Low dose transition instructions
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The low dose method is one way to start buprenorphine-naloxone (the medicine in Suboxone). With this method, you wait until you're in withdrawal, then take small doses often. Starting too soon can cause sudden, more severe withdrawal, so waiting helps you avoid that.
- Pros: Small, frequent doses let you ease in and adjust as you go, which can feel gentler.
- Cons: You still have to go through some withdrawal first, and you'll need to keep dosing every 1 to 2 hours throughout the first day.
Medicines to help you feel more comfortable
Your clinician may have prescribed premedications to help with symptoms like anxiety, restlessness, muscle discomfort, nausea, or vomiting. Take them as your clinician recommended. You can use these withdrawal medicines while you wait for symptoms to start.
When to take your first dose
You can start once you have at least 3 of these symptoms:
- Restlessness
- Heavy yawning
- Large pupils
- Runny nose
- Body aches
- Tremors or twitching
- Chills or sweating
- Feeling anxious or irritable
- Goosebumps
- Stomach cramps, nausea, vomiting, or diarrhea
Day 1
- Once you're in withdrawal, take 1 to 2 mg of buprenorphine-naloxone (half to a whole 2 mg film or tablet).
- Keep taking 1 to 2 mg every 1 to 2 hours.
Over the first 24 hours, your total will likely be between 16 and 24 mg. Don't take more than 24 mg total on day 1.
Day 2 and after
Take your full daily dose of 2 to 3 films or tablets (16 to 24 mg). You can take it all in the morning or split it up through the day, like morning, afternoon, and evening.
What happens next
At your next visit, you and your clinician will work together to find the right daily dose for you. Most people take between 16 and 24 mg a day.
The goal is for you to feel like your usual, healthy self. If your dose is too low, you may feel withdrawal between doses. If it's too high, you may feel sleepy and slow. The right dose can change slowly over time as your body adjusts to daily treatment.
If something doesn't feel right
If you're having a hard time with withdrawal, or anything worries you, call 888-316-0451 or message your care team right away. You don't have to wait for your next visit. If Boulder is closed, you can still reach an on-call medical provider 24/7 at the same number.