Type of medicine: narcotic agonist; narcotic antagonist
Generic and brand names: buprenorphine hydrochloride and naloxone hydrochloride sublingual, oral; Bunavil; Suboxone; Zubsolv
What is this medicine used for?
This medicine is placed under the tongue to treat addiction to narcotic drugs.
This medicine may be used to treat other conditions as determined by your healthcare provider.
What should my healthcare provider know before I take this medicine?
Before taking this medicine, tell your healthcare provider if you have ever had:
An allergic reaction to any medicine
A stroke, head injury, or brain tumor
Adrenal gland problems such as Addison’s disease
An enlarged prostate gland or trouble urinating
A blockage in the intestines
Liver or kidney disease
Low blood pressure
Lung disease such as asthma, chronic bronchitis or emphysema
Mental disorders such as depression or hallucinations (seeing or hearing things that are not there)
Problems with alcohol abuse
Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider’s approval.
How do I take it?
Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.
Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. Do not take more or for a longer period of time than directed by your healthcare provider. Taking too much of this medicine may cause very serious side effects.
Do not stop taking this medicine without your healthcare provider’s approval. You may need to reduce your dosage gradually to avoid withdrawal symptoms.
Check with your healthcare provider before using this medicine in children under age 18.
This medicine comes as sublingual tablets or a sublingual film (thin sheet). Do not cut, chew, or swallow the tablets. The tablets will not work if chewed or swallowed and may cause withdrawal symptoms. Do not talk until the medicine dissolves. Talking while the tablet or film is dissolving can affect how well the medicine is absorbed. If your mouth is dry, take a sip of water to moisten it before taking the tablets. Let them dissolve slowly under your tongue. It will usually take 5 minutes for the tablets to dissolve. Do not drink or eat anything until the tablet has completely dissolved. If you have the film, take a sip of water to moisten your mouth, then place the film under your tongue until it dissolves completely. Do not cut, chew, or swallow the film. The film will not work as well if chewed or swallowed or if you talk while it is dissolving.
If your provider has told you to take more than 1 tablet at a time, put the tablets in different places under your tongue and let them dissolve.
What if I miss a dose?
If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.
What if I overdose?
If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.
Symptoms of an acute overdose may include: slow or shallow breathing, slow or irregular heartbeat, seizures, dizziness, weakness, coma, confusion, extreme sleepiness, fainting, cold clammy skin, pinpoint pupils.
What should I watch out for?
This medicine is very strong and may be fatal to children. Be very careful to keep this medicine out of reach of children.
Your healthcare provider will want to check you regularly while you are receiving this medicine. You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments.
If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.
This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.
You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.
This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.
This medicine may make you constipated. You may need to take a laxative or stool softener while taking this medicine. Talk with healthcare provider or pharmacist about this.
Adults over the age of 65 may be at greater risk for side effects from this medicine. Talk with your healthcare provider about this.
This medicine is a controlled substance. It is illegal for you to give it to anyone else.
What are the possible side effects?
Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.
Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).
Serious (report these to your healthcare provider right away): Yellow skin or eyes, dark urine, light-colored bowel movements, unexplained loss of appetite, severe confusion, severe stomach pain, severe nausea or vomiting, slow or shallow breathing, irregular heartbeat, vision changes, problems walking or talking, severe dizziness or drowsiness, fainting, seizures.
Other: Nausea, vomiting, headache, constipation, mild drowsiness or dizziness, trouble sleeping, sweating, flushing, nervousness, runny nose, mouth numbness or burning.
What products might interact with this medicine?
When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods, may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:
Antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
Antibiotics such as clarithromycin (Biaxin, Biaxin XL), erythromycin (EES, Ery-Tab), linezolid (Zyvox), metronidazole, norfloxacin (Noroxin), telithromycin (Ketek), rifabutin (Mycobutin), rifapentine (Priftin), and rifampin (Rifadin)
Antidepressants such as amitriptyline, bupropion (Wellbutrin), desipramine, doxepin, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
Antifungal medicines such as itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (VFEND),
Antihistamines such as azelastine (Astelin), diphenhydramine (Benadryl), hydroxyzine (Vistaril), chlorpheniramine (Chlor-Trimeton), and meclizine (Antivert, Dramamine)
Anti-HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), etravirine (Intelence), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), indinavir sulfate (Crixivan), and nelfinavir (Viracept)
Antinausea medicines such as prochlorperazine and promethazine (Phenergan)
Antipsychotic medicines such as chlorpromazine, haloperidol (Haldol), iloperidone (Fanapt), olanzapine (Zyprexa), prochlorperazine (Compro), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
Antiseizure medicines such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenytoin (Dilantin), and primidone (Mysoline)
Antiviral medicines such as boceprevir (Victrelis) and telaprevir (Incivek)
Barbiturates such as phenobarbital, butabarbital (Butisol), pentobarbital (Nembutal), secobarbital (Seconal)
Calcium channel blockers such as diltiazem (Cardizem, Tiazac), nicardipine (Cardene), and verapamil (Calan, Isoptin SR, Verelan)
Cyclosporine (Gengraf, Neoral, Sandimmune)
Heart medicine such as amiodarone (Cordarone, Pacerone) and dronedarone (Multaq)
MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
Medicines to treat cancer such as abiraterone (Zytiga), bicalutamide (Casodex), crizotinib (Xalkori), enzalutamide (Xtandi), and imatinib (Gleevec)
Muscle relaxants such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
Narcotic cough medicines such as hydrocodone and chlorpheniramine (Tussionex), hydrocodone and homatropine, guaifenesin and codeine (Tussi-Organidin, Robitussin AC), and promethazine with codeine (Phenergan with codeine)
Narcotic pain medicines such as codeine, fentanyl (Duragesic, Actiq), hydrocodone/acetaminophen (Vicodin), hydromorphone (Dilaudid), meperidine (Demerol), methadone (Dolophine), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet), and pentazocine (Talwin)
Natural remedies such as kava, gotu kola, valerian, and St. John’s wort
Sleeping pills such as flurazepam, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien)
DO NOT drink alcohol while you are taking this medicine.
Grapefruit or grapefruit juice may affect the way this medicine works and may increase the risk of side effects. Talk to your healthcare provider about this.
If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.
How should I store this medicine?
Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.
When you have finished treatment with this medicine, ask your pharmacist or healthcare provider how to safely dispose of the medicine.
This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.
Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.
Keep all medicines out of the reach of children.
Do not share medicines with other people.
Developed by RelayHealth.
Medication Advisor 2015.1 published by RelayHealth. Last modified: 2015-01-30 Last reviewed: 2013-07-15
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.