Suboxone is a powerful medication that can help combat opioid use disorder (OUD). Like many prescription drugs, it can cause side effects. Constipation is one of them.
Your digestive tract slows in response to Suboxone, and your body produces fewer digestive enzymes. Food sits in your body, and it’s harder to push out. You may feel bloated, and you may spend a lot of bathroom time straining.
Using medications and making a few simple adjustments to your lifestyle could help you feel more like yourself.
Does Suboxone Cause Constipation?
Yes, Suboxone (buprenorphine/naloxone) can cause constipation. Buprenorphine is the primary component in Suboxone that renders it effective for treating opioid use disorder by reducing withdrawal symptoms, cravings, and the risk of relapse.
Opioids, including partial opioid agonists like buprenorphine, can change your digestive system in several ways, causing constipation, bloating and more.
Opioids can do the following: [1],[2]
- Delay the release of hormones that begin digestion
- Hinder gastric emptying and peristalsis, or the wave-like motions that move food through the gastrointestinal tract
- Slow the GI tract, allowing fluids to be absorbed during the digestive process, creating harder stool and constipation
- Increase anal sphincter tone, which means the defecation reflex is impaired, leading to blockage due to incomplete bowel movements
- Reduce the emptying of pancreatic juice and bile, so the whole digestive process can be delayed
A study surveying cancer patients who received opioids as part of their treatment plan found that between 40% and 60% of these individuals struggled with constipation due to their prescription painkillers.[2] Opioid-induced constipation reportedly caused the study participants to strain during defecation.
Symptoms of Constipation Caused By Suboxone
Opioid-induced constipation can be extremely uncomfortable. Some symptoms may include: [2], [3]
- It’s very painful or difficult to pass stools
- Stools are lumpy, dry, or hard
- Feeling like not all stood has passed
- Experiencing two or fewer bowel movements per week
- Bloating
- Alternating episodes of constipation and diarrhea
You will also likely experience abdominal pain caused by Subxone-induced constipation. Though Suboxone is a life-saving medication, these GI issues can still negatively affect a person’s quality of life.
When Is It Time to Get Help?
If you develop mild or moderate constipation or are concerned about developing constipation, you can take some steps to manage your health while taking Suboxone as directed. Try these tips: [3]
- Increase your dietary fiber by eating more whole grains, fruits, and vegetables.
- Take a supplement with additional fiber.
- Drink more water.
- Exercise more, as this can improve gut motility and overall fitness.
Unmanaged constipation can cause damage to the sphincter, bowel, intestine, and stomach, so it is important to get help from your doctor if you do not experience relief from constipation.
Signs you should contact your doctor include the following:[3]
- No relief from your at-home treatment plan
- Blood in the toilet bowl
- Intense straining to pass minimal bowel movements
- Nausea and vomiting accompanying constipation
- Bleeding from your rectum
- Constant stomach pain
- Intense lower back pain
- Fever
Your doctor may discuss your history of Suboxone treatment to understand how this might impact your digestion and overall health. They may also perform a physical exam, which could include a rectal exam, especially if you have more serious symptoms like pain or bleeding.
Prescription Laxatives That May Provide Relief
In most cases, your doctor will recommend some steps to improve gut health. They may prescribe laxatives for as-needed use, such as these:
- Senna: This is a laxative taken once daily, which may contain stool softener. This is often prescribed to older adults who are taking opioids for long-term pain management, as it reduces the risk of constipation, but it does not alleviate existing constipation. If you have a history of constipation problems, your Suboxone physician might recommend this.
- Saline laxatives with magnesium citrate: These have an onset of action about 30 to 180 minutes after they are taken. They are good for short-term relief.
- Relistor: This brand name for methylnaltrexone bromide is one of the few opioid antagonists prescribed to alleviate constipation. It does not cross the blood-brain barrier, so it will not stop your regular Suboxone dose from working. However, it will remove opioids from gut receptors, so any buprenorphine lingering in your gut will be eliminated.
- Amitiza: This brand name for lubiprostone increases fluid secretion in the GI tract, increasing tone and peristalsis.
You might also find over-the-counter laxatives effective, but ask your doctor before taking these. They are not designed for long-term use.
Frequently Asked Questions About Suboxone and Constipation
Just as there are opioid receptors in the brain that Suboxone binds to, there are also opioid receptors present throughout the digestive tract. Opioids like Suboxone attach to these receptors, causing many changes in the GI tract, such as slowing down contractions of the intestinal walls, delaying gastric emptying and increasing water absorption. When your GI tract absorbs more fluid, this can cause dry and hard stools. [2]
If your constipation is relatively mild, you may be able to manage it with some lifestyle changes, such as exercising, drinking more water, and taking a fiber supplement. However, if it is more severe and causing health problems, you’ll need to see your doctor, who can prescribe laxatives and adjust your Suboxone dose, if needed.
Since Suboxone is a long-acting opioid that you take on an ongoing basis (unlike short-term prescription painkillers), once constipation develops, it likely won’t go away on its own. Lifestyle changes and treatment may provide some relief but it may take a while before you can feel the difference. [2]
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Peristalsis. National Library of Medicine. https://medlineplus.gov/ency/anatomyvideos/000097.htm. January 2022. Accessed January 2023.
- Opioid Induced Constipation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK493184/ – :~:. August 2021. Accessed January 2023.
- Symptoms & Causes of Constipation. National Institute of Diabetes and Digestive and Kidney Disease. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/symptoms-causes. May 2018. Accessed June 2023.
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