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PostPosted: Fri Sep 04, 2015 1:39 am 
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Hi all,

A bit of background on me here :

never-recovering-t11809.html

It's a long story, but basically, I'm starting Subutex tomorrow.

I was going to be starting on 10mg or 8mg, but I've said I'm happy to start on 4mg (again long story, read my comments above for info)

As it turns out, and due to prior experience, I'm going to split my 4mg tab into 2 x 2mg's.

I think I can be comfortable with 2mg per day.

The question is, would you take the whole 2mg on a morning, or would you take 1mg first thing, then 1mg 6 hours later?

I just don't want to be crashing, feeling irritable and depressed, looking for a 2nd dose if I take my whole 2mg first thing.

Also, is it quite normal when starting to experience "crashes" mid day until you get your dosage correct, and if so, do most people take their whole allowance first thing or split it over 2 doses per day?

It's just that I read somewhere it has a HL of 6-8 hours....

When I took it in the past, I was advised at that point to take 1 or 2 x 0.4mg tablets twice or three times per day (I forgot what exactly) The trouble with that was I remember distinctly waiting for my next dose to keep me happy and stable.

Help really appreciated.

PS. My habit is currently 8-10 10mg Oxycodone per day, OR 12-15 60mg Dihydrocodeine.

Regards


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PostPosted: Fri Sep 04, 2015 2:38 pm 
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I think it's important to flood your receptors with buprenorphine (sub ingredient) when inducted to get the full effect of the medication. So I would recommend taking the 2mg at once. Then see if that takes you 24 hours until your next dose. It may be enough, but it may not. You might have to go to 3 or 4 mg. The half-life of bupe is 24 to 72 hours, so you shouldn't experience the medication wearing off until the next day if your dose is sufficient.

Amy

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PostPosted: Sat Sep 05, 2015 11:46 pm 
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You will not experience a sharp comedown after taking your induction dose. It boils down to how much you trust yourself with staying clean. Combatting withdrawal is a small part of the treatment objective. Speaking anonymously, most offices prescribe 16mg to 24mg regardless of opioid tolerance. The higher the dose the greater the stopping power. A low dose will make you feel comfortable and completely remove your withdrawals. a higher dose of 16 mg (give or take) will make you feel content and help shift your focus from addiction to addiction to recovery.


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PostPosted: Sun Sep 06, 2015 12:25 am 
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Forgive dictation and grammar mistakes.


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PostPosted: Mon Sep 07, 2015 5:41 am 
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Zakhopper316 wrote:
You will not experience a sharp comedown after taking your induction dose. It boils down to how much you trust yourself with staying clean. Combatting withdrawal is a small part of the treatment objective. Speaking anonymously, most offices prescribe 16mg to 24mg regardless of opioid tolerance. The higher the dose the greater the stopping power. A low dose will make you feel comfortable and completely remove your withdrawals. a higher dose of 16 mg (give or take) will make you feel content and help shift your focus from addiction to addiction to recovery.


thanks for the really useful info. I feel a bit better knowing my does isn't too high..
Here's what is happening, I really hope someone can offer any guidance or support, or even info on whether this is typical.

I take 1 x 2mg in the AM, about 9am as I have to pick up a daily tablet from my Chemist :-( - I find a small boost in terms of less agitation and worry, less depression, sweats go, and all is decent. I don't feel content, just steady away.

It wears off in about 3 x 4 hours. I then begin to feel the Doom, a bit sweaty, a bit panicky, irritable, agitated, depressed.

I take the second 2mg tablet at about 2pm, or later if possible.

I feel a decent relief again, but not as effective as the AM Dose.

at about 8pm/9pm I start to feel "things creeping up on me"

I then have no doses left.

In the morning (like today) I wake up in quite a horrible state.

I can't think clearly, I'm depressed near tears, I'm sweaty and edgy, a bit paranoid and full of doom depression and irritation.

The cycle then repeats.

Is this common when starting or is it likely my dose is too low?

I was trying to take as little as possible, as my Opiate use wasn't off the scale. Opiates even stopped being effective at 15+ 60mg Digydrocodeine anyway!

Without wishing to exaggerate it feels like I need a dose of about 3 x what I currently have. That would be 12mg of Subutex daily.

Is that too much? am I expecting too much?

If I got the 12mg, is it better to split it into 2 doses (any and all medication seems to wear off on me within a few hours anyway!)

Please if someone could help me soon that would be great. I felt suicidal this morning (im not suicidal!)


All the best

Mysterio.


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PostPosted: Mon Sep 07, 2015 5:44 am 
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I've got a review tomorrow with my Social Worker (not Doctor) and wondered if it's possible he will be able to get my dose increased or whether he thinks I'm being soft!

I'm then dead scared the 12mg will turn into 16mg, etc etc, although the 2mg dose does help for a few hours, so perhaps just a bigger dose will fill in the gaps of feeling crap and make things sustainable for me.

I'm sorry, but I just could not face coming off this medication - it would kill me, I'm nowhere near strong enough - would this stop them prescribing too (I'm scared if I tell them I'm going to stay on it they will be annoyed)

The good thing is, I've not touched Opiates; this is really good as they were all making my stomach upset and really making me feel sick (I was sick) not because of the dose, but because of the stomach problem it caused.

THANKSYOU


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PostPosted: Mon Sep 07, 2015 8:44 am 
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I am confused. How much total do you take now? It looks like 4 mg, if so maybe it was to low. If you don't feel right them imo, you should tell your doctor.

Good luck


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PostPosted: Mon Sep 07, 2015 9:49 am 
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Hey Mysterio,
Sorry your having early problems with your dosage. I understand in your country you pick up your dailys.

Im getting here that you are currently taking 4mgs a day?, do I have this right.?..If need feel you need more thats ok. Maybe ask for a jump up, say to 8mgs first. 12mgs is a hefty dose. I dont think any dr really would aprove a jump from 4 to 12mgs at once..
Try 8mgs ..
Again I do not totally understand how it works there but if your worker can help you start there. Seems most of these programs are trying to keep dosages down. The days of higher mgs seem to be over in many places, at least here where I am..
The important thing is getting stable AND comfortable. Because of Buprenorphine s ceiling effect your fear of escalating to higher mgs shouldnt scare you . Im no dr, but see this many times.

Your doing well as you said. You ARENT useing opiates, and thats huge! !!

Hope your meeting gos well with Worker... keep posting!!!

Razor


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PostPosted: Mon Sep 07, 2015 10:27 am 
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Hi Mysterio, I think it's important to remember that everyone is different! You could here from ten different people and they all could have a different experience! I too, very often wake up with that gloom and doom feeling. I usually get a drink of water, take my first dose of suboxone (8mgs) and go back to bed for 45 minutes. I get up ready to start the day! I usually take my next 4 mgs late afternoon. That's it for me. I am usually my normal self for the entire day. I will say that hormones and menopause play a role as sometimes these feelings of blah come along without any explanation. Good luck with your appointment and please let us know how it goes!


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PostPosted: Wed Sep 09, 2015 2:09 pm 
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Thanks!

My worker is saying I should take my entire dose together, but when I take 4mg it makes me sick!

If I take 2mg, then 1mg 4 hrs later, and another 1mg before bed time I honestly think that will be enough.

Is there a right and wrong way of splitting your dose?

Is sickness a SURE sign of being over medicated?

For example I had 2mg this morning, been doing well until about 5/6 hours later!


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PostPosted: Wed Sep 09, 2015 2:12 pm 
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Just as an aside, they're putting me up to 6mg as from tomorrow.

I genuinely feel I can cope with 2mg in the AM and then play it by ear late aft/early eve! I'll probably end up with 1-2mg per day spare which can't be a bad thing.

Also been started on Escitalopram so hope the two of them will synergise to improve mental health all round!


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PostPosted: Wed Sep 09, 2015 2:24 pm 
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Just reread my post and realized that I said 8mgs in the am. Its 4mg. I take a total of 8. I do think you have to go by what works for you. It really is a very individual thing. Especially when other medications are involved. I hope the depression starts to lessen with the new med! Please keep us posted!


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PostPosted: Wed Sep 09, 2015 2:29 pm 
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Suboxone treatment was designed to be taken once a day. This is so the need to be reaching for something to feel better can be eliminated.
Taking your doses multiple times daily continues the reward value. So once a day is best, IF you can do it. And at the egining of treatment gives you the best chance at this.Only those taking Buprenorphine for pain control should multi dose....but.....

However many dose twice daily. The reasons are many but some do it because of there doses are high and as you have said, can make you feel sick if your tolerance is to low.After a time you body and brain will get used to the dose.
Mist, try twice a day, see if this can work for you.

Ok, so ive just read here your going with 6mgs a day? But will be taking 4mgs daily? That is good. Try getting stable on 4 after a week or two. You should be fine.

The very best thing overall is your NOT useing anymore!!! And thats what its all about man....

Good luck..keep reading and posting!!

Razor


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