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PostPosted: Thu May 31, 2012 8:38 pm 
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Suboxone is a medication used for the detoxification and as a replacement maintenance medication for the treatment of Opioid Dependence.

Suboxone & Subutex are the high-dose sublingual tablets used, and more recently- the sublingual film has been developed as an alternate method to the tablets. Sublingual adminstration is a pharmacological route of administration and is literally "under the tongue" and is absorbed through the mucosal membrane and diffuses through the tissue under the tongue.

The Right way to take Suboxone.

As per the prescribing information, Suboxone, though not always, is meant to be administered as one single dose. The physician and the patient should discuss this information and personally tailor a plan that works best for the patient, however.

Suboxone & Subutex should be literally placed, into the tissue underneath the tongue. That is, to lift up the tongue so the underside is showing, practice in front of a mirror so that the tablets are placed properly, and drink a glass of water before taking the high-dose tablets before placing them in the mouth, as to allow better absorption and increase bioavailability.
Do not break or chew the tablets, they should be placed in the mouth, under the tongue, intact. It seems to make sense to break the tablet or chew it to increase the surface area to increase absorption but it is Not. This is because the powder will be absorbed by the saliva in the mouth because it is sparingly soluble in water and this will be swallowed or is no longer viable or able to be absorbed via the mucous membranes. When the whole, intact tablets are placed in the tissue underneath the tongue, one should then close their mouth, Do Not talk, move around the tablet in the mouth and do not swallow. This will ensure the maximum amount of the Suboxone is reaching the systemic circulation.

Suboxone Film should be taken in the exact same manner. Do not rip, cut or tear the strips. If you are directed to take more than one strip at a time, for instance, two (2) 8mg strips at once, as directed above, place one strip on one-half of the underside of the tongue, and on the other side of the tongue, place the second strip under the mucous membranes under the tongue. Make sure to drink a glass of water prior to placing the strips in the mouth to moisten the membranes and allow for better absorption. Do not talk with the film in the mouth as this may displace the strips where they may dissolve in the saliva and not be absorbed through the mucousal linings of the the under-side of the tongue.

Take the Suboxone as directed by your physician, but all the other information contained here within is accurate and should not be contested. This information is how the manufacturer, Reckitt-Benckisser intends one to take Suboxone. Take the dose at the same time everyday. Suboxone is not meant to be taken as a PRN medication.

This should help improve the bioavailability and consistency with which the Suboxone is taken and will work to your benefit.



Dr. I


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PostPosted: Thu May 31, 2012 9:13 pm 
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I cut my films all the time. And Dr. Junig actually suggests that you chew the tabs in your front teeth and spread it all over the inside of your mouth. Suboxone dissolves on any of mucous membranes inside the mouth. He states in his blog and videos that the underside of the tongue is not the only way to get absorption, and probably not even the best way to get the maximum absorption.

http://suboxonetalkzone.com/?p=1179


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 Post subject: REPLY FROM SLIPPER
PostPosted: Fri Jun 01, 2012 6:18 am 
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Dr. J suggests taking the bup just the opposite of what you are saying. So who is right, you or Dr. J?

I was instructed by both my bup Drs. to take the bup your way...I took it that way because I had not yet read this forum.

However, after I tried it Dr. J's way I found it was much easier for me to just put the bup under my tongue and let it melt.
I had a hard time holding all that spit in my mouth for such a long period...I also could not tell any difference between the two. Also the Pharm. co. RB does not hold a lot of merit on this forum. A lot of us see them as a big company holding on to their patent and trying to do away with the generics, which are much cheaper, so they can make a big profit. Just some thoughts you might want to know. Also remember there are a lot of people on this forum who are doctors, nurses, pharmacists and medicial experts. Your opinions are always welcome, however, just thought you might want to know this information.
Sincerely,
Slipper

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 Post subject: Re: REPLY FROM SLIPPER
PostPosted: Fri Jun 01, 2012 6:34 am 
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slipper wrote:
[b]Dr. J suggests taking the bup just the opposite of what you are saying. So who is right, you or Dr. J?


On this forum?

Dr. J! :lol:


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PostPosted: Fri Jun 01, 2012 7:15 am 
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There is no reason why the films or the tablets need to go ONLY under the tongue, either. Yes, RB says that, but, again, according to Dr. Junig, and my own experience (and that of others on this site), any of the mucous membranes in the mouth will absorb the bupe. And our experiences bear that out.

If you haven't checked out Dr. J's videos, blogs, etc, as well as his credentials, I urge your to do so.

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PostPosted: Fri Jun 01, 2012 9:28 am 
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Well, there have been very strongly opined inquisitions as to whether or not that "my" way of taking Suboxone is the right way.

The only "right" way to take Suboxone, is what works best for an individual. The right way that I've mapped is the correct way in which the manufacturer has stated to take the medication. Which is the textbook definition. Whether this works well or is right or wrong is not a factual issue. The truth is, take it however it works best on an interindividual basis.

Suboxone can be absorbed sublingually, or buccally, and frankly, the best method of absorption in terms of efficacy and bioavailability would be to snort the medication, with a bioavailability of 70-89%, with around 50-60% sublingually.

However, if I were to go to my addiction medicine class and asked what is the right way to take Suboxone, I would stick to my guns, because right is defined by Reckitt Benckisser, the manufacturer of Suboxone and they are the authority on Suboxone, they are the pharmaceutical company and have employed the teams of pharmacologists to make and test the drug. Is this any more right than wrong? Not necessarily. Like I said, the best way to take the medication is per the individual. What I've listed, is simply the correct way to take the medication as per the pharmaceutical company's guidelines.



Dr. I


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PostPosted: Fri Jun 01, 2012 10:08 am 
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Please resolve what another staff member asked you to with your signature and the "Dr_I" reference...

Thanks.

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PostPosted: Fri Jun 01, 2012 11:22 am 
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Humm, drug company or addicts with experince? I've bn useing dr j's way these last 3 weeks after useing under the tougue only the last 16 months an really,don't see to of a big difference.. just me though


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PostPosted: Fri Jun 01, 2012 11:53 am 
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pharmakon_logy wrote:
Suboxone Film should be taken in the exact same manner.

Take the Suboxone as directed by your physician, but all the other information contained here within is accurate and should not be contested.


I agree that there is no absolute 'correct' way to take Suboxone. I only posted Dr. Junig's suggestion as another option, because in the above statements, it sounds like you are saying that under the tongue is the only way people should take it...especially when stating that this information 'should not be contested'.

But hey, whatever works for you! I personally still put my films under my tongue. :wink:


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PostPosted: Fri Jun 01, 2012 12:09 pm 
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pharmakon_logy - I think it's best - for honesty's sake - if you don't refer to yourself as a "Dr. I" when you've already stated that you're not a doctor (in your intro). If you could edit your signature that would be best.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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