Managing buprenorphine side effects
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Our hope is that you can take your buprenorphine each day and spend the rest of your day on what matters to you, not thinking about medicine. Sometimes side effects do happen, but they usually affect only about 1 in 10 people who take buprenorphine.
Side effects of buprenorphine (including Suboxone) can include dry mouth, tiredness, nausea, headaches, trouble sleeping, and constipation. Here are some things you can try at home. If you're worried about more serious effects, contact your care team right away or get medical care.
Dry mouth
Things that can help:
- Drink more water, at least 2 liters a day.
- Try a toothpaste made for dry mouth, like Biotène.
- Chew sugarless gum for quick relief.
Things to cut back on if you can:
- Caffeine
- Nicotine, like cigarettes, vapes, or other tobacco
- Sugar
- Other medicines that cause dry mouth, like allergy medicine. Talk with your primary care provider before changing any.
Feeling tired
- Take your buprenorphine at night, before bed.
- Don't drive or use machinery when you're tired.
- Make sure you're getting enough sleep. Talk to your clinician or peer if sleep is hard.
- Ask your clinician whether a lower dose might help.
- Ask your clinician about other medicines you take, since the combination might be making you tired.
Nausea
- Eat a light snack before taking your buprenorphine.
- Once your dose has fully dissolved and been under your tongue for at least 10 minutes, try spitting out your saliva instead of swallowing it. You’ll still get all of your medicine, since it’s absorbed under your tongue, not in your stomach. You may also feel less nauseous.
- Drink plenty of fluids during the day.
- Take your buprenorphine before bed.
- Ask your clinician about other medicines you take that could be making it worse.
- If your nausea doesn't get better, ask your clinician about medicine for nausea.
Headaches
- Drink plenty of water, 2 liters or more a day.
- Once your dose has fully dissolved and been under your tongue for at least 10 minutes, try spitting out your saliva instead of swallowing it. You’ll still get all of your medicine, since it’s absorbed under your tongue, not in your stomach. You may also get fewer headaches.
- Take acetaminophen (Tylenol) or ibuprofen (Advil) if it's safe for you.
- Keep caffeine to about 2 cups of coffee a day.
- Make sure you're getting enough sleep. Talk to your clinician or peer if sleep is hard.
- If you've never had headaches before and they're getting in the way of your day, see your primary care provider to get checked.
- Ask your primary care provider about supplements (like magnesium and vitamin B2) and medicines that can prevent headaches.
Trouble sleeping
- Try taking your buprenorphine only in the morning.
- Go to bed and wake up at the same time each day.
- Use your bed only for sleep, not for work or TV.
- Stay active during the day, but avoid exercise in the 4 hours before bed.
- Skip caffeine after 3 p.m.
- Avoid screens before bed, since the light tells your brain to stay awake. If you can't, try a blue-light filter on your phone or computer.
- Ask your clinician or primary care provider about supplements like melatonin or sleep medicines. Changing your sleep habits often helps more than medicine, though.
Constipation
- Drink plenty of water, at least 2 liters a day.
- Eat high-fiber foods, like whole grains, vegetables (broccoli, sweet potatoes, celery, carrots), fruits (pears, avocados, raspberries), nuts like almonds, and lentils or other beans you like.
- Add a fiber drink like Metamucil once a day, or make smoothies with frozen berries, chia seeds, and flaxseed.
- If it's hard to get enough fiber from food (it often is), try a fiber pill or gummy from the pharmacy.
- Cut back on foods that can make constipation worse, like bananas, lots of dairy, and simple carbs like white rice, white bread, cakes, and donuts.
- Take a stool softener every day, not just when you feel constipated. Start with docusate (Colace) and follow the directions on the bottle. If that's not helping, add Miralax daily, following the directions on the bottle. Stop either one if you get diarrhea.
- Talk with your clinician or primary care provider if things don't get better.
We're here to help
The goal of buprenorphine is to help you have less withdrawal and fewer cravings so you can focus on your goals, with as few side effects as possible. Let your care team know about any side effects you're having.