Does Suboxone Cause Nausea?

Some people experience nausea while taking Suboxone. In clinical studies, about 15% of people on the medication reported feeling some nausea at least at first.[1]

At-home treatments can ease your nausea and help you feel better. But if the problem persists or worsens, talk to your doctor. Together, you can find a solution.

Why Does Suboxone Cause Nausea? 

There are a few reasons why nausea may be a side effect in patients taking Suboxone.

Undertreatment of withdrawal symptoms 

People typically need one to four days to find the right Suboxone dose. If your starting amount is too small, you will feel withdrawal symptoms, including nausea.[2] Confusingly, the nausea can be from withdrawal itself, and not from the medication. One way to tease out what might be causing the nausea is if there are other symptoms of withdrawal such as shakiness, abdominal cramping, anxiety, etc. If you feel symptoms are more consistent with your typical withdrawal symptoms, it may mean you may need a slightly higher dose of Suboxone, not a lower dose. As you work with the team to find the dose that's right for your body, your withdrawal symptoms will fade, including withdrawal related nausea. 

Empty Stomach 

Because some residue from the strip/tablet can be left in the mouth after dissolving, this residue can enter the stomach and cause some nausea or stomach discomfort. One of the best ways to avoid this is to make sure you have some food in your stomach prior to taking your Suboxone, to hydrate well, and also to try spitting out the very last residue of the strip/tablet instead of swallowing it (although make sure you do not do this too prematurely which can result in not absorbing the entirety of your dose!) 

Opioid Induced Constipation 

Some people are more sensitive to opioids and can experience opioid-induced nausea and vomiting. Opioids, including Suboxone, can slow down the digestive tract, and are associated with slower gastric emptying, constipation, and bloating. This can likewise cause nausea. The good news is that most people taking Suboxone for OUD are already accustomed to this side effect from full opioid medications. In fact, the Suboxone induced constipation and nausea is often less than full opioid agonists. However, if someone is new to opioids, they might experience symptoms of nausea. And they may still experience some nausea even if they are used to opioids due to the constipating nature of opioids. 

How to Manage Suboxone Nausea at Home

The good news is, most Suboxone associated nausea will resolve on its own after a few days of the body getting used to the medication. There are a few things you can do to help manage nausea caused by Suboxone:

• Try acupressure or acupuncture.
• Avoid greasy and spicy foods.
• Eat at least 30 minutes before your Suboxone dose.
• Try to relax and find a calming area.
• Stay well hydrated by drinking plenty of fluids.
• Try a few medications if necessary that can help with nausea: specifically Zofran, or stool softeners such as Senna, Colace, and Miralax, can be helpful.  

When to Talk to Your Doctor 

If you are experiencing overly bothersome nausea from taking Suboxone or persistent nausea that does not go away after a few days, follow up with your Medication for Addiction Treatment (MAT) provider. Your doctor can prescribe anti-nausea medications if appropriate. You can also determine if a dose adjustment would help.

‍Sources

1. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020733s007s008lbl.pdf. December 2011. Accessed August 2022.
2. A Patient's Guide to Starting Buprenorphine at Home. It Matters. https://www.asam.org/docs/default-source/education-docs/unobserved-home-induction-patient-guide.pdf?sfvrsn=16224bc2_0. Accessed August 2022. 
3. Opiate and Opioid Withdrawal. MedlinePlus. https://medlineplus.gov/ency/article/000949.htm. May 2020. Accessed August 2022.