What are the side effects of Suboxone?

January 7, 2023

What can patients expect as possible side effects of Suboxone (buprenorphine-naloxone)? The most common side effects are constipation, diarrhea, nausea, and headache. Many other side effects have also been reported.

Suboxone is composed of two medications, Buprenorphine and naloxone. Most patients tolerate the medication well, and experience no major side effects (as long as they wait the appropriate amount after taking other opioids and before starting buprenorphine). The list of side effects of buprenorphine can include: 

  • Headache
  • Nausea and vomiting
  • Constipation
  • Sleepiness and fatigue
  • Insomnia
  • Dizziness
  • Muscle cramps
  • Tooth decay–patients should brush their teeth after taking this drug
  • Blurred vision
  • Muscle tremors
  • Fast or irregular heartbeat
  • Attention problems

While this looks like a long list of side effects, most patients have minimal to no adverse reactions (side effects) while on this medication. 

Some of these symptoms can be successfully treated with adjunct medications or lifestyle modifications (high fiber diet, hydration, sleep hygiene, exercising). Another strategy is to take lower doses of the medications more frequently throughout the day (e.g. taking 2-4 mg doses at a time instead of the usual 8 mg). This can be an important strategy. 

In a small cohort of patients, some of these side effects may be caused by the naloxone in the Suboxone, and the buprenorphine mono-product may be attempted instead (i.e. Subutex).

If the side effects are serious, or cannot successfully be treated with lifestyle changes, smaller doses or adjunct medications, you may not be a good candidate for medication-assisted treatment (MAT) with buprenorphine and another treatment should be pursued. It is important to talk to your provider about any side effects you may be experiencing.