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A Guide for Patients Beginning Buprenorphine Treatment at Home

Revised September 2018


Before taking buprenorphine you want to feel very sick from your withdrawal symptoms.

It should be at least:

  • 12 hours since you used heroin/fentanyl
  • 12 hours since you snorted pain pills (Oxycontin)
  • 16 hours since swallowed pain pills
  • 48-72 hours since you used methadone.
Symptoms At Least 3 Should be Present
  • Restlessness
  • Heavy yawning
  • Enlarged pupils
  • Runny nose
  • Body aches
  • Tremors/twitching
  • Chills or sweating
  • Anxious or irritable
  • Goose pimples
  • Stomach cramps, nausea,
    vomiting or diarrhea
NOTE: Wait it out as long as you can.  The worse you feel when you begin the medication the less chance for side effects such as worsening of withdrawal

Day 1

8-12 mg Buprenorphine

  • Step 1 - Take the first dose - 4 mg
    • Put the tablet or strip under your tongue.
    • Keep it there until fully dissolved.
    • Do NOT eat or drink at this time.
    • Do NOT swallow the medication.
  • Allow the Medication to take effect
    • ?Wait 45 minutes.
  • Step 2 - Still feel sick?  Take the next dose of 4 mg. 
    • Most people feel better after the second dose (total = 8 mg)
  • Allow the Medication to take effect
    • Wait 6 hours
  • Step 3 - Still Uncomfortable?  Take the last dose of 4 mg
    • Do not exceed 12 mg on Day 1
    • Stop after this dose

Day 2

16 mg Buprenorphine

  • Take one 16 mg dose
    • Most people feel better with a 16 mg dose. 
    • Repeat this dose until your next follow-up appointment.
NOTE: If you develop worsening symptoms while starting buprenorphine before your scheduled outpatient appointment return to the emergency department.

This page was last updated September 2018

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