, it will prevent withdrawal symptoms and can help you stop taking other prescription or purchased opioids.

Naloxone (Narcan) is added to buprenorphine to prevent people from injecting it. When the pill is dissolved under the tongue, the naloxone doesn’t do anything. If the pill is injected, the naloxone can cause withdrawal symptoms or prevent opioids from working.

How do I take buprenorphine/naloxone?

Take buprenorphine/naloxone by mouth and dissolve it under your tongue. This medicine may take 15​ to 30 minutes to dissolve. It’s important to dissolve this medicine under your tongue as it won’t work if you swallow it. After you take this medicine, wait at least 30 minutes before you eat or drink.

When should I take buprenorphine/naloxone at home?

Take this medicine only when you are in moderate withdrawal. This is the point when you feel like you want to use or inject to prevent more withdrawal symptoms.

It’s important that you feel sick before you take your first dose of buprenorphine/naloxone. If you take it before you feel really sick, it can make your symptoms much worse.

Before you take your first dose, wait at least:

12 hours since you last used a short-acting opioid (fentanyl, heroin, crushed OxyContin, Percocet).

24 hours since you last used a long-acting opioid (OxyContin taken orally, Hydromorph Contin, OxyNeo).

72 hours since you last used methadone.

Dosing

Each dose of buprenorphine/naloxone is 2 mg. Be sure to wait at least 1 hour in between doses. Record the time you take each dose on a piece of paper or in the notes app on your phone.

Don’t take your next dose if you feel worse, sleepy, sedated, or have a hard time focusing. If this happens, call the clinic as your dose may be too strong.

You should feel a little better or about the same after you take each dose. As long as you don’t feel much worse, you can take your next dose.

First Dose

Take your first dose. It will take 30 to 45 minutes for the medicine to start working.

Second Dose

About 1 hour after your first dose, check to see how you feel. Remember, only take your second dose if you feel better, about the same, or not much worse.

Third Dose

Wait at least 1 hour after the second dose before you take your third dose.

Fourth Dose

Wait at least 1 hour after the third dose before you take your fourth dose.

Fifth Dose

Wait at least 1 hour after the fourth dose before you take your fifth dose.

Sixth Dose

Wait at least 1 hour after the fifth dose before you take your sixth dose. This is your final dose until your community clinic appointment.

While you’re taking buprenorphine/naloxone:

  • Don’t use another type of opioid (“dope” or “down”) such as heroin, fentanyl, morphine, dilaudid, hydromorphone, Percocet, or methadone. If you use other opioids while you’re taking buprenorphine/naloxone, you may overdose. If you choose to use other opioids, use as little as possible to lower the risk of an overdose.
  • Don’t take it with other medicines that make you sleepy or relaxed such as benzodiazepines (“benzos”), alcohol, sedatives, or sleep aids.
  • Be careful doing any activity where you need to be alert.
  • Stop taking it if it makes you feel worse, sleepy, or you have a hard time focusing.​

If you have side effects that you’re worried about after you leave the Emergency Department, call Health Link at 811, go back to the Emergency Department or call 911 for help.

For 24/7 nurse advice and general health information call Health Link at 811.

Current as of: May 17, 2019

Author: Emergency Strategic Clinical Network, Alberta Health Services