buprenorphine (oral/sublingual)

What is the most important information I should know about buprenorphine sublingual?

What is buprenorphine sublingual?

Buprenorphine is an opioid medication. Buprenorphine oral/sublingual (given under the tongue) is used to treat opioid addiction.

Buprenorphine sublingual may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking buprenorphine sublingual?

• if you have used another opioid within the past 4 hours.

Tell your doctor if you have ever had:

• tooth problems, including a history of cavities;
• methadone treatment, breathing problems, sleep apnea;
• abnormal curvature of the spine that affects breathing;
• kidney or liver disease (especially hepatitis B or C);
• enlarged prostate, urination problems;
• a head injury or brain tumor, alcoholism, hallucinations, mental illness; or
• problems with your stomach, gallbladder, adrenal gland, or thyroid.

How should I take buprenorphine sublingual?

Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Never use buprenorphine in larger amounts, or for longer than prescribed.

Buprenorphine sublingual is usually taken for only at the start of treatment for addiction. Most people are later switched to another medicine that contains buprenorphine (Bunavail, Sublocade, Suboxone, Zubsolv).

You may receive your first doses of buprenorphine sublingual in a hospital or clinic setting until your condition improves.

Rinse your mouth with water after the buprenorphine sublingual dissolves. Wait one hour after the medicine dissolves to brush your teeth to prevent damage to the teeth and gums. Do not chew the tablet or swallow it whole.

If your doctor has prescribed more than 2 tablets per dose, place the correct number of tablets under your tongue at the same time and allow them to dissolve completely.

You should receive regular dental checkups while taking buprenorphine sublingual.

You may need frequent blood tests to check your liver function.

Never crush or break a buprenorphine pill to inhale the powder or mix it into a liquid to inject the drug into your vein. Doing so could result in death.

Do not stop using buprenorphine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include extreme drowsiness or weakness, cold or clammy skin, pinpoint pupils, slow heart rate, weak pulse, very slow breathing, or coma.

What should I avoid while taking buprenorphine sublingual?

What are the possible side effects of buprenorphine sublingual?

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

• any problems with your teeth or gums;
• noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
• problems with thinking, blurred vision, slurred speech, a light-headed feeling, like you might pass out;
• chest pain, trouble breathing, slow heartbeat or weak pulse;
• opioid withdrawal symptoms --shivering, goose bumps, increased sweating, feeling hot or cold, runny nose, watery eyes, diarrhea, muscle pain;
• low cortisol levels -- vomiting, dizziness, worsening tiredness or weakness; or
• liver problems --nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• constipation, nausea, vomiting, headache, increased sweating, sleep problems (insomnia), or pain anywhere in your body.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect buprenorphine sublingual?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

• cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill"), medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
• other opioid medications --pain medicine or prescription cough medicine;
• a sedative like Valium --diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
• drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
• drugs that affect serotonin levels in your body --a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may affect buprenorphine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about buprenorphine sublingual.