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Emergency Department Buprenorphine/Naloxone (Suboxone)

Instructions for Leaving the Hospital

The Emergency Department gave you buprenorphine/naloxone (Suboxone) to help treat an opioid use disorder. You were given 2 more doses of buprenorphine/naloxone to take with you.

It’s important that you keep taking this medicine. Congratulations on taking this step!

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 10 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 the 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 sick, it can make your symptoms much worse.

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.

First dose

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

If you start to feel sleepy or have a hard time focusing, your dose may be too strong. Don’t take your next dose and call the clinic.

Second dose

One hour after your first dose, check to see how you feel. You should feel a little better or about the same. As long as you don’t feel much worse, you can take your second dose. This is your last dose until you go to your community clinic appointment.

Don’t take your second dose if you feel worse, sleepy, or have a hard time focusing.

What else do I need to know?

When you start taking buprenorphine/naloxone, it usually takes 2 to 3 days to get the right dose of this medicine into your body. Your body will be ready for a higher dose of this medicine tomorrow. Until then, you will likely have some cravings and withdrawal symptoms.

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.
  • Arrange for someone to drive you home from the hospital after you take this medicine.
  • 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.

Current as of: September 24, 2018

Author: Emergency Strategic Clinical Network, Alberta Health Services