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What should I discuss with my healthcare provider before taking buprenorphine and naloxone (Suboxone)?

Do not take buprenorphine and naloxone if:

• the medication was not prescribed for you; or
• you are allergic to buprenorphine, naloxone, or any components of the tablets.

Before taking buprenorphine and naloxone, tell your doctor if you have:

• lung problems or difficulty breathing;
• a head injury or brain problem;
• liver problems;
• kidney problems;
• gallbladder problems;
• adrenal gland problems, such as Addison's disease;
• low thyroid (hypothyroidism);
• enlarged prostate gland;
• problems urinating;
• a curve in the spine that affects breathing;
• severe mental problems or hallucinations (seeing or hearing thing that are not really there); or
• alcoholism.

You may not be able to take buprenorphine and naloxone, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Buprenorphine and naloxone is in the FDA pregnancy category C. This means that it is not known whether buprenorphine and naloxone will be harmful to an unborn baby. Use of buprenorphine and naloxone during pregnancy may cause withdrawal symptoms in a newborn baby. Do not take buprenorphine and naloxone if you are pregnant or could become pregnant during treatment.

Buprenorphine and naloxone passes into breast milk and may be harmful to a nursing baby. Do not take buprenorphine and naloxone if you are breast-feeding a baby.

How should I take buprenorphine and naloxone (Suboxone)?

Take buprenorphine and naloxone exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

The buprenorphine and naloxone tablets should be placed under the tongue and allowed to dissolve. This will take 2 to 10 minutes. If more than one tablet is prescribed per dose, your doctor may tell you to put all of the tablets under your tongue at the same time, or put 2 tablets under your tongue and allow them to dissolve completely, then put the next tablet or tablets under the tongue right away.

Do not chew or swallow the tablets. The medicine will not work this way and you may get withdrawal symptoms.

Do not change the dose of buprenorphine and naloxone or take it more often than prescribed without first talking to your doctor.

Do not inject ("shoot-up") buprenorphine and naloxone. Shooting-up is dangerous and may cause bad withdrawal symptoms.

Buprenorphine and naloxone may cause withdrawal symptoms if taken too soon after a dose of heroin, morphine, or methadone.

Buprenorphine and naloxone can cause drug dependence. This means that withdrawal symptoms may occur if you stop using the medicine too quickly. Withdrawal symptoms may also occur at the start of treatment due to dependence on another drug. Buprenorphine and naloxone is not for occasional ("as needed") use. Do not stop taking buprenorphine and naloxone without first talking to your doctor. Your doctor may want to gradually reduce the dose to avoid or minimize withdrawal symptoms.

When treatment with buprenorphine and naloxone is completed, flush any unused tablets down the toilet.

Buprenorphine and naloxone can cause constipation. Drink plenty of water (six to eight full glasses a day) to lessen this side effect. Increasing the amount of fiber in your diet can also help to alleviate constipation.

Your doctor may want to perform blood tests or other forms of monitoring during treatment with buprenorphine and naloxone.

Store buprenorphine and naloxone at room temperature away from moisture and heat. Buprenorphine and naloxone may be a target for people who abuse prescription or street drugs. Therefore, keep the tablets in a safe place to protect them from theft. Never give them to anyone else. Sell or giving away this medicine is against the law.

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