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Can Suboxone cause low blood sugar?

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Low blood sugar is not a formally recognized side effect of buprenorphine/naloxone (Suboxone). If you have diabetes and an opioid use disorder (OUD), you can use Suboxone safely.

But search the internet, and you may find many people claiming that their Suboxone doses lowered their blood sugar.[1] What's going on?

Suboxone can lower your blood pressure. When your numbers drop too far, you'll feel symptoms commonly associated with low blood pressure, such as these:

  • Cold sweat
  • Cool, pale skin
  • Headache
  • Weakness

If you have diabetes and feel these symptoms, check your blood sugar and take immediate steps to resolve any problems you find. If you don't have diabetes and these feelings are persistent or get worse, talk with your doctor about a dose adjustment. 

Suboxone & Blood Sugar

The U.S. Food and Drug Administration lists known drug side effects. The Suboxone information does not list low blood sugar.[2] In the pre-release testing pharmacists completed, the medication did not lower blood sugar readings. 

Some other OUD medications, including methadone, can lower blood sugar.[3] In fact, opioid drugs like heroin can do the same thing. 

Strong opioid agonists can change your body's core functions. When that happens, your blood sugar can drop. 

But Suboxone doesn't seem to cause this effect. Since it's only a partial opioid agonist, it may not be strong enough to change how your organs work and how you feel. 

Is Suboxone Safe for People With Diabetes?

If you are taking insulin or getting another form of diabetes treatment, let your doctor know. However, many diabetic patients also take buprenorphine/naloxone (Suboxone) without issue. 

In one study, people with diabetes and opioid use disorder had better glucose control while taking Suboxone.[4] Researchers aren't exactly sure why this happens, but it suggests that treating your OUD could bring diabetes benefits you never thought possible.

Experiencing Low Blood Sugar? Do This Next

If you have diabetes or a history of low blood sugar, it might be helpful to check your blood sugar at the time you feel these symptoms.

The Centers for Disease Control and Prevention recommends the 15-15 rule for blood sugar readings between 55 and 69 mg/dL.[5] Follow it by taking these steps:

  • Eat. Take in a food worth 15 grams of carbs. That means 4 ounces of juice, a tablespoon of honey, or a few gumdrops. 
  • Wait. Rest for 15 minutes before testing again. 
  • Repeat. Follow the steps again if your numbers don't rise to good levels. 

If your blood sugar is severely low, get emergency treatment. Talk with your doctor about what an emergency plan should look like for you and your family.

Don't quit taking your Suboxone. Withdrawal symptoms can feel like an extremely bad case of the flu and can appear if you abruptly quit your medication. 

Take your doses as your doctor recommends, even if you think your Suboxone is to blame. A dose adjustment could make things better. So make sure to talk to your doctor about your symptoms.

SOURCES

  1. Suboxone and Hypoglycemia: A Phase IV Clinical Study of FDA Data. eHealth Me. https://www.ehealthme.com/ds/suboxone/hypoglycemia/. June 2022. Accessed July 2022. 
  2. Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf. August 2010. Accessed July 2022. 
  3. Methadone Induced Hypoglycemia, Improved on Dose Adjustment. Journal of Clinical and Translational Endocrinology: Case Reports. https://www.sciencedirect.com/science/article/pii/S2214624520300162. December 2020. Accessed July 2022. 
  4. Opioid Use Disorder and Type 2 Diabetes Mellitus. Canadian Family Physician. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507246/. July 2017. Accessed July 2022. 
  5. How to Treat Low Blood Sugar (Hypoglycemia). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/low-blood-sugar-treatment.html. March 2021. Accessed July 2022. 

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