Key Points

1. Some people experience side effects from buprenorphine
2. There are ways to help reduce your side effects
3. Talk to your Boulder Clinician and Peer Recovery Specialist for help managing side effects

Managing Side Effects

Our goal is that you take your buprenorphine each day and spend the rest of your day focusing on what is important to you, not thinking about medicine. In some cases, however, side effects do happen. They usually only affect about 1 person out of 10 who take buprenorphine.

Side effects of buprenorphine products like Suboxone include dry mouth, fatigue, nausea, headaches, difficulty sleeping, and constipation.

If you are concerned about more serious effects, contact your Care Team right away or seek immediate medical attention.

Below are some things you can try at home to manage these side effects.

Dry Mouth

Things that can help:

• Drinking more water (aim for at least 2 liters daily)
• Switching to a different toothpaste that is made for dry-mouth (Biotin products are one example)
• Chewing sugarless gum for a quick-fix

Things to reduce/avoid if possible:

• Caffeine
• Nicotine (cigarettes, tobacco)
• Sugar
• Other medications that cause dry mouth (like allergy medicine); discuss with your primary care

Fatigue

• Take your medicine at night, before bed
• Avoid driving and operating machinery when fatigued
• Make sure to get enough sleep—talk to your Clinician or Peer Recovery Specialist about healthy sleep if this is a concern
• Talk to your Clinician about a lower dose of medicine
• Talk to your Clinician about other medicines you take—the combination might be causing fatigue

Nausea

• Try eating a light snack before taking your buprenorphine
• After your buprenorphine tablet is completely dissolved and under your tongue at least 10 minutes, consider spitting out your saliva instead of swallowing it. You will still absorb all of the medicine, but might not feel nauseated
• Drink plenty of fluids during the day
• Take your buprenorphine before bed
• Talk to your Clinician about other medicines you are taking that could be making it worse
• If your nausea still does not improve, talk to your Clinician about medicines for nausea

Headaches

• If you have never had headaches before, and your headaches are interfering with your day, see your regular doctor for an evaluation.
• Drink plenty of water (aim for 2 liters or more daily)
• After your buprenorphine tablet is completely dissolved and under your tongue at least 10 minutes, consider spitting out your saliva instead of swallowing it. You will still absorb all of the medicine, but might not get headaches
• Take acetaminophen (Tylenol) or ibuprofen (Advil) if it is safe for you to do so
• Limit caffeine to about 2 cups of coffee a day
• Make sure to get enough sleep—talk to your Clinician or Peer Recovery Specialist about healthy sleep if this is a concern
• Talk to your regular doctor about supplements (like Magnesium and Vitamin B2) and medicines you can take to prevent headaches

Difficulty Sleeping

• Try taking your buprenorphine in the mornings only
• Keep to a sleep schedule (go to bed and wake up at the same times each day). Talk to a Peer Recovery Specialist if you need help setting a sleep schedule.
• Use your bed only for sleep—avoid doing work or watching television in bed
• Try to stay active every day, but avoid exercise in the 4 hours before sleep
• Try not to drink caffeine after 3pm
• Avoid screen time (phones, televisions, computers) before bed—the light from the screens tells your brain to keep you awake. If you cannot avoid using phones or computers before bed, consider using a blue-light filter or app for your screen.
• Talk to your Clinician or regular doctor about supplements like melatonin and medicines that can be used for sleep. Changing your sleep habits, though, can help better than medication.

Constipation

• Drink plenty of water each day (aim for at least 2 liters a day)
• Eat high-fiber foods (whole grains; vegetables like broccoli, sweet potatoes, celery, and carrots; fruits like pears, avocados and raspberries; nuts like almonds; and add lentils and other beans you like).
• Try adding metamucil (fiber) to a beverage a day
• Make fiber smoothies by including frozen berries, chia seeds and flaxseed
• If you cannot get enough fiber in your diet (it’s hard to do!) try a fiber supplement (fiber pill or gummy) you can buy at the pharmacy
• Avoid constipating foods like bananas, too much dairy (cheese and milk) and avoid too many simple carbs (like white rice, white bread, cakes and donuts)
• Take a stool softener. Start with docusate (Colace) and follow the directions on the bottle. Take it every day instead of just when you are feeling constipated. If docusate is not helping, add Miralax and follow the directions on the bottle. Take it daily. Stop either medicine if you get diarrhea
• Talk to your Clinician or regular doctor if the constipation is not improving

Summary

Our goal when prescribing buprenorphine treatment is that you experience less withdrawal, fewer cravings, and are able to meet your wellness goals while minimizing side effects.

Talk to your Boulder Care Team about the symptoms you may experience. We are here to help.

References

• United States Food and Drug Administration (FDA): FDA Buprenorphine Package Insert

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.

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