What Do I Do if I Can’t Tolerate Suboxone?

If you can’t tolerate buprenorphine/naloxone (Suboxone), your doctor can work with you to find a different treatment option. Some people who can’t use Suboxone can take Methadone or Naltrexone instead. 

Reasons Why You Might Not Be Tolerating Suboxone

Suboxone is a safe and effective medication for opioid use disorder (OUD) when taken as prescribed under the consultation of a Medication for Addiction Treatment (MAT) provider. Most people tolerate it well, especially after the first week or two once the body fully adjusts. However, because every person is different, it is possible that some people may not be able to tolerate Suboxone therapy due to undesirable side effects.

Some common reasons for intolerance to Suboxone include the following:

• Dizziness
• Sedation or sleepiness
• Nausea/vomiting
• Constipation
• Unpleasant taste
• Rashes
• Interactions with other medications 

What Should I Do if I Feel Like I Can’t Tolerate Suboxone?

If you feel like you cannot tolerate Suboxone to the point where it interferes with your daily activities, you should contact your MAT provider immediately.

If a side effect is severe, you should call 911 and seek emergency help.[2]

If you stop taking Suboxone and do not contact your MAT provider, you may start to experience withdrawal symptoms from Suboxone, which could further complicate your well-being. Your MAT provider is an expert on Suboxone therapy for OUD and will be able to help investigate the causes of your intolerance.

If the intolerance is minor, then a risk-benefit analysis will help determine the next steps in therapy. If the intolerance is mild and you feel that you can wait it out, this might be preferable to discontinuing your therapy altogether, especially if it is benefiting you and your ability to stay abstinent from other drugs.

If the intolerance is more bothersome, there are a couple of options:

• Your dose could be decreased to minimize side effects 
• Other medications could be added to treat the side effects 
• You could switch to a different medication for OUD altogether 

Alternatives to Suboxone for treatment of OUD

Your treatment team can help you find a new element for your MAT program. It can take a little trial and error, but you can get the answers you need.

Your team might try the following:

• Buprenorphine alone: Some people who can’t tolerate a buprenorphine/naloxone combination do well on buprenorphine alone.
• Methadone: This is an opioid medication that is also very effective at treating OUD. Unfortunately, at this time it can only be dispensed at a Methadone clinic. 
• Naltrexone: This medication is an opioid antagonist (non-opioid) medication that is also FDA approved to treat OUD.

Don’t give up. Keep working with your treatment team to find a solution that’s right for you.

Sources

1. Drug Allergy. Allergy, Asthma & Clinical Immunology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157123/. September 2018. Accessed July 21, 2022.
2. Suboxone Highlights of Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf. 2010. Accessed July 21, 2022.