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Frequently Asked Questions

Girl thinking questions
1. Why do I have to feel sick to start the medication for it to work best?
When you take your first dose of SUBOXONE®, if you already have high levels of another opioid in your system, the Suboxone will compete with those opioid molecules and replace them at the receptor sites. Because Suboxone has milder opioid effects than full agonist opioid, you may go into a rapid opioid withdrawal and feel sick, a condition that is called "precipitated withdrawal." By already being in mild to moderate withdrawal when you take your first dose of Suboxone, the medication will make you feel noticeably better, not worse.
2. How does Suboxone work?
Suboxone binds to the same receptors as other opioid drugs. It mimics the effects of other opioids by alleviating cravings and withdrawal symptoms. This allows you to address the psychosocial reasons behind your opioid use.
3. When will I start to feel better?
Most patients feel a measurable improvement by 30 minutes, with the full effects clearly noticeable after about 1 hour.
4. How long will Suboxone last?
After the first hour, many people say they feel pretty good for most of the day. Responses to Suboxone will vary based on factors such as tolerance and metabolism, so each patient's dosing is individualized. Your doctor may increase your dose of Suboxone during the first week to help keep you from feeling sick.
5. Can I go to work right after my first dose?
Suboxone can cause drowsiness and slow reaction times. These responses are more likely over the first few weeks of treatment, when your dose is being adjusted. During this time, your ability to drive, operate machinery, and play sports may be affected. Some people do go to work right after their first Suboxone dose, however, many people prefer to take the first and possibly the second day off until they feel better. If you are concerned about missing work, talk with your physician about possible ways to minimize the possibility of your taking time off.
6. Is it important to take my medication at the same time each day?
In order to make sure that you do not get sick, it is important to take your medication at the same time every day.    
7. If I have more than one tablet, do I need to take them together at the same time?
Yes and no. You do need to take your dose at one "sitting," but you do not necessarily need to fit all the tablets under your tongue simultaneously. Some people prefer to take their tablets this way because it's faster, but this may not be what works best for you. It is important to take the full daily dose you were prescribed so that your body maintains constant levels of Suboxone.
8. Why does Suboxone need to be placed under the tongue?
There are two large veins under your tongue (you can see them with a mirror). Placing the medication under your tongue allows Suboxone to be absorbed quickly and safely through these veins as the tablet dissolves. If you chew or swallow your medication, it will not be correctly absorbed as it is extensively metabolized by the liver. Similarly, if the medication is not allowed to dissolve completely, you won't receive the full effect.
9. Why can't I talk while the medication is dissolving under my tongue?
When you talk, you move your tongue, which lets the undissolved Suboxone "leak" out from underneath, thereby preventing it from being absorbed by the two veins. Entertaining yourself by reading or watching television while your medication dissolves can help the time to pass more quickly.
10. Why does it sometimes only take 5 minutes for Suboxone to dissolve and other times it takes much longer?
Generally, it takes about 5-10 minutes for a tablet to dissolve. However, other factors (e.g. the moisture of your mouth) can affect that time. Drinking something before taking your medication is a good way to help the tablet dissolve more quickly.
11. If I forget to take my Suboxone for a day, will I feel sick?
Suboxone works best when taken every 24 hours, however, it may last longer than 24 hours, so you may not get sick. If you miss your dose, try to take it as soon as possible, unless it is almost time for your next dose. If it is almost time for your next dose, just skip the dose you forgot, and take next dose as prescribed. Do not take two doses at once unless directed to do so by your physician. In the future, the best way to help yourself remember to take your medication is to start taking it at the same time that you perform a routine, daily activity, such as when you get
dressed in the morning. This way, the daily activity will start to serve as a reminder to take your Suboxone.
12. What happens if I still feel sick after taking Suboxone for a while?
There are some reasons why you may still feel sick. You may not be taking the medication correctly or the dose may not be right for you. It is important to tell your doctor or nurse if you still feel sick.
13. What happens if I take drugs and then take Suboxone?
You will probably feel very sick and experience what is called a "precipitated withdrawal." Suboxone competes with other opioids and will displace those opioid molecules from the receptors. Because Suboxone has less opioid effects than full agonist opioids, you will go into withdrawal and feel sick.
14. What happens if I take Suboxone and then take drugs?
As long as Suboxone is in your body, it will significantly reduce the effects of any other opioids used, because Suboxone will dominate the receptor sites and block other opioids from taking effect.
15. What are the side effects of this medication?
Some of the most common side effects that patients experience are nausea, headache, constipation, and body aches and pains. However, most side effects seen with Suboxone appear during the first week or two of treatment and then generally subside. If you are experiencing any side effects, be sure to talk about it with your doctor or nurse, as he or she can often treat those symptoms effectively until they abate on their own. Refer to your common side effects section for further information.