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What happens if I miss a dose (Suboxone)?

Take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose (Suboxone)?

Seek emergency medical attention.

Symptoms of a buprenorphine and naloxone overdose may include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold and clammy skin, and small pupils.

What should I avoid while taking buprenorphine and naloxone (Suboxone)?

In an emergency, have family members tell emergency room staff that you are taking buprenorphine and naloxone and that you are dependent on opioids.

Use caution when driving, operating machinery, or performing other hazardous activities. Buprenorphine and naloxone may cause drowsiness, dizziness, or impaired thinking. If you experience drowsiness, dizziness, or impaired thinking, avoid these activities.

Dizziness may be more likely to occur when rising from a sitting or lying position. Rise slowly to minimize dizziness and prevent a fall.

Avoid alcohol while taking buprenorphine and naloxone. Alcohol may dangerously increase drowsiness and dizziness caused by the medication.

Buprenorphine and naloxone may dangerously increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicine, including herbal products, without first talking to your doctor.

What other drugs will affect buprenorphine and naloxone (Suboxone)?

Buprenorphine and naloxone can cause death from overdose, especially if it is injected with a tranquilizer. Use buprenorphine and naloxone exactly as directed by your doctor.

Do not take buprenorphine and naloxone without first talking to your doctor if you are taking:

• a benzodiazepine such as alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), clorazepate (Tranxene), lorazepam (Ativan), chlordiazepoxide (Librium), oxazepam (Serax), triazolam (Halcion), temazepam (Restoril), estazolam (Prosom), quazepam (Doral), or flurazepam (Dalmane);
• erythromycin (Ery-Tab, E.E.S., E-Mycin, others) or clarithromycin (Biaxin);
• itraconazole (Sporanox) or ketoconazole (Nizoral);
• an HIV protease inhibitor such as indinavir (Crixivan), ritonavir (Norvir) or saquinavir (Fortovase, Invirase);
• rifampin (Rifadin, Rimactane), rifapentine (Priftin), or rifabutin (Mycobutin);
• phenytoin (Dilantin);
• carbamazepine (Tegretol);
• a barbiturate such as phenobarbital, mephobarbital (Mebaral), and others.

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

Buprenorphine and naloxone may dangerously increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), other pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicine, including herbal products, without first talking to your doctor.

Drugs other than those listed here may also interact with buprenorphine and naloxone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

Your pharmacist may have additional information about buprenorphine and naloxone written for health professionals that you may read.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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