En español
NIDA

A Guide for Patients Beginning Buprenorphine Treatment at Home

Revised September 2018

Introduction

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

Get this Publication

Science to Medicine Series: Medication Treatment for Opioid Use Disorder

Science to Medicine graphic - a scientist with a microscope and two doctor's talking

Learn from fellow clinicians in this first topic of the Series

Get Waivered to Prescribe Buprenorphine