Fentanyl can be found in the bloodstream to a significant extent for approximately 12 hours after it has been taken. However, small amounts stay in the body as it is slowly released by the body’s fat tissue.
When coming off fentanyl, do I need to wait to take Suboxone?
When transitioning from fentanyl to Suboxone (buprenorphine/naloxone), it is recommended to wait 48 to 72 hours (two to three days) after your last dose of fentanyl before beginning Suboxone. This is to avoid extremely uncomfortable precipitated withdrawal symptoms.
What are the signs and symptoms of precipitated withdrawal?
- Muscle pain
- Dilated pupils
- Suicidal thoughts
- Rapid heartbeat
- High blood pressure
Another option to avoid precipitated withdrawals is microdosing, which means taking small amounts of Suboxone in shorter intervals.
Note that many street opioids (e.g., oxycodone or hydrocodone) are not chemically pure and are often laced with fentanyl. This not only causes deadly overdoses but can also cause precipitated withdrawals when transitioning to Suboxone.
Generally speaking, the more time that passes between the last dose of street opioids or fentanyl and Suboxone induction, the more comfortable and smooth the transition will be for the patient.