Boulder Care

Low Dose Buprenorphine Transition Instructions

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Method Overview

You have chosen the low dose method for transitioning to buprenorphine-naloxone. To avoid causing severe withdrawal symptoms you should wait to take the first dose until you're in withdrawal.

Premedication

Your clinician may have prescribed you medications to ease your transition. These might include:

  • Clonidine for anxiety and restlessness
  • Gabapentin for anxiety and muscle spasms
  • Ondansetron for nausea/vomiting

Please refer to the instructions on the packaging for how you should take any of these medications.

Withdrawal

To avoid causing severe withdrawal symptoms you should wait to take your first dose of buprenorphine until you're in withdrawal.

You can use your withdrawal medications to help with your symptoms. Once you have at least three of these symptoms you can start treatment:

  • Restlessness
  • Heavy yawning
  • Enlarged pupils
  • Runny nose Body aches
  • Tremors/twitching
  • Chills or sweating
  • Anxious or irritable
  • Goose pimples
  • Stomach cramps, nausea, vomiting or diarrhea

Transition to Treatment

Day 1:

When you're in withdrawal take 1-2mg buprenorphine-naloxone (half to whole of one 2mg film/tab).

Take 1-2mg buprenorphine-naloxone every 1-2 hours.

In the first 24 hours your total dose will likely be between 16mg and 24mg. 24mg is the maximum total for the day.

Day 2 and after: Normal Daily Dosing

Take your full daily dose of 16-24mg buprenorphine-naloxone in the morning.

Follow-up Plan

At our next visits we will work together to find the best daily dose for you. A person's total daily dose of buprenorphine-naloxone is usually between 16mg and 24mg.

Our goal is to help you feel like your normal, healthy self. Too low a dose allows withdrawal symptoms between doses. Too high a dose can make you feel sleepy and slow. The right dose for you may change slowly over time as your brain adjusts to daily treatment.

Questions, concerns, or feedback?

You can send a message to your Care Team in the app with non-urgent questions or feedback, or you can always call Boulder's 24/7 Support at 888-316-0451.