What Happens if I Miss a Suboxone Dose?

Most people take Suboxone once daily. If you miss your dose within a 24-hour window, take it as soon as you remember.[1] But if you miss a few doses, your doctor should help you decide what to do next.

About half of all prescription medications for chronic conditions aren’t taken as prescribed.[1] We’re human, and it’s easy to forget to take our medications. Even if you miss some doses, you can get back on track.

An Immediate Action Plan

What should you do when you realize you’ve missed a Suboxone dose? Follow these steps:[2]

1. Determine how many doses you missed.
2. If you missed just one, and it’s still hours until the next dose is due, take your missed dose.
3. If you missed just one and it’s almost time for the next dose, skip the one you missed.
4. If you’ve missed more than one, call your doctor and ask what to do next.

It’s dangerous to take too much Suboxone at once. Never double up on your doses by taking two at once. If you ever have questions about how much to take or when to take it, contact your doctor.

What to Do After Missing a Suboxone Dose 

Your plans will vary, depending on how quickly you remember that you didn’t take today’s Suboxone. 

Within 24 Hours 

Take your dose as soon as you remember it. If it’s almost time for another dose, skip the one you missed and take your next dose at the regular time.[2]

For example, if you always take your Suboxone at 10 a.m. and remember it at noon, take it at noon and return to your 10 a.m. dose the next day. But if you remember your missed dose at 8 a.m. the next day, skip it and take your regular dose at 10 a.m.

After Several Days

Your Suboxone is an important part of your recovery, and you should take your dose every day as directed by your doctor. If you miss multiple doses, talk with your doctor before you do anything else.

You may need to take a smaller dose when you return to your medication, and your doctor may want to discuss your recovery.[6] If you forget your doses regularly, there’s something blocking your progress. 

Consequences of Missing Doses 

Suboxone stays in the body for a long period of time, and so an occasional missed dose shouldn’t have much impact on your recovery.[3] However, if you miss many doses, you may experience opioid withdrawal symptoms or cravings that could lead to a relapse. 

Suboxone Withdrawal 

If you do miss several doses in a row, and you could experience withdrawal symptoms, including these:[4]

• Nausea
• Anxiety 
• Restlessness
• Muscle aches 
• Chills 

Withdrawal is dangerous, as it can cause you to return to hard drugs (like heroin) to make the discomfort fade. Untreated withdrawal can also lead to dehydration, which can be serious.

Suboxone Overdose

Some people panic when they realize they’ve missed their doses, and they try to make up for lost time all at once. This can lead to a Suboxone overdose, which causes the following symptoms:[2]

• Pinpoint pupils
• Sedation
• Low blood pressure
• Respiratory depression
• Death

The opioid antagonist naloxone can reverse an opioid overdose in minutes. If you’re using Suboxone, it’s smart to keep a naloxone nasal spray (i.e., ‘Narcan’) with you at all times and train your family to use it.[2] After naloxone treatment, you should follow up with a medical team to ensure you’ve recovered fully.

To prevent an overdose, do not “double up” on your dose. Take a forgotten dose when you remember it unless your next dose is almost due. Never take two doses at once.  

Drug Relapse

Without Suboxone in your body, your cravings could return. Skipping doses can also mean at least part of your brain is considering a return to using hard drugs. If you’re not putting your recovery first, your long-term sobriety is at risk.

If you’re struggling to remember or prioritize your Suboxone, consider this a recovery warning sign. Contact your treatment team and ask for help. You may need additional counseling or therapy to get back on track.

When to Contact Your Doctor

One missed Suboxone dose may not be cause for concern. But some signs and symptoms associated with skipped doses are serious and should prompt you to contact your doctor.

These are serious warning signs:

• Withdrawal: If you’ve skipped multiple doses and have the withdrawal signs we’ve described above, contact your doctor and ask about restarting your medication appropriately.
• Overdose: If you took two doses at once, this is a medical emergency. Your family should administer naloxone if there are signs of an overdose, and call 911.
• Lack of commitment: If you can’t remember your Suboxone or don’t want to take it, contact your treatment team and ask for help.

Respect Your Suboxone

If you are having trouble remembering to take your dose or are frequently missing doses, talk with your doctor. There are many strategies to help keep you on regular dosing, including setting an alarm clock, pairing your dose to a regular habit or daily activity, etc. 

Your medication is powerful. Just one high dose is capable of reducing opioid cravings.[5] Be an active part of your recovery, and always take your medication as your doctor instructs.