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Can I have an allergic reaction to Suboxone?

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It is possible to have an allergic reaction to Suboxone, but it is rare. Most allergies or adverse effects are minimal or absent when Suboxone is taken appropriately.

If you have any adverse reactions, contact the doctor who prescribed your Suboxone immediately.

What Ingredients Are in Suboxone?

The active ingredients in Suboxone are buprenorphine and naloxone. Inactive ingredients include maltitol, polyethylene oxide, acesulfame potassium, hydroxypropyl methylcellulose, citric acid, lime flavor, sodium citrate, white ink, and FD&C yellow #6.

Though rare, it’s possible to have an allergy or adverse reaction to one of the active or inactive ingredients in Suboxone.

How to Spot an Allergy to Buprenorphine

A buprenorphine allergy generally manifests as hives, a rash, and itchiness. However, most people who are allergic to buprenorphine are allergic to all opioids. Therefore, if have taken opioids prior without an allergic reaction, it is very unlikely for you to have a true allergy to buprenorphine. 

In very rare cases, just like any other medication, a systemic reaction can result, which includes anaphylactic shock, trouble breathing, low blood pressure, or loss of consciousness. 

If you experience any adverse reactions, contact a doctor immediately. Systemic reactions require emergency medication attention.

How to Spot an Allergy to Naloxone

An allergic reaction to naloxone is also extremely uncommon, but as with any medication, it is possible. Signs of a naloxone allergic reaction include swelling of the lips, throat, and face as well as hives.[1] 

If you experience any swelling or hives, seek emergency medical attention.

Are Allergic Reactions to Suboxone Common?

No, allergic reactions to Suboxone are extremely rare. Patients with a known hypersensitivity to buprenorphine or naloxone should not take Suboxone.[2] 

If you suspect you have a hypersensitivity to either ingredient, talk to your doctor about another form of Medication for Addiction Treatment (MAT) that would work for you. For example, if you are allergic to naloxone, you could take Subutex instead, which only contains buprenorphine.[3]

Suboxone Side Effects

Having a side effect from a medication is very different from having an “allergy”. Side effects are uncomfortable but rarely life threatening. Here are the most common side effects associated with Suboxone and how they can be managed. Most side effects are short term when the medication is first started and usually do improve on their own once the body gets used to the medication. However, if they do persist, there are some treatments available:

| Most Common Side Effects | How to Manage | |:-----------------------------------------------------:|:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------:| | Headaches | Take aspirin, ibuprofen, or acetaminophen (if there are no contraindications). | | Nausea | Consider spitting saliva out after Suboxone is absorbed rather than swallowing it. Your doctor can prescribe anti-nausea medication if needed. | | Constipation | Stay well hydrated. Aim for at least 8–10 cups of water per day.Eat a high-fiber diet. Eat fruits, vegetables, and beans/legumes. Choose whole wheat and brown rice rather than white flour or white rice products.Exercise regularly.Your doctor can also prescribe you constipation medications if needed. | | Dry mouth, which can lead to gum and teeth infections | Stay well hydrated.Avoid sugary drinks like sodas and juices.Maintain good oral hygiene. Brush twice daily and floss daily. |

SOURCES

  1. Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone. April 2022. Accessed April 2022.
  2. Sublingual Desensitization for Buprenorphine Hypersensitivity. The Journal of Allergy and Clinical Immunology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850949/. April 2010. Accessed April 2022.
  3. Buprenorphine. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf. December 2019. Accessed April 2022.

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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