What Are the Side Effects of Buprenorphine & Naloxone?

The prescription medication Suboxone contains two active ingredients. Both can cause side effects.

Buprenorphine and naloxone side effects tend to be mild, and many of them can be confused with your addiction recovery symptoms. But some can be serious.

Remember to tell your doctor about any side effects you experience. Together you can adjust your dose or use other medications to mitigate side effects so that you can continue to safely and effectively use this medication in your recovery. 

Common Side Effects

Prescription medications like Suboxone cause chemical changes deep within your brain and body. Side effects are common, particularly at first as your body gets used to the medication. Most side effects will abate on their own. However, some side effects may be more persistent, depending on the individual. 

Buprenorphine Side Effects

Buprenorphine is a partial opioid agonist. This ingredient blocks your cravings and helps you avoid the temptation to return to drugs. Since it works on the same receptors used by opioids, it causes many of the side effects as opioids (although often to a lesser degree than a full opioid), such as:[1]

• Constipation
• Constricted pupils
• Drowsiness
• Dry mouth 
• Urinary retention 
• Dizziness 
• Itching/pruritus 
• Sexual dysfunction 

Naloxone

Naloxone is an opioid antagonist. It is included in the Suboxone film to prevent people from injecting the medication. However, if taken as directed under the tongue, the Naloxone is not absorbed and does not get into the body. Therefore, if taken as directed, you should not actually be absorbing any of the Naloxone from the Suboxone strip. Even if you do ingest Naloxone, it has very few side effects. It does not tend to cause dizziness, sedation, constipation, itching, or any of the other side effects common with opioid medications.

Some people develop allergic symptoms while on naloxone, such as these:[4]

• Difficulty breathing
• Facial swelling
• Hives

True allergies to Naloxone or Suboxone are exceedingly rare. However, if you do experience any side effects of an allergy such as facial/lip or neck swelling, or difficulty breathing, discontinue your medication right away and seek emergency attention. 

Suboxone

As a combination medication, Suboxone contains both buprenorphine and naloxone. During research conducted as part of the FDA approval process, some side effects were spotted. 

This table of symptoms seen in people using Suboxone tablets can help you understand what those symptoms are and how often they’re experienced.[6]

Serious Suboxone Side Effects

Suboxone’s FDA-approved prescribing information includes data on serious side effects. Doctors are encouraged to look for these signs in their patients and address them when they appear.

Serious side effects include the following:[6]

• Respiratory depression, especially when patients combine Suboxone with benzodiazepines
• Adrenal insufficiency
• Liver damage

Never take Suboxone without a doctor’s instruction. While the medication is safe and effective, your doctor should monitor your progress and ensure you’re feeling well while using Suboxone.

If you feel sick or unwell, talk with your doctor about your dose. You may need liver function tests or other bloodwork to ensure you’re tolerating the medication.

If you feel overly sedated, talk with your doctor about your dose. If you’re combining your Suboxone with other drugs, ask your doctor for help. You may need to switch up your routine to stay safe.

Side Effects vs. Drug Withdrawal

The FDA considers drug withdrawal a common side effect of Suboxone, especially when it’s used too early. People who start withdrawal while drugs like heroin are still active within their bodies can experience severe withdrawal signs when Suboxone kicks opioids off their receptors.[6]

People who use Suboxone for long periods can develop physical dependence. When they quit the drug abruptly, they may experience flu-like symptoms. The withdrawal syndrome is typically mild when compared to potent drugs like heroin.[6]

To help prevent drug withdrawal, doctors typically taper the Suboxone dosage. You’ll take a little less every day on a customized schedule until you’re not taking any medications at all. Your doctor can design a program for you when it’s time to quit.[6] Never adjust your dose without talking to your doctor first.

3 Ways to Prevent Side Effects

To lower your risk of side effects, you can do the following: [5]

• Take your Suboxone doses as directed. Read every pamphlet and leaflet that comes with your prescription, and don’t change the rules. If you’re using a dissolving strip, for example, rinse your mouth after using the product. Don’t snort or sniff it. 
• Talk with your doctor. Some side effects fade with dose adjustments. If you’re uncomfortable, ask your doctor if a larger or smaller dosage would help. 
• Be mindful of interactions. Don’t use herbs or OTC meds to manage your symptoms unless you check with your doctor first. Many medications interact with Suboxone and can make you more uncomfortable. 

Should You Skip a Suboxone Dose If You Are Having Side Effects?

If you develop a side effect from Suboxone, you might be tempted to skip a dose or stop taking the medication altogether.

Suboxone is FDA-approved as a single daily dose. It’s not meant to be used occasionally or when you feel you need it.[6]

If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed one and take your next dose at your regular time. Don’t take two doses at once.[6]

If you feel the need to skip doses because of side effects, don’t wait: call your doctor as soon as possible for advice. They may be able to adjust your dose or use a different medication to treat side effects without you needing to discontinue the medication.