Microdose Buprenorphine Transition Instructions
This content is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information contained herein should not be used for diagnosing or treating a health condition, and those seeking medical advice or guidance should consult with a licensed and qualified healthcare provider. Always seek the advice of a qualified healthcare provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have learned here or elsewhere.
If you think you may have a medical emergency, call 911 or go to the nearest emergency department immediately. No physician-patient or provider-patient relationship is created by this website or its use. Boulder Care makes no representations, express or implied, with respect to the information provided herein or to its use.
Method Overview
This option for starting buprenorphine involves taking very small amounts of your medication while taking less and less of a full opioid. You will slowly work your way up to your full dose to avoid withdrawal.
You can start your buprenorphine doses within a few short hours of taking another opioid because your first doses of buprenorphine are not enough to cause major precipitated withdrawal symptoms.
During your transition process, use only the amount of fentanyl/heroin/opioid you need to not get sick. Stop fentanyl/heroin/opioid use when you do not have any cravings for it. Buprenorphine will keep you feeling well.
During your transition week you are not yet protected from overdose.
Please keep yourself safe by making sure you have Narcan available, are not using alone, using a test dose and/or testing your supply to make sure you know what you’re taking.
Transition to Treatment Timeline:
For Days 1-5, use your buprenorphine-naloxone 2mg films/tablets:
Day 1:
Take ¼ film or tablet (0.5mg)
You may continue to use full opioids (fentanyl, heroin, etc.) to prevent withdrawal symptoms.
Day 2:
Morning: take ¼ film or tablet (0.5mg)
Evening: take ¼ film or tablet (0.5mg)
You may continue to use full opioids to prevent withdrawal symptoms.
Day 3:
Morning: take ½ film or tablet (1mg)
Evening: take ½ film or tablet (1mg)
You may continue to use full opioids to prevent withdrawal symptoms.
Day 4:
Morning: take 1 film or tablet (2mg)
Evening: take 1 film or tablet (2mg)
You may continue to use full opioids to prevent withdrawal symptoms.
Day 5:
Morning: take 1.5 film or tablet (3mg)
Evening: take 1.5 film or tablet (3mg)
You may continue to use full opioids to prevent withdrawal symptoms.
Day 6:
From now on you will use your 8mg buprenorphine-naloxone films or tablets. At this point you may not need to use full opioids (fentanyl, heroin, etc.) at all.
Morning: take ½ film or tablet (4mg)
Afternoon: take ½ film or tablet (4mg)
Evening: take ½ film or tablet (4mg)
Day 7:
Morning: take 1 film or tablet (8mg)
Afternoon: take 1 film or tablet (8mg)
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.