Buprenorphine/naloxone is a medication that works in the brain to treat opioid use disorders Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone, it reduces the mortality of opioid use disorder by 50% by reducing the risk of overdose on full-agonist opioids such as hydrocodone, oxycodone, morphine, and fentanyl.
It relieves cravings to use and withdrawal symptoms. This medication can either be dissolved under the tongue or dissolved on the inside of the cheek. Use this medication as directed by your doctor, usually once daily. Drink some water to moisten your mouth before use. This helps the film dissolve.
With dry hands, open the foil packet just before use and place the medication film under your tongue or inside your cheek. Keep the film in place until it completely dissolves. Do not talk, swallow, chew, or move the film after placing it under your tongue or on the inside of your cheek, or it will not work as well.
Do not inject buprenorphine naloxone. Injecting it is dangerous, and will likely cause severe withdrawal symptoms due to the naloxone in this medication, especially if you have been using opioids such as heroin, morphine or methadone. If you suddenly stop using this medication, you may also have withdrawal symptoms such as restlessness, watering eyes, runny nose, nausea, sweating, muscle aches.
To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used this medication for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal. Side effects may include respiratory depression, headaches, opioid withdrawal syndrome, pain, nausea, increased sweating, and difficulty sleeping.
The most common side effects seen in film formulations are tongue pain, decreased sensation and redness in the mouth, headache, nausea, vomiting, excessive sweating, constipation, signs and symptoms of opioid withdrawal, sleeping difficulties, pain, and swelling of the extremities, small pupils, sleepiness, and low blood pressure.
The risk of overdose with buprenorphine/naloxone (unless combined with other sedating substances) is exceedingly low, and lower than with methadone. However, people are more likely to stop treatment on buprenorphine/naloxone than methadone.
Buprenorphine Naloxone: Naltrexone vs Naloxone
Naloxone and Naltrexone are both opioid antagonists, meaning they block the opioid receptors and prevent the effects of opioids. Naltrexone is a drug used as part of treatment for opioid use disorder, it is given as a long-acting injection prescribed to block the pleasurable (euphoric) and relaxing (sedative) effects of an opioid drug like heroin or morphine.
Naltrexone is not an opioid and is not addictive. It does not cause withdrawal symptoms when stopped suddenly. Naltrexone may also be used to treat alcohol use disorder. This drug is given as a daily pill or as a long-acting injection. Taking naltrexone daily may reduce cravings for alcohol and help a person maintain sobriety.
While Naloxone is a short-acting drug used to reverse the effects of an opioid overdose. It can be given as a nasal spray or an injection. Naloxone treatment requires immediate medical intervention to avoid serious opioid withdrawal symptoms. Naloxone can be a life-saving medication for people at risk of opioid overdose death.
Naloxone only works against opioids like heroin, morphine or oxycodone. It does not block the effects of drugs like alcohol, tranquillizers, cocaine or amphetamines. The effects of Naloxone are felt immediately while Naltrexone takes some time to kick in. The side effects of both drugs can include irritability and restlessness, nausea, and vomiting. Naloxone can also trigger flu-like symptoms such as fever, chills, runny nose, sneezing, and muscle weakness. Naltrexone can cause aches, pains, and appetite loss.
Buprenorphine Naloxone: Naloxone Dose
The Naloxone dose is based on your medical condition and response to treatment. Do not switch between sublingual tablets and film, because you may need a different dose if you switch. Do not increase your dose or use this drug more often or for longer than prescribed.
Naloxone at lower doses results in the usual opioid effects; however, high doses beyond a certain level do not result in greater effects. This is believed to result in a lower risk of overdose than some other opioids. Naloxone is an opioid antagonist that competes with and blocks the effect of other opioids (including buprenorphine) if given by injection.
Naloxone is poorly absorbed when taken by mouth and it is added to decrease the risk that people will misuse the medication by injection. Misuse by injection or use in the nose, however, still occurs. Rates of misuse in the United States appear to be lower than with other opioids.
The buprenorphine dosage your doctor prescribes for you will depend on several factors. These include the type and severity of the condition you’re using naloxone to treat, your age, the form of naloxone you take, other medical conditions you may have. Typically, your doctor will start you on a low dosage.
Then they’ll adjust it overtime to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect. Typically, you shouldn’t take your first dose of naloxone until at least 4 hours after you last took a short-acting opioid, such as heroin.
And you shouldn’t take buprenorphine until at least 24 hours after you last took a long-acting opioid, such as methadone. It is intended for sublingual administration and is available in two dosage strengths, 2 mg buprenorphine with 0.5 mg naloxone and 8 mg buprenorphine with 2 mg naloxone.
Each sublingual tablet also contains lactose, mannitol, cornstarch, povidone K30, citric acid, sodium citrate, FD&C Yellow No.6 colour, magnesium stearate, acesulfame K sweetener and a lemon/lime flavour. On Day 1, an induction dosage of up to 8 mg/2 mg Suboxone sublingual film is recommended.
Clinicians should start with an initial dose of 2 mg/0.5 mg or 4 mg/1 mg buprenorphine/naloxone and may titrate upwards in 2 or 4 mg increments of buprenorphine, at approximately 2-hour intervals, under supervision, to 8 mg/2 mg buprenorphine/naloxone based on the control of acute withdrawal symptoms. On Day 2 of treatment, a single daily dose of up to 16 mg/4 mg buprenorphine Naloxone sublingual film is recommended.
Buprenorphine NaloxoneNaloxone Kit
Naloxone kits are portable pouches containing an opioid antidote that can be administered by injection or through the nose to revive an unresponsive person who is overdosing. The kits contain a lot of medicine to reverse opioid overdoses for about 10-15 minutes, allowing time to access emergency services.
Naloxone is only effective for opioids such as fentanyl, heroin and oxycodone but not non-opioid drugs like cocaine, crystal meth, and MDMA. It is a safe medication that will not cause more harm, even if non-opioids have been used. There are two types of kits: an injectable naloxone kit and a nasal spray naloxone kit – each comes with its own supplies.
Each kit also contains education material and contact information that could help prevent future overdoses. If you suspect someone is having an overdose, follow these steps
Buprenorphine Naloxone: Pentazocine naloxone
Pentazocine naloxone is a pain reliever. It is used to treat moderate to severe pain. It also contains naloxone, which is used to prevent the misuse of this medicine. Take this medication by mouth with or without food, usually every 3 to 4 hours or as directed by your doctor. If you have nausea, it may help to take this drug with food.
The dosage is based on your medical condition and response to treatment. Do not take more than 600 milligrams of pentazocine in a 24-hour period. Do not increase your dose, take the medication more frequently, or take it for a longer time than prescribed. Though it helps many people, this medication may sometimes cause addiction.
This risk may be higher if you have a substance use disorder. Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details. Properly stop the medication when so directed.
Suddenly stopping this medication may cause withdrawal, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly.
Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as restlessness, mental/mood changes watering eyes, runny nose, nausea, diarrhoea, sweating, muscle aches, or sudden changes in behaviour. Never crush or break a naloxone pentazocine pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This can cause death.