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PostPosted: Fri Mar 13, 2015 7:31 pm 
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I was getting so nauseated on the suboxone film with the naloxone in it. So, I cut my dose of sub from 4mg to 2mg a day. When I did, the depression was so awful I was just totally crushed. I called me doc and she agreed to let me go on Bupe without naloxone, so I'm back to 4mg of that a day, mood is awesome again and my nausea is gone. This ever happen to anyone? I feel like I need the bupe more for depression than anything now!


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PostPosted: Sat Mar 14, 2015 6:54 am 
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Maya

I wish i could get my doctor to switch me! I have asked for plain bupe but my doctor wont' give it. I am glad to hear you are feeling much better!


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PostPosted: Sat Mar 14, 2015 4:06 pm 
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Tiki, does the suboxone with naloxone make you nauseous too? The plain bupe is so much better for me and my nausea and I"m only on day 2 with it. I also seem to not have some of the other side effects at 4mg on plain bupe than I did on the suboxone film. So, they say the naloxone doesn't do anything but I beg to differ! It made me nauseated along with some other side effects that I don't feel with plain bupe! I"m so glad my doc put me on it and didn't give me a hard time. I was pondering going off it if she wouldn't switch me because the nausea from the films was so bad. Only thing is the films were easier to cut so if I wanted to taper I would prob go back to the films. Take care,
Maya


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PostPosted: Sat Mar 14, 2015 8:50 pm 
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Hi Maya

No it doesn't make me really nauseous but i noticed when i went on Zubsolv (my insurance won't pay for sub films unless the doctor calls & fights for it) that my ankle swelling & pain got a little better along with less headaches. I honestly believe i would feel much better on just plain bupe. My ankles swell and i have pain with every step. I am older and have custody of my 1 year old grandson so i have to carry him etc. plus i work FT. I really think the naloxone is to blame. After noticing the swelling went down I check the dose and there is less bupe & less naloxone in Zubsolv.

The doctors in my area rarely write for subutex unless it's a pregnant woman.. :( Just saying it gets my doctor hyper. He gets all excited and says "oh no, i don't write subutex" blah blah blah. When i go for my appt next week i am going to ask him WHY. What is the big deal about it...i just don't get it and i know based on my own experiment that the naloxone is an issue for me. This particular swelling & pain didn't start until i started suboxone.

Sorry for the rant LOL It just makes me crazy to not get an answer about "why".

I am sincerely happy for you. Even your thread titles sound better LOL


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PostPosted: Sun Mar 15, 2015 5:46 pm 
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The issue is very complicated. I see patients struggle when they change ANY formulation of buprenorphine/naloxone, especially if the change is against their will. I see many patients struggle, initially, with Suboxone film or Zubsolv or Bunavail.. but over time, get used to the medication.

That said, I have to admit that many patients prefer plain buprenorphine. The preference doesn't make a whole lot of sense, because only about 3% of the naloxone gets absorbed, and naloxone is cleared from the body very quickly-- after 20-30 minutes or so.

Many doctors, pharmacists, district attorneys, politicians, and newspaper writers think that buprenorphine is more dangerous than buprenorphine/naloxone. To be honest, some of the attitudes are based on complete ignorance. I've heard many, many people say that 'buprenorphine is abused more because it doesn't have the naloxone, so there is no ceiling effect'. That statement is just plain stupid, of course; the ceiling effect is ALL buprenorphine, and not related, at all to naloxone. Naloxone does nothing at all unless the buprenorphine is injected, and even in those cases, the naloxone competes poorly with buprenorphine. In other words, I doubt that the naloxone does anything at all. It is there for marketing purposes more than for neurochemical purposes.

But even stupid ideas have consequences. In some parts of the US, docs who prescribe plain buprenorphine get a lot of negative attention. They are seen as less responsible than other doctors; less concerned about 'diversion' and IV use of buprenorphine. Again, I believe that the science behind the issue is mostly bogus... but in some areas a doc who prescribes a lot of buprenorphine may end up harassed by law enforcement.

Some state agencies simply do not allow doctors to prescribe plain buprenorphine, out of concern over diversion. Wisconsin state employees are not allowed to use plain buprenorphine for opioid dependence; the state sent a letter to all physicians about the issue a few years ago. People on Medicaid cannot be treated with plain buprenorphine either, unless pregnant or breastfeeding.

I encourage you to cut your doc a bit of slack; I am often pressured by patients, who don't seem to understand (even after I explain it many times) that I can get in trouble for prescribing plain buprenorphine. The policies against buprenorphine are bogus, and based in ignorance... but as a licensed professional, you really have to pick your battles. Otherwise you can end up without the ability to prescribe anything at all!


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PostPosted: Sun Mar 15, 2015 9:07 pm 
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Dr J

Thank you so much for taking time to explain that to me. I will consider cutting my doctor some slack :) It just bothers me that i may have less pain with plain bupe and the option isn't there because of bogus information. Who knows, it may not help the swelling but it would have been nice to try it and see (sigh).

You are a special person to help so many here and to have the responsibility of the forum & the talk zone site. Thank you from the bottom of my heart!

The Mods here are wonderful people and the majority of posters are helpful & often offer support & hope to the new people.

Tiki


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PostPosted: Wed Apr 29, 2015 1:27 am 
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I can speak from experience on this one. I was on suboxone 8MG for about a year and had the absolute worst depression and mood throughout the year. I assumed it was normal while I was first using suboxone so I didn't think much of it but once a year came I was actually getting worse and I had huge problems with "moodiness" and agitation. I investigated it online and read that some people have a reaction to the naloxone so I eventually switched to Subutex and WITHIN 1 WEEK I was literally a different person. No other changes during that timeframe and have been better ever since. I can say with 100% certainty that the naloxone in Suboxone was causing these horrible side effects! Don't take no for an answer - find a doctor who will prescribe you subutex! My suboxone doctor was "licensed" by suboxone and wouldn't switch to Subutex and told me I was not having side effects from the naloxone so I CALLED AROUND AND FOUND A NEW DOCTOR. I literally called all the local suboxone places and told them the reaction I was having and quickly found a great family doctor(who was licensed for Bup) who said that he was open to it after meeting with me so I made an appointment and was given a script immediately and have been on subutex ever since.


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PostPosted: Wed Apr 29, 2015 8:16 am 
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Sam

Thank you for sharing your experience. When i went for my April appt i spoke to the doctor again about plain bupe, told him what i learned here from Dr J. He had apparently thought about it & did give me a script for just bupe. I honestly find very little difference and will go back on zubsolv on my May appt. If i had noticed a significant change in joint pain/swelling as i did when i went to the Zub i would stay on it but that's not the case.

I am glad you found that plain bupe took away the depressed mood and that you were able to find a doctor to prescribe it.

IMO, the doctors should listen more to their patients about side effects and report them.


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PostPosted: Sun Feb 07, 2016 5:58 pm 
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Hello. I am in my first week on Suboxone films 8mg. I spoke to my dr Friday since it was making me so sleepy and he said try 4mg twice a day so I have and I felt down and not good at all so I went back up to maybe 6mg today and feel better. I wanted to know how long I should wait between dousing. During the week I take it at 530am but I don't get up Til 10-11 on weekends so I don't wanna mess myself up on weekends. Is there a recommended time to wait between doses? I have been going 5-6 hours and feel like I may need to go 4-5 hours but that's such a long time from say 2pm Til I wake up at 530am. What do u recommend?
Thank you!


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PostPosted: Mon Feb 08, 2016 3:19 am 
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Hiya catz,
I'm glad you felt better returning to 6mg. I was a little unsure with the hours you highlighted but I will give you an example of my schedule.
Given subs have a long half life (half your dose is still in your system after 24-36 hrs) it's not IMO a huge deal to be rigid with the time of dosing.
I take my dose sometime after work and my shifts vary, so there can be a 4 or 5 hr gap between the time taken from the day before.
On your dose you should still have enough subs in your system to avert any WD. On lower doses ppl may feel slight symptoms between dosing.
Personally I would continue a weekend sleep in and dose when you wake.
What I would do to sleep in of a weekend....


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PostPosted: Mon Feb 08, 2016 1:07 pm 
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I agree with Katipo. It doesn't have to be an exact time every day. If ur over the ceiling level, there is enough sub in ur system to keep u from withdrawal so that ur not having to take it to the minute every day.

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