What Are the Side Effects of Buprenorphine & Naloxone?

June 20, 2022

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The prescription medication Suboxone contains two active ingredients. Both can cause side effects.

Buprenorphine and naloxone side effects tend to be mild, and many of them can be confused with your addiction recovery symptoms. But some can be serious.

Remember to tell your doctor about any side effects you experience. Together you can adjust your dose or use other medications to mitigate side effects so that you can continue to safely and effectively use this medication in your recovery. 

Common Side Effects

Prescription medications like Suboxone cause chemical changes deep within your brain and body. Side effects are common, particularly at first as your body gets used to the medication. Most side effects will abate on their own. However, some side effects may be more persistent, depending on the individual. 

Buprenorphine Side Effects

Buprenorphine is a partial opioid agonist. This ingredient blocks your cravings and helps you avoid the temptation to return to drugs. Since it works on the same receptors used by opioids, it causes many of the side effects as opioids (although often to a lesser degree than a full opioid), such as:[1]

  • Constipation
  • Constricted pupils
  • Drowsiness
  • Dry mouth 
  • Urinary retention 
  • Dizziness 
  • Itching/pruritus 
  • Sexual dysfunction 

Naloxone

Naloxone is an opioid antagonist. It is included in the Suboxone film to prevent people from injecting the medication. However, if taken as directed under the tongue, the Naloxone is not absorbed and does not get into the body. Therefore, if taken as directed, you should not actually be absorbing any of the Naloxone from the Suboxone strip. Even if you do ingest Naloxone, it has very few side effects. It does not tend to cause dizziness, sedation, constipation, itching, or any of the other side effects common with opioid medications.

Some people develop allergic symptoms while on naloxone, such as these:[4]

  • Difficulty breathing
  • Facial swelling
  • Hives

True allergies to Naloxone or Suboxone are exceedingly rare. However, if you do experience any side effects of an allergy such as facial/lip or neck swelling, or difficulty breathing, discontinue your medication right away and seek emergency attention. 

3 Ways to Prevent Side Effects

To lower your risk of side effects, you can do the following: [5]

  • Take your Suboxone doses as directed. Read every pamphlet and leaflet that comes with your prescription, and don't change the rules. If you're using a dissolving strip, for example, rinse your mouth after using the product. Don't snort or sniff it. 
  • Talk with your doctor. Some side effects fade with dose adjustments. If you're uncomfortable, ask your doctor if a larger or smaller dosage would help. 
  • Be mindful of interactions. Don't use herbs or OTC meds to manage your symptoms unless you check with your doctor first. Many medications interact with Suboxone and can make you more uncomfortable. 

Should You Skip a Suboxone Dose If You Are Having Side Effects?

If you develop a side effect from Suboxone, you might be tempted to skip a dose or stop taking the medication altogether.

Suboxone is a timed-release medication meant for regular dosing. Skipping a dose means leaving your brain and body open to relapse temptations and also to the risk of developing unpleasant withdrawal symptoms. While withdrawal from missing a dose is never life threatening, it can be extremely uncomfortable and can put you at risk for wanting to use opioids to resolve the discomfort.

If you feel the need to skip doses because of side effects, don’t wait: call your doctor as soon as possible for advice! They may be able to adjust your dose or use a different medication to treat side effects without you needing to discontinue the medication. Communication is key!

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. April 2022. Accessed June 2022.
  2. Buprenorphine Sublingual and Buccal (Opioid Dependence). U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a605002.html. January 2022. Accessed June 2022.
  3. Naloxone Drug Facts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/naloxone. January 2022. Accessed June 2022.
  4. Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone. April 2022. Accessed June 2022. 
  5. Adverse Events After Naloxone Treatment of Episodes of Suspected Acute Opioid Overdose. European Journal of Emergency Medicine. https://pubmed.ncbi.nlm.nih.gov/15167188/. February 2004. Accessed June 2022.

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