The following directions have been prescribed by a licensed medical provider for the individual named above, may not be redistributed, and are not to be used by any other person for any reason.
Hello, welcome to Bicycle Health.This video is created to help guide you through a microdosing induction over the course of the next seven days.
This video will go over the materials needed to have a successful induction, review withdrawal symptoms, and how and when to take your medication appropriately over the next seven days.
When watching this video, if you have not received your medication, you can always return to this video at a later time. The materials needed will be your Suboxone tablets or films, a tablet cutter or clean sharp scissors for cutting films.
Suboxone is a brand name for a combination of buprenorphine and naloxone. This is the medication that we offer here to patients at Bicycle Health. Naloxone is an opiate receptor blocker. And when Suboxone is taken as prescribed under the tongue, not injected or snorted, naloxone actually has no effect. Buprenorphine, is a partial opiate receptor activator that works very differently than other opioids. It helps with opioid withdrawal, cravings and lets the brain heal while you're in treatment.
When taking Suboxone, make sure to follow these tips to maximize the effects of a medication. Do not swallow the medication and do not eat or drink while the medication is dissolving. This can cause the medication to have little or no effect. It is usually best practice to not eat or drink 10 minutes before and 10 minutes after taking the medication. It is also helpful to rinse out the mouth after each dose to help decrease the risk of dental irritation in the future.
Unlike traditional induction in which you stop your opioids and wait a period of time to go into withdrawal before starting Suboxone, microdosing induction is a way to start Suboxone without having to go through this waiting period. Microdosing introduces very small doses of Suboxone and gradually increases these doses over a week while you are still continuing to take the same dose of opioids every day. Because Suboxone is more long acting and attaches more strongly to the receptors compared to other opioids, you will never go into precipitated withdrawal and all of your receptors will gradually be covered by Suboxone by the end of the week. If you follow the directions closely under the guidance of your medical provider, you will be able to comfortably start Suboxone at home. Although microdosing is not included in clinical practice guidelines it has increasingly been in clinical practice with success by medical professionals since 2016. So, let’s move on to day 1.
Here is the microdosing schedule that we will use for the next 7 days. You may use this as a reference but it also will be included in a Bicycle Health app where your provider will provide detailed instructions for your microdosing schedule. For day one you will take one quarter of the film or tablet which is equivalent to 0.5 mg of buprenorphine, once in the morning and then once again at night time for a total dose of 1 mg on this day. Remember to allow the medication to fully dissolve under the tongue and do not eat or drink anything prior to the medication for about 10 minutes. Also continue to take your other opioids at your normal usual dose as you would throughout the day this will help keep your withdrawal symptoms to a minimum.
On day two, you will take half of the film or tablet, which is equivalent to 1 mg of buprenorphine, again once in the morning and then again once at night. For a total of 2 mg of buprenorphine on this day. Once again continue to take your other opiates as usual as you would throughout the day.
For day three, you do not need to cut the tabs or films, as you will take the full dose as it is. You'll take one film or tablet in the morning and then again at night time for a total for four milligrams for the day. Once again continue to take your opioids as usual.
For day four, please take one and a half films or tablets, equaling 3 mg of buprenorphine, once in the morning and again once at night. You will place both pieces under the tongue to dissolve and once again continue to take your usual dose of opioids throughout the day.
On day number five, it is not unusual to experience increased withdrawal symptoms as your dose of Suboxone has increased drastically. On this day you will take two films or tablets total in the morning and once again at night time, for a total of 8 mg of buprenorphine for today. Continue to use your opioids as you would throughout the day despite feeling any forms of withdrawal symptoms.
For day number six, we will actually take the medication three times today. You'll take two full films or tablets under the tongue, once in the morning, again at lunch time, and then lastly at night. The total of buprenorphine will be 12 mg for this day as you continue to once again take your opioids. As this is the last day of your illicit opioid use! Congratulations on making it to day seven. You may be experiencing slightly increased withdrawal symptoms. Which is very normal.
On day seven, you will take six films or tablets all at one time, placed under the tongue for a total of 12mg of buprenorphine on this day. Once again, today you have stopped all other opioid use and you will now rely on the Suboxone moving forward.
If you do experience withdrawal symptoms they usually will be mild and most commonly occur on day four or day five. This means that your receptors are mostly occupied by Suboxone and you should start to feel better in about 1 to 2 days if you continue to follow the plan with your medical provider. Continuing to take the same dose of opioids is very important to help prevent withdrawal symptoms. If you do experience mild to moderate withdrawal symptoms, please refer to the medication sent to you by your provider known as comfort medications, to help offset some of these withdrawal symptoms. You may also reach out to your provider for continued guidance on this matter.
This concludes the video on microdosing induction. Please refer back to this video for any questions or concerns that you may have as you go through this process. You may also reach out to your medical provider with any ongoing concerns that you may have that might not have been addressed in this video. Once again, we're glad you're here and congratulations on your new season of sobriety.
