Can Suboxone Cause Fluid Retention?

Fluid retention is not usually considered a common side effect of Suboxone. Swelling in the legs, feet, arms, and hands are listed as “infrequent” side effect of Suboxone -  somewhere between 1 in 100 - 1 in 1000 people experience it. It is therefore considered a very rare side effect. However, everyone’s body is different and if you do experience this side effect, speak to your doctor about it. 

Is the fluid retention caused by Suboxone dangerous?

If you have swelling as a result of taking Suboxone, it is unlikely to be dangerous. However, swelling, especially in the legs and feet, can be a sign of a serious medical condition unrelated to Suboxone. 

Serious causes of leg and feet swelling include:

• Kidney disease
• Cirrhosis of the liver
• Heart failure
• Blood clot
• Overweight
• Leg infection
• Older age
• Venous insufficiency
• Preeclampsia (in a pregnant woman)
• Other medications such as antidepressants, blood pressure medications, hormone pills, steroids. 

If you develop leg swelling while taking Suboxone, it is important to be evaluated by your doctor as soon as possible to make sure that the swelling is not a sign of another medical problem.

What are some other common and important side effects of Suboxone?

Common side effects that are frequent but not life threatening include:     

• Constipation
• Headache
• Nausea and vomiting
• Dizziness
• Drowsiness and fatigue
• Sweating
• Dry mouth
• Generalized muscle aches and cramps
• Insomnia
• Fever
• Blurred vision 
• Dilated pupils
• Tremors
• Feelings of skipped heartbeats
• Attentional problems
• Tongue pain

Other more serious side effects are rare, but do include: 

• Respiratory suppression
• Overdose (usually only if taken in excess or with other sedating medications)
• Euphoria, misuse, addiction
• Withdrawal symptoms upon discontinuation
• Precipitated opioid withdrawal (if taken with other opioids present in the system)

Why Does Suboxone Cause Fluid Retention?

Few people who take Suboxone get fluid retention. Those who do often see symptoms in their hands and feet. 

This type of fluid retention (peripheral edema) is uncomfortable, especially when you can't slip into your favorite shoes or flex your fingers. 

Peripheral edema from Suboxone is most common in people who meet the following criteria:[1]

• Female
• Ages 40 to 49
• Suboxone users for more than a month

Doctors aren't entirely sure why medications like Suboxone cause edema.[2] 

Some say that opioid medications like buprenorphine release histamines, and those open up cells lining your blood vessels. Some other experts think opioids spark the release of antidiuretic hormones, making you more likely to hang onto fluids. 

Experts must do more research to prove or disprove these theories.[3]

How Can Your Doctor Help With Fluid Retention? 

Swollen hands and feet can be frustrating. If your doctor truly thinks the swelling is due to Suboxone and not another cause, they may switch medications, or change your dose.[4] Reducing your dose might also be helpful. There are some other treatment options, including:  [5]

• Elevate your legs when you're sitting or lying down.
• Wear support stockings to compress tissues in your legs and feet. 
• Sit regularly instead of standing on your feet all day.
• Limit your salt intake.
• Consider a diuretic medication to help your body evacuate fluid 

Remember that Suboxone is a critical part of your opioid use disorder recovery plan. Don't stop taking your medication or reduce your dose without talking to your doctor first. But speak up if your medication’s side effects are uncomfortable. Your treatment team can help you find a solution that works without compromising your recovery.

Sources

1. Suboxone and Oedema Peripheral: A Phase IV Clinical Study of FDA Data. eHealthMe. https://www.ehealthme.com/ds/suboxone/oedema-peripheral/. June 2022. Accessed June 2022.
2. Naloxone-Induced Peripheral Edema: A Case Report. Addictive Disorders and Their Treatment. https://journals.lww.com/addictiondisorders/Abstract/2021/03000/Naloxone_induced_Peripheral_Edema__A_Case_Report.9.aspx. March 2021. Accessed June 2022. 
3. Opioids Causing Peripheral Edema. Journal of Pain and Symptom Management. https://www.jpsmjournal.com/article/S0885-3924(02)00404-9/fulltext. June 2002. Accessed June 2022. 
4. Edema in a Patient Receiving Methadone for Chronic Low Back Pain. Medscape. https://www.medscape.com/viewarticle/568656_3. 2007. Accessed June 2022. 
5. Edema. American Academy of Family Physicians. https://familydoctor.org/condition/edema/. April 2020. Accessed June 2022.