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Unread 12-02-2007, 03:44 PM   #1
karen in Penna
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Default Started suboxone 7 days ago and still very sick

Hello, Have over 4 months clean but started subxone because cravings were coming back. Doc started me on 8mg, 1/2 in morning and 1/2 at night. Everyday i am nautious, light headed, constipated and am not able to do much. Very weird. Called dr. he said does not sound right. he said on Wed. to cut back to 1/4 of the pill which would be 2mg per day.Still sick and it is SUnday. After reading a lot of these forums some people have reactions to suboxone and switch to subutex. Any thoughts. thanks so much Karen
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Unread 12-02-2007, 03:49 PM   #2
Hackman
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Hi Karen - sorry you're so sick. Sounds like something needs to change for you. I had severe nause with Suboxone which cleared with a lower dose. Are you on 2mg once or twice a day? I think you're right, you need to switch to Subutex. I know that a lot of folks think that small amt of nalaxone doesn't make that big of a difference but as a nurse I'm here to tell you that sometimes, people have reactions to things that the books say they shouldn't have and they do. Your doc should switch you and see if it works. Sorry for you-I'd rather have severe pain any day than to be sick to my stomach. Hang in there. I hope the cravings are gone????
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Unread 12-02-2007, 04:11 PM   #3
karen in Penna
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Thank you so much for your input. Cannot even eat. My follow up appoint. is not til wed. however I am hoping he can see me tomorrow. What do you think will happen if i do not take anything today? Since the sickness has been consistent when I started. Too sick to have cravings. thanks again
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Unread 12-02-2007, 04:22 PM   #4
Pearl
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Hello Karen! I'm sorry you are feeling badly. The half life of Buprenorphine is about 37 hours or so, not taking it for a day or so SHOULD not cause you any problems. Actually, that may be a good way to see what is what... have you considered maybe you just have a bad flu? Just a thought. I'm trying to brainstorm for ya, but many here know much more than me! I'm sure someone with more knowledge will be along shortly. Hang in there and let us know how you are doing, ok?

Elizabeth:}
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Unread 12-02-2007, 04:54 PM   #5
sarah
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people who are not opioid dependent when they start sub are supposed to start at 2mgs/day. I think your dose is too high by a factor of 4. Are your pupils pinned in low light? if so the dose is probably too high. You will eventually get used to it but it could all be fixed with a lower dose. Dose decrease take 3 days or more before you feel the effects.
Sarah

I see Tim already answered thsi for you in another thread, sorry to be repetitive, but here's your answer;

Quote:
quote:Originally posted by TIM

Karen,
Excerpt from Government publication TIP-40

Patients Not Physically Dependent on Opioids

Patients who are not physically dependent on
opioids but who have a known history of
opioid addiction, have failed other treatment
modalities, and have a demonstrated need to
cease the use of opioids, may be candidates for
buprenorphine treatment. Patients in this
category will be the exception rather than the
rule, however. Other patients in this category
would be those recently released from a
controlled environment who have a known
history of opioid addiction and a high
potential for relapse.

Patients who are not physically dependent on
opioids should receive the lowest possible dose
(2/0.5 mg) of buprenorphine/naloxone for
induction treatment.

http://www.naabt.org/links/TIP_40_PDF.pdf
page 54/ PDF page 80
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Unread 12-02-2007, 06:32 PM   #6
JStephen
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hello Karen, I'm sorry to hear that you're having a hard time. I hate to say this, b/c looking back, I'm still very ashamed of my behavior, but I had a relapse after about 2.5 years with suboxone, and during that time, I gave 4mg to a co-worker who was opiate naive b/c he was having severe back pain and liked getting high, and he got sick. He was sweating, his stomache was really bothering him-he threw up several time, and he was nodding out but unable to sleep. If you're taking more suboxone than you need, then I think the most likely effects would be getting sick to your stomache, feeling lightheaded/dizzy, not having any energy, and getting constipated-but that usually happens anyway. But, as hackman suggested it could be caused by the naloxone. Obviously, I'm no doctor, but from others I've heard whose doses were too high, they had similar effects.

I hope you're able to find a solution soon, b/c this really is great stuff, and I know for me, taking suboxone has given me a whole new life.

Best wishes

-Stephen
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Unread 12-02-2007, 08:12 PM   #7
karen in Penna
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thanks everyone for all of your input. Yep cut back to 2mg 2 days ago and still the same. I don't want to give up. As my whole life(well you may know the routine). Can get a year, then the cravings come back. I'm 48 and been like this 30 years. I attend N/A And AA support group faithfully.Even had 6 years but then relapse. Well I am not going to give up on this as many of you say it is a miracle. Hope I can see the dr. tomorrow. Again thanks. Karen
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Unread 12-02-2007, 08:18 PM   #8
Pearl
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Karen, I hope you can get in to see your doctor tomorrow too! I will be thinking about you...as I'm sure will many here. Let us know, ok?

Elizabeth;}
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Unread 12-02-2007, 08:24 PM   #9
Mike
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Karen, I'd be surprised if you did feel well now. It take at least 3 days to feel the effects of a dose decrease. I would ask the doc if you could just take 1mg/day unless you feel you need more later on. Right now there is still quite a bit of bupe still in your system. look how long one dose can last. http://www.naabt.org/tl/bupe_half-life-graph.jpg then if you take more before its all gone, it has an adding effect, so even if you stop you will have bupe in you for days. But don't worry, you will even out soon and find a nice low dose that will stop cravings and allow you to concentrate on normal life. good job!

(edited to fixed link)
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Unread 12-03-2007, 03:20 AM   #10
Smith
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Like others have said, Sounds like you are on to much to me. Especally if you were clean when you started. Don't think a switch to subutex will do anything good for you. Good luck.
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Unread 12-03-2007, 11:25 PM   #11
karen in Penna
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Again, thanks so much for the support. Got in touch with mY Dr. today. said to cut to 2mg, which I all ready did Saturday. Queaziness is starting to subside but still have other side effects. I guess I will wait and see what happens at my visit on wed. Have lloked at all of this great educational information that everone has sent me. Thanks!!
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Unread 12-03-2007, 11:53 PM   #12
Chuck
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Hi, Karen you do not know me, I am from Miami. Now, I am not a doctor, but I am wondering whether you might have something else. I know that when I used to get sick early in my recovery. One of the first things that would happen for me was that I started to have cravings. [u]Did your cravings stop?</u> if it did maybe you doctor should be looking somewhere else, I am not too sure how much playing with your dose, has to do with how you feel, but if you keep moving it around, I am not too sure you are going to get a clear feel with what is going on. [u]Unless it is the agonist, natraxon, that might be causing you some problems.</u> I do not have the referance with me right away, but I remember reading one study (an only one) that natraxon had a tendency not only to take the injected effect of opiates, but also the natural opiates that are in our bodies normaly. [Has any body else read a similar study that they can remember?].

I was only one day sick when I started on Suboxon, I was not doing much heroin either, only about one or two bags a day. The next day I felt better than I felt in years. Even better than when I was on methadone. I was okay and I was not feeling too sedated and nooding, nor any other simptoms like that.

You do seem to have some interesting symptoms. I am almost willing to bet that you might be having some other physical condition that the doctor should be looking at. Are your vital signs okay and has he given you any blood test to rule out any other diseases that you might be having?
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Unread 12-04-2007, 01:03 PM   #13
NancyB
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Hi Karen,

The NALOXONE in Suboxone is considered clinically insignificant unless injected. Then it could cause a rapid onset of withdrawals.

You're still stabilizing, so hopefully once you are, any side effects you're having will subside, as happens with many people.

Let us know how you're doing.
Nancy
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Unread 12-04-2007, 02:09 PM   #14
lookingup
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First thing I would think of would be to skip a day and cut dosage. When used for pain the max bupe dosage recommended is .4mg. If you have 2mg pills try quartering one and maybe even shave some off of that. Also try spitting the residue after you melt, this may help. To an opiate naive person this is a very powerful drug.
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Unread 12-05-2007, 04:30 AM   #15
karen in Penna
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Thanks everyone for your concern. The dr. gave me 8mg which i cut into 4pieces. Only took 2mg.Queaziness is gone, however I do not feel right yet. Very agitated,still constipated. My sister is a nurse checked all my vital signs and everything is normal. Off to see the doc tomorrow. I surely hope something changes. Thanks!!
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Unread 12-05-2007, 12:28 PM   #16
NancyB
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Hi Karen, Good luck at the doctor today, hopefully you'll start feeling better soon.

Here's an older thread on constipation - a common side effect - that might be helpful:
http://www.naabt.org/forum/topic.asp?TOPIC_ID=3334

Keep us posted if you have a chance.
Nancy
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