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PostPosted: Fri Aug 10, 2012 11:51 am 
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I just started taking suboxone again 2 days a go. I had previously taken it for 2 years, was off it for 5 months and now I'm back on it. I've never felt so bad since I've been back on it. This horrible feeling of nausea and headaches are the worst I've ever felt. The dose is the same. The first time around, I was induced with the tablets. This time he started me on the film. I remember when I switched to the film, how much stronger it was. I also remember experiencing more side effects as well. Any thoughts as to why I'm feeling so awful the second time around? I mean, I've never felt this bad. It's scaring me.


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PostPosted: Fri Aug 10, 2012 1:19 pm 
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Hello there. In my experience, when I was induced on sub, I had the same thing happen to me. I had a headache and nausea for the first week. After that it went away completely. My thoughts are that it is the naloxone. Some people have a sensitivity to the naloxone in suboxone. I don't know why but that just seems to be the case. Like I said, this isn't a fact for everyone, it's just the conclusion I've drawn after reading so many posts on this and other fourms.

If your side effects don't improve, I would lower your dose a little until they do, and then if you feel like you need to up it again, you can because you still will have the same script. I've also heard the same as you as far as the films being stronger. On a few seperate occasions, I've taken the film and noticed the same thing....that it "felt" stronger. I think it's because I got better absorption with the film. I know I do. I always spit out whatever saliva is left in my mouth after my tabs dissolve and it seems to have tiny little pieces of suboxone still in it. Nothing overwhelming....but they are there. With the film, all the saliva I spit out, is clear. So I know I'm getting more absorbed with the film.

All of these things could be contributing to your side effects. Once I started spitting the saliva out, the headaches went away. Thats what made me think it was the naloxone. You could try doing this after your dose and see if it helps.

I'm sorry you are feeling this way and I hope that you are feeling better soon. Let us know either way...

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PostPosted: Sat Aug 11, 2012 2:12 pm 
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Years ago when I started suboxone , I don't remember being this sick. Maybe I was lucky but something isn't adding up. Hopefully this will all pass. Im just a little worried cause I already missed a day of work because of it. And I'm usually a fighter and can tolerate being sick but this is really putting me out.


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PostPosted: Sat Aug 11, 2012 7:11 pm 
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I am so sorry you are this sick. Hopefully you are just having a hard time adjusting to the meds this time, and it will pass quickly. Please let us know how you are doing. Hopefully some people come along and give you some more advice. I'm sorry I don't have any other advice for you....hang in there.

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PostPosted: Sat Aug 11, 2012 9:07 pm 
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Maybe your dose is too high? Is your opiate tolerance lower this time around?

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PostPosted: Sat Aug 11, 2012 9:30 pm 
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I would say my opiate tolerance is lower this time. Was wondering if that had anything to do with it. I was surprised when my doctor put me back on the same dose. I've only been off suboxone for 5 months. And I haven't been using near as much as what landed me in the program initially. I had been a heavy user for about 7 years.


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PostPosted: Sat Aug 11, 2012 11:34 pm 
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Hi Love, I feel so sorry for you! I certainly can identify with what you described. It is definitely the naloxone. I was prescripbed suboxone when I was induced and for the first 3 months of my induction I suffered the same as you. I was so sick from suboxone that I lost 30 pounds. Finally got up the courage to ask my sub doctor to switch my to subutex and have never looked back. I don't feel any of the things on subutex that I felt on suboxone.

Take it from one who has been where you are - get off suboxone and on to subutex!!!!!

Please let me know how you are doing. All of this on this forum really do care and want to help.

Best regards and good luck!!!


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PostPosted: Sun Aug 12, 2012 12:43 am 
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You could try taking less - I don't know what dose you're on but if your tolerance was down you'd be able to get by with a lower dose of Sub - it's a strong drug. You could try taking half of whatever you're taking now and see if that works - you can always take more later in the day if you need to.

If the naloxone didn't bother you last time you were on it I don't know why it would be bothering you now. You could try spitting after you absorb your dose (instead of swallowing) and see if that helps. Just make sure you leave the medication under your tongue long enough to absorb before you spit.

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PostPosted: Mon Aug 13, 2012 2:34 pm 
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I just had this exact same experience after going back on Subs again. I had been off of them for about 8 months.....omg, I got so sick this time! The nausea was the worst. The first time I went on Subs, I didn't get sick at all, so I was really wondering what happened. Fortunately, after a difficult few weeks my body adjusted this time and I feel fine. The only thing that is going to help is lowering the dose, and taking anti-nausea treatments. I got my doc to prescribe generic Zofran, and it worked well.

I, too, find the strips to be much stronger. I inducted on the pills this time at 16 mg a day. After a month, when I should have been fully tolerant to the effect of buprenorphine, I asked my doc to switch me to the strips. Wow, after my first 16 mg dose of the strips I got a strong euphoric effect. I think my body absorbs a lot more bupe with the strips. Actually, I threw up again for a full two days after switching, it was so strong.

James


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PostPosted: Mon Aug 13, 2012 5:24 pm 
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Damn, that sucks ! Are you sick constantly or mostly right after you take a dose? I agree with DOaQ that if you didn't have any issue with the naloxone before it's probably not that- though stranger things have happened I suppose.. That's probably just as well because getting a DR to prescribe subtext is darn near impossible these days..

I think Bunnyman and the others that suggested lowering your dose are right on the money..


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PostPosted: Mon Aug 13, 2012 6:42 pm 
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LoveHereAfter,

If you don't have good insurance and can't get Zofran (ondansetron), Anzemet (dolasetron), Kytril (Granisetron), or Aloxi (palonosetron), which are AWESOME for nausea, other things work that don't need a prescription. BTW, the first three of those I listed are available as generics. I got generic Zofran and it totally stops my vomiting, and it works super fast so I can keep it down long enough for it to work.

Benedryl (diphehydramine) 50-100 mgs every 4-6 hours works OK. Vistaril/Atarax (hydroxyzine) works even better, and Phenergan (premethazine) is the best antihistamine of all for it - but both of those require a prescription in the US. Most antihistamines work for nausea as long as they cause drowsiness (once-a-day nondrowsy ones like ceterezine (Zytec), fexofenadine (Allegra), and loratadine (Claritin) will not work for nausea, so don't even bother ;).

While I was so sick, which did indeed last for over a month, I found that lying down flat on my back and deep breathing actually helped a lot. And lower your dose until it's just above what will keep you out of withdrawal - that's what I had to do. IMO, your dose being too high is what's probably making you sick, not the naloxone. If you're taking your Sub under the tongue as directed, you're barely getting any noloxone into your bloodstream. Plus, if you consider that the half-life of naloxone is very short (1-2 hours), then IF it was the culprit, your symptoms of being sick would disappear within a few hours of each dose. My PDR shows studies done by Reckitt-Benckiser during phase III clinical trials of Suboxone, and in them researchers measured naloxone levels in subjects on various doses of Sub. Even after several weeks of continuous sublingual use, the amount of naloxone found in those patients who even tested positive were almost immeasurably low, and totally insignificant from a clinical point of view. Not to mention that buprenorphine has a higher affinity for mu opioid receptors than naloxone anyway, and any naloxone that somehow gets into your body is over 98% eliminated in it's first past through the liver. While I believe a very select number of people are somehow sensitive to the effects of the naloxone contained in Suboxone, I think the credit given to negative affects due to naloxone exposure are greatly exaggerated. As an extra precaution, however, I never swallow my saliva after using my Sub strips (even though it probably doesn't even matter).

Your Sub doc might prescribe you something for nausea if you call their office and explain to a nurse what's going on. Mine did not require me to come in to get the Zofran, he just called it in to the pharmacy. Unfortunately, one of his nurses actually accused me of trying to use heroin on top of the Suboxone to get high!! She told me that "Suboxone doesn't cause nausea. Only strong opiates like heroin or oxycodone do." I don't think that stupid b*tch even knew that Suboxone contains one of the strongest opiates in the world, which I was happy to explain to her. But I didn't bother to try to explain that all opioids are capable of causing nausea or that taking another opioid agonist on top of the Suboxone won't cause it either - it wasn't worth it. I just insisted that I had not relapsed, and even asked her why I would bother to call them to complain about my symptoms if I was trying to get high. And wouldn't it just be smarter (and cheaper) to quit taking the Sub if I had decided to use another opioid? However, I'm sure she just dismissed me as another drug addict - it is just a general practicioner's office and some of the staff is not understanding of Suboxone or addiction. Her ignorance, her loss!

Bunny


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PostPosted: Mon Aug 13, 2012 10:55 pm 
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Great post bunnyman! I too was prescribed anti-nausea meds by my sub doctor which did help. The name of the meds she prescribed me is Promethazine - 25mg. I must warn you that these pills did stop the nausea, but they made me extremely sleepy. If you have to go to work the next day, I would start out with taking only 1/2 a pill. If you don't have to go to work the next day, then you can take the whole pill.

I hope this helps you out LoveHereAfter!!

Take care,


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PostPosted: Wed Aug 15, 2012 7:09 pm 
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Really appreciate everyone's advice. It made quite a difference for me. Well, it's been a week and the bad nausea and headaches seem to be gone. I hope! Finally had a good day where I actually felt good and back to my old self. I played with my dosage quite a bit til I found something that worked for me. Needless to say, I'm pretty positive I was over medicated. Dr. had me on 8 mgs twice a day but it was clear I didn't need that much. Crazy thing is, dr. still didn't want me to lower my dose even though I told him how sick I was. Anyways, I'm just so relieved I feel better. Thanks for all the support. Helped me out a bunch.


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PostPosted: Sun Oct 14, 2012 1:33 am 
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This is exactly why im scared to start on suboxone. the doctor started me on 8mg... i snort/smoke 1-3 roxies/day and then i just moved to smoking 1g of heroin (I make that last 4 days). I have a huge job on Tuesday, I'm worried that I'm going to be exhausted. some people say they feel amazing and some say they feel like shit. Should I wait it out and induce when I have a few days of free time? Help! I want to get better but I'm nervous to start.


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