There are two large veins under your tongue (you can see them with a mirror). Placing the medication under your tongue allows SUBOXONE to be absorbed quickly and safely through veins and into your bloodstream as the film or tablet dissolves. If you chew or swallow your medication, it will not be absorbed effectively as it will be metabolized by the liver. Similarly, if the medication is not allowed to dissolve completely, you won’t receive the full effect.
When you talk, you move your tongue, which lets the SUBOXONE “leak” out from underneath, thereby preventing it from being absorbed by the two veins. Entertaining yourself by reading or watching television while your medication dissolves can help the time pass more quickly.
While it usually takes about 5-10 minutes for a tablet to dissolve, some factors such as a dry mouth can affect that time. Drinking something before taking your medication can help it dissolve as normal.
If you already have high levels of another opioid in your system, the SUBOXONE will compete with those other molecules and replace them at the opioid receptor sites. Because SUBOXONE has milder effects than full agonist opioids, you may go into rapid opioid withdrawal and feel sick, a condition known as “precipitated withdrawal.”
However, by already being in mild to moderate withdrawal before you take your first SUBOXONE dose, the medication will make you feel noticeably better instead of much worse. Most SUBOXONE patients feel a measurable improvement within 30 minutes, and notice the full effect of the medication after approximately an hour.
Typically, after the first hour, most patients say they feel pretty good for the duration of the day. However, your response to SUBOXONE may vary, depending on factors such as tolerance and metabolism. Your physician may adjust your dose of SUBOXONE during your first week of treatment to prevent you from feeling sick.
SUBOXONE can cause side-effects such as drowsiness and slow reaction times. These side-effects are more likely to occur during your first few weeks of treatment while your dosage is being adjusted. Some patients are in fact able to go to work right after their first dose; however, many patients prefer to take off from work during the first and second day of treatment, or until they begin to feel better.
If you are concerned about missing time from work, talk to your physician about possible ways you can minimize the amount of time you need to take off.
If you have more than one SUBOXONE tablet, you will need to take the full dosage in one sitting, but you do not necessarily need to take all of the individual tablets at the same time. By this we mean you do not need to fit all of the tablets under your tongue simultaneously. Some patients may prefer to take their dosage in this way because it is faster, but this method may not work best for you. The most important thing to remember is to make sure you take the full daily dose you were prescribed in one sitting so that your body maintains consistent levels of the medication.
SUBOXONE is most effective when it is taken every 24 hours—at the same time every day. The medication may last past 24 hours, so you may not feel sick if you forget to take it. However, if you do miss your dose, try to take it as soon as possible, unless it is almost time for your next dose. If this is the case, skip the dose you missed and take the next dose as prescribed. Do not take two doses at once unless you are directed to do so by your physician.
There are a few reasons why you may still feel sick even after undergoing SUBOXONE treatment for a while. For one, you may not be taking the medications correctly or the dose may not be right for you. If you’re still feeling sick, make sure you address your concerns to your physician.
Some of the most common side effects that patients experience while taking SUBOXONE include nausea, headache, constipation, and body aches and pains. However, most side effects seen with SUBOXONE appear during the first week or two of treatment, and then generally subside. If you are experiencing any side effects, be sure to talk about it with your physician as she/he can often treat symptoms effectively until they abate on their own.