What Is the Best Time of Day to Take Suboxone?

Taking your Suboxone dose in the morning is usually best.[1] The reason for this is that it gets the medication in your system when you first wake up to prevent you from having any cravings for other opioids throughout the day. 

However, if you feel groggy after your Suboxone dose, you could be taking too much. In cases like this, Suboxone can be taken at night in certain cases. 

Most individuals take Suboxone once a day. However, some individuals may require twice a day or even three times a day dosing. 

Is There a Best Time to Take Suboxone? 

Suboxone films and strips interact with your mucosal membranes and are dissolved in the mouth. The buprenorphine in your Suboxone tablets isn’t as effective when swallowed because it is not absorbed as well in the stomach as in the mouth. 

To use film and strips, do the following:

• Wash your hands. 
• Open your Suboxone dose. 
• Place the film or strip on your cheek or under your tongue per your doctor's instructions. 
• Keep your mouth completely closed (no eating, drinking, or talking) until the strip or film has dissolved. 
• Take a sip of water, swish it around your teeth and gums, and swallow. 
• Wait at least one hour before brushing your teeth. 

Does Suboxone cause dental problems?

Suboxone strips can cause some dental issues, so it is also important to maintain good oral hygiene with twice daily brushing. [2]

All buprenorphine-containing medications, including Suboxone pills and tablets, have been linked to oral health issues.[3] To combat those problems, experts recommend the following steps:

• Place the medications under your tongue.
• Wait for the pills or tablets to dissolve completely.
• Rinse your mouth with water and swallow the rinse.
• Wait an hour before brushing your teeth. 

When Is the Best Time to Take My First Dose of Suboxone?

Taking your first Suboxone dose before opioid withdrawal begins can be extremely unpleasant as it can produce precipitated withdrawal. [4] While precipitated withdrawal is temporary and not life threatening, it can make people feel sick for a number of hours, and can make people biased against using this medication when, in general when used properly, it is a very well tolerated medication. 

Therefore, getting the very first dose right is probably the most important part of starting Suboxone. 

How much opioids you take, and how long your addiction has lasted, can all influence the ideal amount of time you should wait before taking your last dose of an opioid and your first dose of Suboxone. While times may vary for each individual, in general you should wait: [5]

• 12 to 16 hours after taking short-acting opioids like heroin, hydrocodone, and oxycodone (immediate-release version)
• 17 to 24 hours after taking intermediate-acting opioids, like oxycodone (sustained-release version) 
• 30 to 48 hours or longer after taking long-acting opioids like methadone and fentanyl

Have you waited long enough? Watching for opioid withdrawal symptoms could help you find out. Before you take your first Suboxone dose, you should have the typical symptoms of withdrawal, such as:

• Watery eyes 
• Runny nose 
• Nausea or abdominal cramps
• Aching muscles 
• Headache 

When these symptoms are moderate (not mild), you’re in withdrawal. Then, you can take your first Suboxone dose safely. 

What to Expect During The First Days of Suboxone Treatment 

Your doctor will choose your Suboxone dose carefully based on your drug use history, health, weight, and other characteristics. Even so, it can take some time to get the dose titrated just right. 

To help you prepare, do the following:

• Take time off. You may feel sick or unfocused as your body adjusts to Suboxone. Don’t go to work or visit friends. Focus on your recovery. 
• Anticipate sickness. You must be in moderate withdrawal before Suboxone enters your body. If you’re uncomfortable, you’re following the process properly. 
• Gather your materials. Your team might use a form like this to help you understand how to start Suboxone.[6] To fill this out, you’ll need an accurate clock, a pencil, and a clear head. There’s no shame in asking someone to help you. 

During the first day, you may feel uncomfortable. But during the next two days, your discomfort will ease, and you’ll find a Suboxone dose that’s right for your body. 

How Long to Continue Therapy 

Your recovery timeline is personal, but far too many people stop using Suboxone too soon. Your medication can help you focus, stay sober, and resist relapse. If you quit using your medication too soon, relapse is possible and even probable. 

For many people, Suboxone treatment can be indefinite. Decisions to decrease or stop using Suboxone should be made in consultation with your doctor. You'll be asked about the following:

• Stable housing 
• Income stability 
• Robust support systems 
• Absence of legal problems

If you’ve achieved all of these factors (which experts call indices of stabilization), it could be an ok time to taper or discontinue.[7] But there’s no rush: If quitting puts you at risk for relapse, most patients and doctors would agree that continuing the medication is better than relapsing for your overall health and long term recovery. 

About Bicycle Health 

For many people, finding adequate Suboxone providers is tough. Bicycle Health is different. Our providers use telemedicine techniques to meet you where you are. 

If you're approved for Suboxone, our doctors work with your pharmacy to get your medication order filled. And our teams offer telemedicine appointments and therapy sessions to get you on track. If you've been searching for help, we could be just what you've been looking for. 

SOURCES

1. What Is Buprenorphine Treatment Like? National Alliance of Advocates for Buprenorphine Treatment. https://www.naabt.org/education/what_bt_like.cfm. Accessed October 2022. 

2. Suboxone Film Prescribing Information. U.S. Food and Drug Administration. https://www.suboxone.com/pdfs/prescribing-information.pdf. June 2022. Accessed October 2022. 

3. Buprenorphine: Drug Safety Communication—FDA Warns About Dental Problems with Buprenorphine Medicines Dissolved in the Mouth to Treat Opioid Use Disorder and Pain. U.S. Food and Drug Administration. https://www.fda.gov/safety/medical-product-safety-information/buprenorphine-drug-safety-communication-fda-warns-about-dental-problems-buprenorphine-medicines. January 2022. Accessed October 2022. 

4. Buprenorphine Tablet Prescribing Information. U.S. Food and Drug Administration. https://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Roxane/Buprenorphine%20HCl%20Sublingual%20Tabs/10004964_01%20Buprenorphine%20HCl%20Sublingual%20Tabs.pdf. February 2015. Accessed October 2022. 

5. Buprenorphine Induction. Providers Clinical Support System. https://pcssnow.org/wp-content/uploads/2021/12/PCSS-GuidanceBuprenorphineInduction.Casadonte.pdf. November 2021. Accessed October 2022. 

6. Day 1 Starting Suboxone. British Columbia. https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/oud-induction-handout.pdf. Accessed October 2022. 

7. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction: Treatment Improvement Protocol Series 40. Substance Abuse and Mental Health Services Administration. http://lib.adai.washington.edu/clearinghouse/downloads/TIP-40-Clinical-Guidelines-for-the-Use-of-Buprenorphine-in-the-Treatment-of-Opioid-Addiction-54.pdf. 2004. Accessed October 2022.