Opioid addiction is a very difficult and painful experience for a person to face. Trying to get rid of it is also challenging. But there are medical methods and medications that can help you on this journey. Today we are talking about one such very important drug, a combination of drugs called Buprenorphine and Naloxone. You will usually find this under brand names like Suboxone and Zubsolv.
What really happens with this medicine?
Simply put, this is a medication that is used to treat opioid use disorder. It has two main things going for it.
1. Buprenorphine: This is used to control the unpleasant physical symptoms that occur when you stop using opioids, called 'withdrawal symptoms.' It also reduces cravings to use opioids again.
2. Naloxone: The other part of this. This is to prevent the misuse of this medicine (for example, injecting it). That is, it ensures the safety of the medicine.
The most important thing is that the best results are achieved when this medication is combined with counseling and behavioral therapy, rather than using it alone.
Things to tell your doctor before taking the medicine
Your doctor will need to have a complete understanding of your health before prescribing this medication. Therefore, if you have any of the conditions listed below, be sure to tell your doctor.
| Type of conditions | Description |
|---|---|
| Head and brain related problems | Conditions such as a brain tumor, head injury, or seizures. |
| Heart and lung problems | Heart disease, irregular heartbeat, lung disease, asthma, or other breathing difficulties. |
| Stomach and digestive system | Liver disease, gallbladder disease, pancreatic disease, stomach or intestinal problems. |
| Other health conditions | Low adrenal gland function, dental or gum disease, mouth sores. |
| Lifestyle and other medications | Frequent alcohol use, addiction to other drugs, taking an MAOI type of medication such as Marplan, Nardil, or Parnate in the past 14 days. |
| Special occasions | Being pregnant or trying to get pregnant, breastfeeding a child, having an allergic reaction to Buprenorphine, Naloxone or other medications, foods, or dyes. |
What is the best way to use the medicine?
The way you use this medicine is very important. Try to take it at the same time every day, just as your doctor tells you.
- This tablet should be placed under the tongue and allowed to dissolve . It does not require water.
- Do not chew, cut, or swallow the tablet. It should dissolve completely under the tongue and be absorbed into the body.
- If you have to take more than two pills at a time and it's difficult to keep them all under your tongue at once, you can keep the pills two by two under your tongue and let them dissolve.
- Continue taking the medicine until your doctor tells you to stop.
What if the dosage of the medicine is increased? (Overdosage)
If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately . Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
This medicine has been prescribed for you only . Do not share it with anyone else for any reason . It is dangerous and illegal.
What if I forget to take my medicine?
If you forget to take your medicine on time, take that dose as soon as you remember. But if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at the same time.
Other medications that may interact with this medicine
Some medications can interact with this medicine and cause dangerous conditions. Therefore, it is essential to inform your doctor about all medications you are taking.
| Do not take this medicine with any other medicine. | |
|---|---|
| Cisapride | Dronedarone |
| Pimozide | Safinamide |
| Samidorphan | Thioridazine |
| Other drugs and substances that may interact | |
| Alcohol | Medicines for allergies, coughs, and colds (Antihistamines) |
| Some antibiotics, antifungals, antivirals | Medications for stress, depression, and sleep |
| Certain medications for seizures | Other drugs that affect the heart rate (QT interval) |
| General anesthetics | Other opioid (narcotic) painkillers or cough medicines |
This list is not complete. Tell your doctor about all medications, vitamins, herbs, and supplements you are taking. Also, tell your doctor if you smoke, drink alcohol, or use other drugs.
Things to be careful about when taking medicine
- Doctor Visits: Visit your doctor on scheduled days. Attend any scheduled counseling services.
- Do not stop taking this medicine suddenly: Do not stop taking this medicine suddenly. Doing so may cause severe reactions. Since your body is used to this medicine, if you do stop, do so as per your doctor's instructions, gradually reducing the dose.
- Drowsiness: This medication may make you feel drowsy and dizzy. So, do not drive or operate machinery until you know how it affects you.
- Alcohol: Avoid drinking alcohol. Alcohol can interfere with the effectiveness of the medication and increase side effects.
- Constipation: This medicine may cause constipation. If you do not have a bowel movement after 3 days, call your doctor.
- Dry mouth: Dry mouth is another side effect. This can be controlled by chewing sugar-free gum, sipping soup, and drinking plenty of water.
- Dental health: Tell your dentist that you are taking this medicine. Keep your teeth clean.
Side effects you may experience
Like any medicine, this one can have side effects. Some are serious, some are common.
| Side effects that should be reported to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, difficulty breathing, excessive sleepiness, confusion. |
| Liver injury | Pain in the right upper abdomen, loss of appetite, nausea, light-colored stools, dark yellow/brown urine, yellowing of the skin or eyes. |
| Low blood pressure | Dizziness, fainting, blurred vision. |
| Side effects that usually do not require medical attention (tell your doctor if they persist) | |
| Constipation | Dizziness |
| Drowsiness | Dry mouth |
| Headache | Nausea and vomiting (Nausea, Vomiting) |
Take-Home Message
- This medication is only an important aid in the journey to recovery from opioid addiction. It should be taken along with other treatments, such as counseling, for best results.
- Dissolve under the tongue as directed by your doctor. Never chew, swallow, or crush.
- Avoid stopping the medication suddenly without medical advice. It can cause severe reactions.
- Tell your doctor about all other medications you are taking. Avoid alcohol completely.
- Keep this medicine in a safe place, out of the reach of children and pets . Sharing or selling it is illegal and dangerous.
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