What is Buprenorphine-Naloxone: Uses, Warnings & Interactions

How to take Buprenorphine-Naloxone

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

• You must let the medicine dissolve. Never swallow the film or tablet. Your body may not absorb enough of the medicine if you swallow it.

• Your health caregiver should show you how to use the medicine. If you do not understand, ask for help. It is important to use the medicine correctly.

• Do not talk while the medicine is inside your mouth.

• Buccal film: Rinse your mouth with water to moisten it. Place the film against the inside of your cheek. If your doctor told you to use more than 1 film, place the second film inside your other cheek. Do not place more than 2 films inside of 1 cheek at a time. Do not move or touch the film. Do not eat or drink anything until the film is completely dissolved.

• Sublingual tablet: Place the tablet under your tongue. If your doctor told you to use more than 1 tablet, place all of the tablets in different places under your tongue at the same time. You can use 2 tablets at a time until you have taken all of the medicine, if that is easier for you. Let the tablets dissolve completely in your mouth. Do not eat or drink anything until the tablets are completely dissolved.

• Do not break, crush, chew, or cut the film or tablet.

• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website:www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

• Sublingual film: Drink some water to help moisten your mouth. Place the film under your tongue. If your doctor told you to use more than 1 film, place the second film on the opposite side from the first one. Do not move the film after you placed it under your tongue. If you are supposed to use more than 2 films, use them the same way, but do not start until the first 2 films are completely dissolved.

• You must let the medicine dissolve. Never swallow the film or tablet. Your body may not absorb enough of the medicine if you swallow it.

• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website:www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

• Buccal film: Rinse your mouth with water to moisten it. Place the film against the inside of your cheek. If your doctor told you to use more than 1 film, place the second film inside your other cheek. Do not place more than 2 films inside of 1 cheek at a time. Do not move or touch the film. Do not eat or drink anything until the film is completely dissolved.

• Do not break, crush, chew, or cut the film or tablet.

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

• Sublingual film: Drink some water to help moisten your mouth. Place the film under your tongue. If your doctor told you to use more than 1 film, place the second film on the opposite side from the first one. Do not move the film after you placed it under your tongue. If you are supposed to use more than 2 films, use them the same way, but do not start until the first 2 films are completely dissolved.

• Do not talk while the medicine is inside your mouth.

• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

• Sublingual tablet: Place the tablet under your tongue. If your doctor told you to use more than 1 tablet, place all of the tablets in different places under your tongue at the same time. You can use 2 tablets at a time until you have taken all of the medicine, if that is easier for you. Let the tablets dissolve completely in your mouth. Do not eat or drink anything until the tablets are completely dissolved.

• Your health caregiver should show you how to use the medicine. If you do not understand, ask for help. It is important to use the medicine correctly.

What to do if you miss a dose of Buprenorphine-Naloxone

Buprenorphine-Naloxone contraindications

• This medicine is not right for everyone. Do not use it if you had an allergic reaction to buprenorphine or naloxone.

Buprenorphine-Naloxone warnings

• Keep all medicine out of the reach of children. Never share your medicine with anyone.

• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease (including hepatitis), lung or breathing problems (including sleep apnea), adrenal gland problems, an enlarged prostate, trouble urinating, gallbladder problems, thyroid problems, stomach problems, or a history of depression, brain tumor, head injury, alcohol or drug abuse.

• This medicine may cause the following problems:High risk of overdose, which can lead to deathRespiratory depression (serious breathing problem that can be life-threatening)Sleep-related breathing problems (including sleep apnea, sleep-related hypoxemia)Liver problemsSerotonin syndrome, when used with certain medicines

• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.

• Tell any doctor or dentist who treats you that you are using this medicine.

• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.

• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

• This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.

• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Buprenorphine-Naloxone interactions

• Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.

• Some medicines can affect how buprenorphine/naloxone works. Tell your doctor if you are using the following: Carbamazepine, cyclobenzaprine, erythromycin, ketoconazole, metaxalone, mirtazapine, phenobarbital, phenytoin, rifampin, tramadol, trazodoneDiuretic (water pill)Medicine to treat depression, anxiety, and mental health illnessMedicine to treat HIV/AIDS (including atazanavir, delavirdine, efavirenz, etravirine, nevirapine, ritonavir)Phenothiazine medicineTriptan medicine to treat migraine headaches

• Do not drink alcohol while you are using this medicine.

• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are also using butorphanol, nalbuphine, pentazocine, or a muscle relaxer.

• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.

• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.

• Keep all medicine out of the reach of children. Never share your medicine with anyone.