Each sublingual tablet of Suboxone 8 mg contains 8mg of buprenorphine hydrochloride and 2mg of naloxone hydrochloride dihydrate. Buprenorphine drug is a partial agonist that affects the mu-opioid receptor and an antagonist acting at the kappa-opioid receptor while Naloxone is an antagonist working at the mu-opioid receptor.

Buprenorphine hydrochloride can be identified as a white powder-like substance, that is weakly acidic with limited solubility in water. Whereas, Naloxone hydrochloride drug is available as a white to slightly off-white powder and is soluble in water, in dilute acids, and in strong alkali. Buprenorphine drug is classified as a Schedule III narcotic under the Controlled Substances Act and thus Suboxone is also listed under the same class.

Suboxone medicine is supplied as uncoated hexagonal orange-colored tablets intended for sublingual administration. It is available in two dosage strengths, Suboxone 2 mg (2 mg buprenorphine with 0.5 mg naloxone), and Suboxone 8 mg ( 8 mg buprenorphine with 2 mg naloxone). Apart from tablets, Suboxone is also available as an oral strip or film.

Working in The System

Buprenorphine is able to exert agonistic effects at mu and delta opioid receptors in CNS (Central Nervous System) while the Naloxone drug produces opioid withdrawal signs and symptoms in individuals who are physically dependent on full opioid agonists.

After taking the Suboxone 2 mg tablets, the medication takes about 1-2  hours to reach peak concentration in the bloodstream. Then after, the Buprenorphine drug present in Suboxone is metabolized by N-dealkylation via CYP3A4 to norbuprenorphine and by glucuronidation but then Naloxone drug is metabolized by direct glucuronidation to naloxone-3-glucuronide.

After metabolization and absorption from the gastrointestinal tract, residual Suboxone is eliminated from an individual’s system via urine and feces. In about 1-2 days (24-42 hours) Suboxone dose will be completely eliminated from an individual’s system.

How to Use Suboxone Pills

At the beginning of the treatment, Suboxone tablets must be taken under the supervision of an authorized doctor who has appropriate experience in managing opioid addiction. The effectiveness of the Suboxone 8 mg pill primarily depends on the individual’s health conditions, social, and psychological support.

Proper Dosage

• Whatsoever, the Suboxone tablets should never be swallowed directly, rather they should be placed under the tongue and allowed to dissolve gradually.
• An individual may start the treatment with an initial dose of Suboxone 2 mg /0.5 mg. This dose may be further optimized by the doctor depending on the patient’s response to Suboxone medicine.
• Never stop using Suboxone (buprenorphine and naloxone) suddenly, as you could have unpleasant withdrawal symptoms. Consult your concerned doctor before ending the treatment with this medicine.
• The daily dose should not exceed 24 mg of buprenorphine. Once the individual’s system is observed to be stabilized, the maintenance dose of Suboxone may be reduced gradually, and eventually, the treatment can be stopped.

Missed Dose and Overdosing on Suboxone

Take the missed dose of Suboxone 8 mg medicine as soon as you can, but you may skip the missed dose if it is almost time for the next dose. Never take multiple doses at a time. For further advice stay in touch with your concerned doctor.

An opioid drug overdose situation may arrive when an individual takes an inappropriate dose of Suboxone in a day. This can be fatal, especially in children or any individual using the medicine without a prescription. Overdose symptoms may include severe drowsiness, constricted pupils, slow breathing, etc. To avoid any such overdose symptoms it is crucial to follow the prescription for dosage and the concerned doctor’s advice.

Do Not Co-Administer Suboxone 8 mg with:

• Sedatives such as benzodiazepines or related products should be prohibited along with Suboxone. The simultaneous use of opioids with sedative medicinal products such as  Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam), and Restoril (temazepam) may increase the risk of sedation, respiratory depression, coma, and even death.
• Serotonergic medicinal products, such as MAO inhibitors, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants. These might increase the risk of serotonin syndrome.
• Alcohol, marijuana, and other narcotic products can promote severe sedation and drowsiness when taken along with Suboxone 8 mg tablets.
• Certain antibiotic medicines like Biaxin (clarithromycin) and Ery-Tab (erythromycin)
• Antidepressants, including Prozac (fluoxetine) and Nardil (phenelzine)
• St. John’s wort, HIV medicines, etc.

Suboxone 8 mg During Pregnancy

At the final stage of pregnancy, Buprenorphine (Suboxone) may induce respiratory depression in the newborn infant. Long-term administration of this drug during the last three months of pregnancy may cause withdrawal syndrome in the neonate. Furthermore, an individual may use Suboxone 8 mg during pregnancy only after assessing its potential benefits.

It is unknown whether the Naloxone drug is excreted in human milk or not, but studies show that Buprenorphine and its metabolites are excreted in human milk. Therefore, breastfeeding should be discontinued during treatment with Suboxone 8 mg pills or vice versa. Suboxone medicine should only be approved for breastfeeding mothers if its potential benefits outweigh the potential risk to the infant.