Suboxone Side Effects: What Are the Common Side Effects?

January 2, 2023

Table of Contents

Suboxone Side Effects

Suboxone Side Effects

Suboxone is a safe and effective therapy for people with opioid use disorder (OUD). This medication is widely underutilized despite its safety.[1] But even so, it can cause a few side effects, just like most medications. 

Talk to your doctor about any side effects. Adjusting your dose could help you feel more comfortable. Many side effects will resolve on their own with time. Other side effects could be mitigated with other medications. 

Breaking Down the Side Effects of Suboxone

All medications can cause side effects, including over-the-counter herbal medications.[2] Suboxone also has some side effects to be aware of. 

Some side effects are serious or dangerous. But some side effects are simply frustrating or a minor annoyance. Some people find they are able to tolerate mild side effects because the benefit of staying abstinent outweighs the burden of the side effect. It is up to you to decide if medication side effects are worth tolerating, or if they are severe enough that you need to change your dose or even switch medications. 

Common Side Effects

People taking Suboxone may experience some mild or moderate symptoms at first when they start suboxone, including the following:

  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea or mild GI distress/diarrhea 
  • Sexual side effects
  • Sweating
  • Urinary retention

Many of these side effects may be temporary and improve rapidly as your body gets used to the medication. Step one is to have a little patience! 

In the meantime, talk to your doctor if any of these common side effects become severe and interfere with your daily life. There are many ways to make them better. 

Precipitated Withdrawal 

Suboxone's buprenorphine ingredient is a partial opioid agonist. It binds more strongly to opioid receptors than other opioids. Therefore, if a person takes Suboxone for the first time too soon after taking opioids, it can cause a side effect called precipitated withdrawal, causing an acute onset of the same withdrawal symptoms that a patient might experience when they stop taking opioids abruptly. 

While withdrawal from opioids is never life threatening, it can be extremely uncomfortable and unpleasant to go through. 

Your risk of precipitated withdrawal is higher depending on a few factors: [3]

  1. Your dose: The more Suboxone you take, the greater the risk of causing withdrawal IF there are still opioids in your system. 
  2. Your interval: The biggest cause of precipitated withdrawal is taking a first dose of suboxone too soon after taking full opioids. Usually, doctors recommend waiting at least 12-24 hours after your last opioid dose OR waiting until you feel natural withdrawal symptoms, which is a sign that opioids are out of your body, before you take your first dose of Suboxone. 
  3. Your history: The more dependent you were on opioids, the greater your risk of withdrawing if opioids are stopped too quickly

Following your doctor's instructions carefully prior to taking your first dose is the best way to avoid any precipitated withdrawal. As stated above, the best way to avoid precipitated withdrawal is waiting at least 12-24 hours after your last opioid dose OR waiting until you feel natural withdrawal symptoms, which is a sign that opioids are out of your body, before you take your first dose. 

Serious Side Effects 

Contact your health care provider immediately if you experience any severe side effects of Suboxone, such as these:

  • Allergic reactions
  • Difficulty breathing
  • Difficulty driving or operating heavy machinery
  • Liver damage
  • Low blood pressure
  • Respiratory depression or sedation 

Liver Damage & Suboxone

The buprenorphine in Suboxone can cause subtle liver changes, but doctors aren't sure how serious they are.[4] Some people using Suboxone have pre-existing liver damage due to their drug use. But at least a few people have developed liver problems due to their medication use.

Your liver works hard to process buprenorphine, and your doctor can monitor your liver function while on your medication if necessary. 

What Factors Determine if You Get Side Effects (& Their Severity)?

Anyone can develop side effects due to their prescription use. But some factors could raise your risk. 

You're more likely to get side effects due to the following:

  • Age: Older people may have more side effects than younger people, although it is usually safe to take Suboxone at any age (over age 16). 
  • Underlying health issues: You may have more side effects from Suboxone if you have other co-occurring health conditions
  • Suboxone dose: Larger amounts can cause more side effects.
  • Misuse: Shooting, snorting, or otherwise tampering with your Suboxone can lead to more side effects. 

Combining medications: Taking Suboxone with other medications increases your risk of side effects.

Understand Suboxone Withdrawal

Side Effects of Suboxone Withdrawal

If Suboxone treatment is stopped “cold turkey” or not taken as prescribed, it can lead to withdrawal symptoms. Remember, the buprenorphine component is still an opioid and, as such, can cause withdrawal.

Suboxone Withdrawal Symptoms

Once Suboxone is stopped, whether due to completion of treatment or abrupt discontinuation, withdrawal symptoms can occur, such as these:

  • Anxiety 
  • Depression
  • Diarrhea
  • Headache 
  • Muscle aches
  • Nausea
  • Restlessness
  • Stomach cramps
  • Sweating
  • Tremors 

Suboxone Withdrawal Timeline

A typical Suboxone withdrawal is as follows:

  • The first 72 hours: Physical symptoms, like vomiting, nausea, and diarrhea, are at their worst.
  • After 1 week: Body aches and pains, difficulty sleeping, and mood swings start to appear.
  • After 2 weeks: People may begin to experience depression (the timeframe with the greatest potential for relapse).
  • After 1 month: Cravings and depression may continue to persist

Suboxone withdrawal can last days to several months, depending larely on you, your degree of dependence on opioids, and your personal addiction history. Therefore, if you do decide to discontinue your Suboxone, you should always let your doctor know so they can come up with a plan to help you decrease your dose slowly to avoid any withdrawal symptoms and make sure you have no cravings or concerns for returning to opioid use. 

Suboxone Treatment That is Convenient & Effective

Suboxone is a good option for OUD treatment, but many people struggle to get the help they need. Doctors need a special license to prescribe this medication, and some parts of the country don't have enough or even any Suboxone prescribers. 

At Bicycle Health, we use telemedicine techniques to bring Suboxone treatment to you. Meet with a qualified doctor in a virtual meeting, and we'll send a prescription to a pharmacy near you. Stay up-to-date with your doctor in more virtual meetings, and know we'll be available if you need help or have questions. 

Contact us to see if Suboxone therapy is right for you.

Medically Reviewed By 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.

Reviewed By

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Citations

  1. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. Spring 2018. Accessed November 2022.
  2. Medicines and Side Effects. State Government of Victoria, Australia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. July 2021. Accessed November 2022.
  3. Sublingual Buprenorphine/Naloxone Precipitated Withdrawal in Subjects Maintained on 100mg of Daily Methadone. Drug and Alcohol Dependence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094723/. October 2008. Accessed November 2022.
  4. Buprenorphine. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. https://www.ncbi.nlm.nih.gov/books/NBK548871/. November 2020. Accessed November 2022.

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