Buprenorphine dosing: Form, strengths, when to take, and more
Buprenorphine is a sublingual tablet that dissolves under the tongue. It’s usually taken once per day. The drug is also available in other forms not described in this article.
Buprenorphine is approved for use in adults to treat opioid use disorder. It’s a part of a complete treatment plan that includes counseling and psychotherapy.
Buprenorphine is a generic and belongs to a drug class called partial opioid agonists. The drug isn’t available in a brand-name version.
This article describes the dosage of buprenorphine, as well as its strengths and how to take it.
Your doctor will likely start you on a low dosage and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended for buprenorphine. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those mentioned here.
Buprenorphine is available as a sublingual tablet. It’s placed under the tongue until it’s dissolved.
Buprenorphine comes in two strengths: 2 milligrams (mg) and 8 mg.
Buprenorphine is approved to treat opioid use disorder. The treatment plan contains two phases: the induction (starting) phase and the maintenance (long-term) phase.
Always follow your prescribing doctor’s instructions. They’ll explain what dosage of buprenorphine to take and when to take it. Notify them if you experience any side effects that may prevent you from taking your medication.
Note: Buprenorphine is not used to manage pain. See the “Is there a buprenorphine sublingual dosage for pain?” section for more details.
The buprenorphine dosage that you start treatment with is based on whether you were taking short-acting or long-acting opioids. It also depends on the severity of your opioid withdrawal symptoms.
The usual starting dosage ranges from 2 to 8 mg once per day. You’ll take your first dose when you start to have withdrawal symptoms after stopping other opioids:
If your opioid withdrawal symptoms aren’t managed on the first day of buprenorphine induction treatment, your doctor will likely increase your buprenorphine dose the following day. And they’ll continue to adjust your buprenorphine dosage until your withdrawal symptoms are managed.
The buprenorphine dosage for long-term treatment ranges between 4 and 24 mg once per day. But the recommended target dosage is 16 mg once per day. Your doctor will increase your dosage as needed in 2- or 4-mg increments to reach the most effective dose for you. They’ll prescribe the lowest possible buprenorphine dosage that manages your opioid withdrawal symptoms.
The maximum dose of buprenorphine in 24 hours is 24 mg. Higher doses than 24 mg haven’t been shown to be more effective than lower doses.
Your doctor will likely prescribe buprenorphine with naloxone (Narcan) during the maintenance phase. This drug is used in cases of opioid overdose, which is a serious risk during buprenorphine treatment. (See the “Buprenorphine overdose” section to learn more.)
Your doctor or pharmacist will advise you how to take buprenorphine sublingual tablets. You’ll place the tablet under your tongue to dissolve. If you need to take more than 2 tablets for your dose, you can either place all the tablets at once under your tongue or place 2 tablets at a time. Be sure to take your dose in the same way each time.
After the tablet has fully dissolved, you can take a sip of water, swish gently around your teeth and gums, and swallow.
Buprenorphine is usually a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long-term.
No, buprenorphine sublingual tablet is not approved to treat pain, so it does not have a dosage for this use. It’s only used to treat opioid use disorder with counseling and psychotherapy.
In fact, the buprenorphine sublingual tablet has a warning against using it for pain. This is because it can cause opioid overdose in people who are not used to taking opioids. Death occurred in people who took 2 mg of the drug for pain.
It is important to take buprenorphine as prescribed by your doctor. If you have pain, talk with your doctor about the right treatment option for you.
Do not take more buprenorphine than your doctor prescribes, as this can lead to harmful effects. Also, keep the drug out of reach of children. Buprenorphine can cause severe and possibly fatal respiratory depression in children.
Buprenorphine overdose can also be fatal.
Your doctor will likely prescribe naloxone (Narcan) with a buprenorphine sublingual tablet. It’s also available over the counter. This medication is a nasal spray that can temporarily reverse the effects of an opioid overdose, including a buprenorphine overdose.
Narcan is given by caregivers or loved ones to a person who has a known or suspected opioid overdose. It is not possible to self-administer Narcan. It should be given until emergency medical help arrives. But using Narcan should not replace emergency medical care. 911 (or the local emergency number) should be called immediately, or the person should be taken to the nearest emergency room.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.