What Happens if I Miss a Suboxone Dose?

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Most people take Suboxone once daily, but some people may take it 2 or even 3 times a day. If you miss your dose within a 24-hour window, take it as soon as you remember. But if you miss a few doses, your doctor should help you decide what to do next.

About half of all prescription medications for chronic conditions aren't taken as prescribed.[1] We're human, and it's easy to forget to take our medications. Even if you miss some doses, you can get back on track. 

What to Do After Missing a Suboxone Dose 

Your plans will vary, depending on how quickly you remember that you didn't take today's Suboxone. 

Within a Few Hours 

Take your dose as soon as you remember it. If it's almost time for another dose, skip the one you missed and take your next dose at the regular time.[2]

For example, if you always take your Suboxone at 10 a.m. and remember it at noon, take it at noon and return to your 10 a.m. dose the next day. But if you remember your missed dose at 8 a.m. the next day, skip it and take your regular dose at 10 a.m.

After Several Days

Your Suboxone is an important part of your recovery, and you should take your dose every day as directed by your doctor. If you miss multiple doses, talk with your doctor before you do anything else.

You may need to take a smaller dose when you return to your medication, and your doctor may want to discuss your recovery. If you forget your doses so regularly, there's something blocking your progress. 

Consequences of Missing Doses 

Suboxone stays in the body for a long period of time, and so an occasional missed dose shouldn't have much impact on your recovery.[3] However, if you miss many doses, you may experience opioid withdrawal symptoms or cravings that could lead to a relapse. 

Suboxone Withdrawal 

If you do miss several doses in a row, and you could experience withdrawal symptoms, including these:[4]

  • Nausea
  • Anxiety 
  • Restlessness
  • Muscle aches 
  • Chills 

Suboxone Overdose

Some people panic when they realize they've missed their doses, and they try to make up for lost time all at once. Do not “double up” on your dose. Instead, reach out to your doctor. 

Drug Relapse

Without Suboxone in your body, your cravings could return. You could relapse to drug misuse, and since you’re no longer accustomed to high doses of opioids, you could overdose. 

Respect Your Suboxone

If you are having trouble remembering to take your dose or are frequently missing doses, talk with your doctor. There are many strategies to help keep you on regular dosing, including setting an alarm clock, pairing your dose to a regular habit or daily activity, etc. 

Your medication is powerful. Just one high dose is capable of reducing opioid cravings.[5] Be an active part of your recovery, and always take your medication as your doctor instructs.

Sources

  1. Missing Medication Doses Can Bring Serious Consequences. Penn State Health. https://www.newswise.com/articles/the-medical-minute-missing-medication-doses-can-bring-serious-consequences. February 2020. Accessed August 2022.
  2. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020733s022lbl.pdf. February 2018. Accessed August 2022.
  3. I've Missed a Dose; What Should I Do? New Zealand Medicines and Medical Devices Safety Authority. https://www.medsafe.govt.nz/profs/PUarticles/missed.htm. May 2003. Accessed August 2022.
  4. COWs Score for Opiate Withdrawal. MD Calc. https://www.mdcalc.com/calc/1985/cows-score-opiate-withdrawal. Accessed August 2022. 
  5. Single High-Dose Buprenorphine for Opioid Craving During Withdrawal. Trials. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-3055-z. 2018. Accessed August 2022.

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.

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