Buprenorphine, a derivative of thebaine, is an opioid that has been marketed in the United States as the Schedule V parenteral analgesic Buprenex®. In 2002, based on a reevaluation of available evidence regarding the potential for abuse, diversion, addiction, and side effects, the DEA reclassified buprenorphine from a Schedule V to a Schedule III narcotic.

In October 2002, Reckitt Benckiser received FDA approval to market a buprenorphine monotherapy product, Subutex®, and a buprenorphine/naloxone combination product, Suboxone®, for use in opioid addiction treatment. The combination product is designed to decrease the potential for abuse by injection. Subutex® and Suboxone® are currently the only Schedule III, IV, or V medications to have received FDA approval for this indication. In January 2003, Reckitt Benckiser began shipments of Suboxone® to pharmacies in the United States.

The FDA approval of these buprenorphine formulations does not affect the status of other medication-assisted opioid addiction treatments, such as methadone and LAAM (levo-alpha-acetyl-methadol). As indicated in Title 42 Code of Federal Regulations Part 8 (42 CFR Part 8), these treatments can only be dispensed, and only in the context of an Opioid Treatment Program. Also, neither the approval of Subutex® and Suboxone®, nor the provisions of DATA 2000, affect the use of other Schedule III, IV, or V medications, such as codeine, that are not approved for the treatment of addiction. Lastly, note that aside from Subutex® and Suboxone®, other forms of buprenorphine, e.g., Buprenex®, are not approved for treatment of opioid addiction.

Buprenorphine is an opioid partial agonist. This means that, although buprenorphine is an opioid, and thus can produce typical opioid agonist effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone. At low doses buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The agonist effects of buprenorphine increase linearly with increasing doses of the drug until at moderate doses they reach a plateau and no longer continue to increase with further increases in dose-the "ceiling effect." Thus, buprenorphine carries a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, in high doses and under certain circumstances, buprenorphine can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream.

Buprenorphine has poor oral bioavailability and moderate sublingual bioavailability. Formulations for opioid addiction treatment are in the form of sublingual tablets.

Buprenorphine is highly bound to plasma proteins. It is metabolized by the liver via the cytochrome P4503A4 enzyme system into norbuprenorphine and other metabolites. The half-life of buprenorphine is 24–60 hours.
Because of its ceiling effect and poor bioavailability, buprenorphine is safer in overdose than opioid full agonists. The maximal effects of buprenorphine appear to occur in the 16–32 mg dose range for sublingual tablets. Higher doses are unlikely to produce greater effects.

Respiratory depression from buprenorphine (or buprenorphine/naloxone) overdose is less likely than from other opioids. There is no evidence of organ damage with chronic use of buprenorphine, although increases in liver enzymes are sometimes seen. Likewise, there is no evidence of significant disruption of cognitive or psychomotor performance with buprenorphine maintenance dosing.

Information about the use of buprenorphine in pregnant, opioid-addicted women is limited; the few available case reports have not demonstrated any significant problems due to buprenorphine use during pregnancy. Suboxone® and Subutex® are classified by the FDA as Pregnancy Category C medications.

See the Buprenorphine Clinical Practice Guidelines (available soon on this Web site) for more information about the use of buprenorphine in pregnancy. Currently, methadone remains the standard of care for the medication-assisted treatment of opioid-addicted women in the United States.

Side Effects
Side effects of buprenorphine are similar to those of other opioids and include nausea, vomiting, and constipation. Buprenorphine and buprenorphine/naloxone can precipitate the opioid withdrawal syndrome. Additionally, the withdrawal syndrome can be precipitated in individuals maintained on buprenorphine. Signs and symptoms of opioid withdrawal include:
Dysphoric mood
Nausea or vomiting
Muscle aches/cramps
Lacrimation
Rhinorrhea
Pupillary dilation
Sweating
Piloerection
Diarrhea
Yawning
Mild fever
Insomnia
Craving
Distress/irritability
drug Interactions, Cautions and Contraindications
Refer to the Subutex® and Suboxone® package inserts (http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm) for a complete listing of drug interactions, contraindications, warnings, and precautions.

Abuse Potential
Because of its opioid agonist effects, buprenorphine is abusable, particularly by individuals who are not physically addicted to opioids. Naloxone is added to buprenorphine to decrease the likelihood of diversion and abuse of the combination product. Sublingual buprenorphine has moderate bioavailability, while sublingual naloxone has poor bioavailability. Thus, when the buprenorphine/naloxone tablet is taken in sublingual form, the buprenorphine opioid agonist effect predominates, and the naloxone does not precipitate opioid withdrawal in the opioid-addicted user.

Naloxone via the parenteral route, however, has good bioavailability. If the sublingual buprenorphine/naloxone tablets are crushed and injected by an opioid-addicted individual, the naloxone effect predominates and can precipitate the opioid withdrawal syndrome.

Under certain circumstances buprenorphine by itself can also precipitate withdrawal in opioid-addicted individuals. This is more likely to occur with higher levels of physical addiction, with short time intervals (e.g., less than 2 hours) between a dose of opioid agonist (e.g., methadone) and a dose of buprenorphine, and with higher doses of buprenorphine.

Evidence of Effectiveness
Studies have shown that buprenorphine is more effective than placebo and is equally as effective as moderate doses of methadone and LAAM in opioid maintenance therapy. Buprenorphine is unlikely to be as effective as more optimal-dose methadone, and therefore may not be the treatment of choice for patients with higher levels of physical dependence.

Few studies have been reported on the efficacy of buprenorphine for completely withdrawing patients from opioids. In general, the results of studies of medically assisted withdrawal using opioids (e.g., methadone) have shown poor outcomes. Buprenorphine, however, is known to cause a milder withdrawal syndrome compared to methadone and for this reason may be the better choice if opioid withdrawal therapy is elected.

Non-pharmacological Therapies
Effective treatment of drug addiction requires comprehensive attention to all of an individual’s medical and psychosocial co-morbidities. Pharmacological therapy alone rarely achieves long-term success. Thus Suboxone® and Subutex® treatment should be combined with concurrent behavioral therapies and with the provision of needed social services. This point is of such importance that physicians must attest to their capacity to refer patients for counseling when they submit their Notification of Intent to SAMHSA to begin prescribing Suboxone® and Subutex®.

The choice of treatment setting in which to provide non-pharmacological therapies should be determined based on the intensity of intervention required for a patient. The continuum of treatment setting intensities ranges from episodic office-based therapy to intensive inpatient therapy. For more information on this topic refer to the American Society of Addiction Medicine’s Patient Placement Criteria (ASAM PPC-2R, (www.asam.org), the most widely used and comprehensive national guidelines for placement, continued stay, and discharge of patients with alcohol and other drug problems.

Many different types of behavioral therapies (e.g., Motivational Enhancement Therapy, self-help programs) have been used successfully for substance abuse disorders. The SAMHSA Treatment Improvement Protocol (TIP) series (http://www.treatment.org/Externals/tips.html) includes a number of documents that contain best practice guidelines for the provision of interventions and therapies for individuals with substance abuse disorders.

Opioid Addiction Therapy with Buprenorphine
This section provides a brief overview of the clinical use of buprenorphine (Suboxone® and Subutex®) for opioid addiction therapy. For detailed information on this topic see the Buprenorphine Clinical Practice Guidelines (available soon).

Ideal candidates for opioid addiction treatment with buprenorphine are individuals who have been objectively diagnosed with opioid addiction, are willing to follow safety precautions for treatment, can be expected to comply with the treatment, have no contraindications to buprenorphine therapy, and who agree to buprenorphine treatment after a review of treatment options. There are three phases of buprenorphine maintenance therapy: induction, stabilization, and maintenance.

The induction phase is the medically monitored startup of buprenorphine therapy. Buprenorphine for induction therapy is administered when an opioid-addicted individual has abstained from using opioids for 12–24 hours and is in the early stages of opioid withdrawal. If the patient is not in the early stages of withdrawal, i.e., if he or she has other opioids in the bloodstream, then the buprenorphine dose could precipitate acute withdrawal.

Induction is typically initiated as observed therapy in the physician’s office and may be carried out using either Suboxone® or Subutex®, dependent upon the physician’s judgment. As noted above, Buprenex®, the parenteral analgesic form of buprenorphine, is not FDA-approved for use in opioid addiction treatment.

The stabilization phase has begun when a patient has discontinued or greatly reduced the use of his or her drug of abuse, no longer has cravings, and is experiencing few or no side effects. The buprenorphine dose may need to be adjusted during the stabilization phase. Because of the long half-life of buprenorphine it is sometimes possible to switch patients to alternate-day dosing once stabilization has been achieved.

The maintenance phase is reached when the patient is doing well on a steady dose of buprenorphine (or buprenorphine/naloxone). The length of time of the maintenance phase is individualized for each patient and may be indefinite. The alternative to going into (or continuing) a maintenance phase, once stabilization has been achieved, is medically supervised withdrawal. This takes the place of what was formerly called “detoxification.”

Hello!

I just received 6 viles of temgesic but they are only .3 mg each. Is this useless to me?

Thanks for any help you may be able to give!!

Also, I wanted to use it to help the w/d process from Hydrocodone.

Nikki

Where did you get them from? How did they work?

It may already say this above, but how would one use temgesic to taper off of hydro (if I can ever find a source for it)!

I know there's some kind of step-down routine, but I don't know the doses needed (which I sure vary).

I have a friend who is on Suboxone. It is Buprenorphine in the pill form . It is dissolved under the tongue. He is on 8mg 3x day. He gets it from one of the certifed doctors . I will get more info if anyone wants it- there is a website where you can find a Dr. in your state (city) to prescribe it. The only thing- it is not only in my state, but Insurance do not pay for the fee of the physician yet but DO pay for the actual prescription. He pays $150 every 2 weeks to see the Dr. and his insurance covers the script.

I went to the website before, I think it it SAMHSA.GOV
I will post again tomorrow....will get more info. Or PM me ...I know more, but am in a bit of a hury now.

After a 3 part back surgury I was put on perc's then tapered to lortab 10's. The I decided I didi not like being filled with opiods. Please understand I made this up (the step down off wd's)not the story. If I cut down the Lortab 10's I got the WD's.

I ordered some temgesic back when it was available, it worked awesome and it was long lasting, no euphoria, but I felt great not having any form of WD's started 2 under the toungue x 2 day (total 4) a week later dropped to 3 day, then 2, then 1 and I saw in a movie you always take you last pill, drink, whatever your poision and flush it. I did (mental thing).

These are great and am sorry they are not more widely available. Pills for a while had a hold on me, the tems made where I could reverse it. Even if you took 5 - no euphoria - no abuse.

Feel free to PM me if you have questions except where did you get them It is gone (and left w some people's $$)

ashpup

Interestingly, buprenorphine is supposedly remotely used "off label" as an anti-depressant and that perks my curiosity as any other opiate would over time very likely cause a depressed person many additional problems, even if it did initially ameliorate their depression. So this makes me wonder, how long would it take for a person on bup to need to up the dose to retain the same effect? I am sure it varies depending on whether one is on the micro dose Temgesic .2 mg type or the full-on suboxone multi milligram type. Opiates generally don't take long before they fizz out and dosage needs to be upped. I guess many ofthe SSRIs poop out too, but not nearly as quickly and not with everyone.

Ona side note, I have seen lists of drugs that are used "off label" and some drugs companies make extraordinary claims, a few meds seem to be good for practically every illness, and I can only guess that the drug companies are either very hopeful or outright deceitful when they suggest such a wide array of uses for their new products. Gabapentin for example is supposed to be good for so many things it is doubtful that the company making it is honest. There are even lawsuits against the makers of gabapentin claiming the company is excessive with their off label suggestions.

On a side note on a side note, I read (sorry link lost) that small amounts of Tramadol (Ultram) will be added to some well known antidepressants to augment the supply of serotonin in the brain synapse, creating a new line of more pOwerful, quicker acting antidepressants. It seems that there is no consistency in the latest research in drug development and my guess is that they really do not know what they are doing, sometimes they just dump the drugs on people and see what happens. Yikes!

What would be a reasonable price to charge/pay for the
8mg Suboxone.

On an international site they were selling Temgesic; 100 .2mg tabs for $200, so a
.2mg Temgesic costs $2.00 per pill.

Using that price as a guide

Suboxone 2mg would cost $20.00 per pill and the
Suboxone 8mg would cost $80.00 per pill

That sounds ridiculous but if you mess with the math at the International site and change the 100 .2mg tabs to 1 20mg tab (100 X .2= 20), that's paying $200 for 2 1/2 8mg tabs.

I'd be willing to put up with the withdrawal symptoms if I could get that kind of money for my meds.

JP

I payed 370.00 for 30 8mg pills

Why dont you go to a certified bupe doctor and get a script? There have been posts here about temgesic vs suboxone. I have a lot of experience with both and here is my advice: The doctors who prescribe buprenorphine (suboxone) are only required to take an 8 hour course to be certified. I took the course and it is amazingly weak. The doctors are, for the most part, uneducated in the proper dosing. The rule with bupe is that LESS IS MORE (DONT go chasing a buzz with this!! it actually is an agonist at small doses and more of an antagonist at larger doses. SO, your best chance for feeling good from bupe is to take SMALL doses). In other words, those .2 mg temgesics DO work. When you go to a bupe doctor they will put you on anywhere from 8mg-32mg's per day for up to a year! this is WAY overdosing. If you go to a sub doctor and get the 8 mg pills, try breaking off a small piece and letting it dissolve under your tongue for [censored] long as possible. wait an hour and see how you feel. if you are still in withdrawals, take another small piece and wait. (I forgot to mention, you must be in mild withdrawals before you start or the bupe will put you into withdrawals and it wont be pretty. Also, the naloxone mixed in with the bupe in Suboxone will have ZERO effect on you sublingally or orally, if you happen to swallow some. it only has antagonistic effects if administered IV)).

Anyway, I think the cheapest, best route is to find a bupe doc if you can and get the script for the 8mg's and make them last. The final piece of the puzzle is to get off of them ASAP. As in 2 weeks MAX. If you stay on over a month, you will need to do a 6 month taper to get off of it and it WILL BE DIFFICULT. Bupe withdrawals (if you take it too long) will be MUCH worse that regular opiate withdrawals and can last months, instead of days. So, this drug is a miracle drug for getting off opiates if you take small doses for a short period of time.

It's hard to give this kind of info when it goes against what your doc may tell you. I'm not a doc, but have reviewed over 1500 case studies and taken the same course they take. People wonder why the .2 temgesics work while epople are prescribed 8mg-32mgs a day by a bupe doc and it's because they are being overdosed and this will lead to bupe dependence and, ultimately, a bupe withdrawal nightmare.

When I used bupe to get off a SERIOUS hydro habit (started with legit pain, but got way out of control as in 60+ norcos a day, I made an 8 mg suboxone pill last 5 days. at the end of my detox, I was taking pieces of suboxone the size of a crumb, and they worked!!, then, it was easy to step off the drug and get on with the real battle - staying clean!.

Sorry to ramble, but tis drug is HIGHLY misunderstood and misused. Please PM me if you are interested in going this route and I will help you out the best I can. My first piece of advise - get the drug from a certified doctor and not from an IOP if you can. In the long run it will be cheaper and healthier (you should have your vitals monitored and have a doc make sure you're not mixing bupe with counterindicated drugs ie: benzos).....

enough rambling. PM me if you want and if you're sick of opiates and feel you need to get off, please reach out to me and I'll help..
-bcousin

cousin:

You are so freakin right about the tems/bupe in small doses. When taking the .02 tems, I would put 1 or 2 under my tounge. When I got the 8mg suboxone from the doctor, I took a whole one and I think I had an out of body experience so after that I took only a small portion of the 8mg pill and it worked perfectly.

ReOkie

I have trouble taking them under the tongue. No matter how long I wait they put me in Wd's. I have started them again after 14 days of taking hydro. I felt nothing from the hydro no matter how many I took. I started the Subox yesterday by just swallowing half of an 8mg It takes the Wd's right away. So I figured I would let my body get use to the Subox then try them under the tongue. I just get to sick when I dissolve them. They must have some affect swallowing because I haven't had a hydro in about 18 hours and I just have a little bit of sweating. No runny nose no runs. The last time I did the subox I could barely pick my legs up and my back hurt so freakin bad. Maybe The subox is still in my body. I hope because I want to stay clean after the fourth time trying to do it by subox. I just don't understand why I get clean then put my body through the WD's again.

yumbo,

i'm glad you're feeling ok, but the suboxone has nothing to do with it. It CANNOT be absorbed through the stomach lining. Swallowing suboxone has the same effect as swallowing a rock. you will get NO medical benefit from it. Maybe you just are having an easy go of it?
As far as suboxone putting you into w/d's no matter how ong you wait to take it, you may be taking too much. Too much on your first dose can have terrible sickening effects. That's why it's important to take a little at a time with 1 hour breaks till you feel good.
Everyone is different and suboxone does not work for everyone (I think it's around 2% of a French study where the suboxone did nt have the desired effect). But, I am sure that swallowing it is not doing anything for you. maybe the magic power of your brain is making your w/d's ore bearable.

I have a question: you say when you take it sublingually you can barely lift your legs. Are you taking clonodine too? if so, dont. you dont need it. It lowers your blood pressure and has that exact effect on your limbs. you also said you back hurts when you take it that way. Is back pain your main problem? Sublingual bupe isnt much of a pain killer (the injectable ,pure form of bupe is). maybe that's your pain returning?

All I can say is please dont waste anymore by swallowing it until you've found the proper way to feel good taking it under the tongue. you'll want those ones you swallowed back.....

best
cuz

I was actually prescribed Suboxone to get off of Tramadol.

I had an enormous Daily intake of Tramadol.

Through a health care worker friend I found my Bupe doctor.

I went to the ER and the doctor met me there and admitted me for 5 days.

I was put on 2mg every 4 hours for the first 48 hours.

I kept insisting that the withdrawal I was experiencing was just as nasty as usual. I didn't seem to feel any lessening of W/D symptoms.

After about a day and a half of this misery the doctor upped me to an 8 mg tab every 8 hours.

The doctor happened to be in the room when the nurse brought me the 8mg bupe which I promptly swallowed.

The doctor was quite upset that the nurses didn't know that I was supposed to dissolve the tab under my tongue.

He immediately had me dissolve another tab the proper way.

I began to feel better almost immediately. He didn't reduce my dosage back to the 2mgs even though they might have worked had I not been swallowing them for the last 36 hours so I really don't know if the 2mgs would have been enough to ease the discomfort of w/d.

Unfortunately the Suboxones are crappy pain killers so after about a month of the Sub., my Sub doctor put me on Methadone until after my pending back surgery.

I would definitely say that Suboxone is a wonder drug when they are taken properly.

JP

I was going through Wd's 2 days ago sweating looking bad. I had half of an 8mg left from before. I kid you not I swallowed it and I started to feel myself, better in 15 minutes. I hear what you are saying but I feel fine right know swallowing it. I was going to melt one under my tongue tomorrow to see what happens. I am not taking the clonodine. The very first time I tried to quit I used that and it just slowed down my heart. I could not even fuction. I still have some left. I was telling the doctor about swallowing and he said that he has heard of it working that way for a small percentage of people. The first time I stopped I had the .2mg ones I followed the directions to the T. I went into Wd's a little then 1 1/2 hours later took another and wasn't great. I got sick at 2:00 am throwing up so bad. I just hope I can stay off. I tapper down pretty good. I cut and cut and cut that 8 mg pill so it is as small as I can get after a few days. I just hope no WD's when I stop the Subox. See Ya J

However it's happening, it's just great that you're feeling better. It's such a new drug that we're learning more about it everyday. I'm glad it works for you when swallowed, but I would just caution anyone reading this that you are a rare exception. Best of luck to you and I hope you continue to feel good

cuz

Just changing the title back.

Although it isn't supposed to be swallowed, there are probably some type of mucous membranes between the mouth and the tummy that absorb some of the medication.

JP

there is an oral form of temgesic overseas that subosedly is not suiblingual.
I did not know this could exist/.

Dont know if anyone is interested in this still since the thread is quite old.

Previous experience tells me this.

Tabs come in 0.4mg 2mg 8mg tabs. Sublingual, under the tongue and disolve. Works within 10-20 minutes.

I advise anyone who uses actual Opiate based products whether that be Heroin to Methodone, Oxy or even DF118 or just Codeine to go without and do a little turkey for a few days until you flush the opiates out from your body (usualy day 3ish). Once taking Subutex (its called in England) or Buprenorphine it will immediately start to block ANY opiates within your system. Anyone there will now understand that you may go into withdrawel and end up clucking.

I switched from methodone to subutex (synthetic opiate) - 3 days I left it and I was in AGONY. NOTHING TOOK THE PAIN AWAY. I wouldnt want it to happen to anyone else.

All the best to whoever tries this drug and has used opiate based products before. Changing to Synthetic opiate based products such as this is much more "clearer in the mind" if you know what I mean.

I'll be happy to discuss this - but the French have been using this drug for years - so perhaps find a french board and ask some questions???

E

Halo from Athens Greece
Just find this fantastic forum I write other time because i must live now Just i say here in Greece we have many problems.......................I WANT HELP!!!!!!!!!!!!!!@

Jig

PS
sorry about my english

Happy New Year from Athens Greece

Just one of the clinical studies which I have personally witnessed these results, I have many more but must dig through my archives a little deeper.

At the receptors: (Per my research) In a clinical setting a few years ago (2001/02.

Bupe has a high affinity at all 4 major opioid receptors (mu, delta, kappa,
and ORL1) (Miller,Bourne.el 2001, (1))
Order of affinity (How much attraction to and how tightly it binds to each
receptor):
mu > kappa > delta > ORL1
(delta has about 30 fold less affinity than mu)
Bupe is a partial agonist at mu, delta, and ORL1. It is a full and potent
antagonist at kappa*. (J.Bourne,Miller 2001) It's efficacy at the receptors
is related to dose. The higher the dose, the less efficacious it works, (1)
until it reaches a dose (~32mg SL) where increasing it any more would make
it work less efficacious, although more data is necessary. (See Bupe and
Dose)

Order of efficacy (how strong it works as an agonist):

ORL1 (34%) > mu > delta (Miller,Bourne., 2001,)
The fact that it is efficient at ORL1 is very significant; as I don't think
any other traditional opioids can stimulate ORL1 (this definitely includes
morphine and heroin.) Unfortunately it has a very low affinity for it, which
would require large doses to create a significant effect there. Fairly large
doses have been attempted in limited studies with no interesting results,
other than the apparent reversal of agonist effects. (Bourne) I Believe ORL1 has
been shown to have similar effects to mu. Describing ORL1 is beyond the
scope of this document and my knowledge.

* There is a lot of conflicting studies in regards to kappa. Some say that it
does indeed produce kappa agonism. This isn't the case, I'm fairly positive
of it, but I'd like to know why this is. It possibly has something to do
with in vitro testing, however the in vitro testing summary (Miller,Bourne et al.,
2001) has determined bupe to be a kappa antagonist. I look forward to
finding further information on this, as always, for the next version...

Bupe has an extremely long half-life at the receptors. It takes about a
month for the drug to be completely removed from your system.

Finally, Buprenorphine has a major active metabolite, norbuprenorphine,
which has activity at the receptors,See metabolism for more information(J.Bourne)P.2232 LLMA Subjective analysis)

General Pharmacological Information:

Bupe has a slow onset of action, with peak effects taking place in
approximately 100 minutes. (Suboxone full prescribing information.) The peak
effects for methadone take place in approximately 120 minutes (VERIFY.)

Bupe readily crosses the blood brain barrier, and is highly lipophilic.

Bupe is about 10x more potent IM than PO (oral), which is about the same
ratio as morphine. You CAN eat bupe, although there is no reason. Nor should it be done in this manner..Sublingual absorption varies greatly, and can be anywhere from 25%-75%.~ The same percentages can be applied to an IM/SL potency comparison. However,
in most people, their personal variation from one dose to another is low.
(Subutex full prescribing information)

A comparison of bupe to 'done for respiratory effects found that bupe had a
much higher incidence of respiratory depression *not* requiring medical
intervention. Bupe can cause respiratory depression, but *very* rarely
anything resembling life threatening. Both drugs decreased 02 saturation to
the same degree. The chances of severe respiratory depression are increased
via the injection route. (Suboxone full prescribing information)

Bupe is a very safe drug for an opioid. Overdose is very difficult, even for
opiate naive individuals. (Subutex full prescribing information)

Buprenorphine is approximately 96% plasma bound, primary to alpha and beta
globulin (Subutex full prescribing information)

Bupe has a mean half-life plasma elimination of 37 hours.

I can take 2mg suboxone at 6am and at 2pm I can take a CII (morphine, oxycodone,fentanyl,etc) and the CII’s will clear the receptors within 30 minutes.
But if I use a CIII as hydro it makes me feel worse.

This is per my research, others may vary.

.2 temgesic IS NOT THE SAME as suboxone.

There is no equivalency.

2X .2 temgesic, twice a day will give you no WD's even with a 200mg hydro tolerance.

Do not think that Tems and Suboxone or Subutex are interchangable.

As anyone who is on suboxone treatment knows, they are very expensive. Does anyone have experience with ordering them from an online pharmacy WITH a prescription? Or any generics available at a lower price?

Thanks for any info.

Temgesic has a fraction of the medicine that Subutex does.

Also, Temgesic comes in an injectable form, whereas Subutex is sublingual tab's only.

Thanks for the response, dmg. The potency is the only difference? This is also the conclusion I came to but wasn’t sure after I read leontes’ post.

i had a friend who used marijuana to get off hydro and oxy it helped him a ton those few days after because it surpresses nasea and helps stomach pain and the headaches but now she just smokes at bedtime so she is still addicted to something but that once every night cant hurt her body as bad as the oxy was 3 times a day but shes doing it illegal no medical thc in my state

Please this is misinformation to compare the potency of Temgesic and suboxone. They are DIFFERENT drugs that do different, though similar things. Temgesic 2 mcg's twice a day will eliminate a 200 mg hydro tolerant WD. And the weaning off the .2 tems is MUCH MUCH easier than getting off Suboxone.

It is simply not true that it takes 40 .2 tems to equal 1 8mg Sub. I don't have the time right now to link to the equivalency page, but it is easy to find.

Who's doing that? We were comparing Subutex, but not Suboxone, and still, even at that, we were saying that there are major differences between the two...so what's the deal?

Leon, what is the difference between the three drugs, Temgesic, Subutex, and Suboxone, other than potency and Suboxone has naloxone. This is my confusion. Aren’t they all buprenorphine? Is Temgesic a more potent form buprenorphine which explains the lower dosage?

Thanks for the response anyone!

Okay, I am going to risk talking to myself and answer my own question.

The only difference between the three drugs (besides naloxone in Suboxone) is potency. The lower dose is marketed as Temgesic and the larger doses as Subutex.

If you can show me any information to the contrary, leon, I would love to see it.

Bupe is Buprenorphine is Temgesic is Buprenex (injectable form .3mg) is subutex!
Even Suboxone is buprenorphine with a 45 minute active ingredient (Naloxone,full antagonist as Narcan).

Naloxone (pure antagonist) is only active for the first 45 minutes ( to keep people from injecting it), otherwise suboxone is pure bupe also!

The main problem most people don't realize it is because they take too much of subutex and suboxone.

"Less is Best" when it comes to any form of Buprenorphine.

If you go to an addictionologist they will most likely start you on subutex (doesn't have the naloxone).
Although most pharmacologists, psychologists, and addictionologist will most likely tell you that the Naloxone in Suboxone is inert and will only effect you differently than pure buprenorphine is if you inject it.

Well, those that have run this gamut know these doctors also know this is pure propaganda.

Take 2mg of suboxone only 12 hours since your last dose of opiate. you'll be sicker than you'd ever thought possible.

On the otherhand after taking your last hit 400mg of oxycontin wait 8 hours and take a temgesic or buprenex or subutex and it will be a much more pleasant experience.

But, the key is, only take a minute amount! Don't take that whole 2mg (or, even worse that full 8mg suboxone)which the doctor just prescribed you and advised you to take it 12 hours after your last dose of a full agonist!!!!! 1/4 of a 2mg subutex or a couple .2mg Temgesics is all you will need.

Remember, less is the only way to take any form of buprenorphine...

As long as you take a very small amount of anykind of bupe (although, I wouldn't reccommend taking suboxone within 18 hours after your last dose of a full opiate) you can take any full agonist within a few hours without ANY ill effects.

The worst thing that will happen is that your full agonist probably won't work as well due to the MU receptors being taken over by the antagonist portion of the combination agonist/antagonist of buprenorphine.
Although morphine will knock the antagonists off the mu~ completely if a large enough dose is taken.

paullback, what are you trying to say? Most of your post is correct, but not all of it. Doctors dont prescribe people to take 8mg of suboxone 12 hours after that last dose of hydro,oxy, whatever it be. Doctors TITRATE your dose up. plain and simple. yes, you will get sick if you dont give it enough time. People, wait more like 18 to 24 hours after the last dose before they start suboxone. and they start out small--like 2mg then maybe 2 more that night or something. next day 4mg and 2 at night or something and then 6 or 8 by the next day. sorry. close but no cigar. and sheesh, once yer on it, yer on it. less is more. well, do whats right and if you end up taking 16mg a day then so be it. after a while, you can step back down. dont be afraid. bone

Bone,
Yes,absolutely most doctors wouldn't dare put there patients on 8mg of suboxone to start!
But it happened to my friend in Cincinnati and not just 8mg but 32mg to start. It was the VA hospital and he wanted to get the highest dose possible so he asked the doctors to prescribe that much. They held him at the VA overnight after giving him 8mg.,after a urine test the previous day. the next day they RX'd him 8mg 4x's a day right off the bat (32mg per day!).

This was when suboxone treatments were in the embryonic stages and were using VA.hospitals as testing grounds back in 2002 just started.He (my friend) had plans on getting the huge doses prescribed so he could take what he needed for himself and selling the balance in order to try and make a little $.

He titrated his doses of Temgesics up over a four week period prior to getting his first visit so he would be able to handle 8mg at once.
Yea, he was going to make allot of $ selling all those 8mgers. Well, that tactic didn't work out very well, to say the least!

But NO, It would be a rare occation for a dr. to RX a new patient that much under the current prescribing standards.

I think it is common practice for a doctor to prescribe an initial dose of Subutex or Suboxone at 8mg or higher(daily not at once) as an induction and immediately taper. This is if the medication is being used for opioid withdrawal. I am sure doctors use different prescribing methods, but it is certainly not uncommon to have a high initial dose. This is my understanding.

well, Im sorry for your friend. the embryonic stages, yes. I believe sub has been fda approved since 2002 or 2003. It truly is a unique drug and works a little differently than most. I hope your friend didnt have to suffer to much doing that. Sorry it didnt work out for him.

Yea, there is alot happening in the world today.Suboxone is still being learned about and how best to deal with it and stepping off of it. I read somewhere where they are also starting or looking into making other drugs similar to suboxone. something like oxcodone mixed with naloxone or bupe or something. Im sorry, I just cant remember what, but it was a partial agonist just as sub is. Perhaps giving the same results as suboxone, but dealt with much easier to step off of. Im excited to see the future in these certain medicines. take care. bone

I had very bad side effects from the suboxone unstoppable vomitting, nasea, dizziness, lethargic feeling like i was gonna die i couldnt drive or do nothing, the doc said take one 8mg one a day, well i cut it half still same problem, then i tried a quarter of it did nothing, needless to say i went to the ER for withdrawl symtoms they treat you like [censored] but they gave me Methadone now that made me feel much better and happy without cravings for hydro. I cant find a doctor to prescribe it though, anyone know anything about that? Thanx for any help

I know everyone and every situation is different.
I've heard of hard core IV users starting out at 8mg 4x per day.

A very good friend had 8mg prescribed first visit and was told to titrate either way depending on how it worked for her.

The Dr started her out on suboxone only after 24 hours clean (so she said!),but indeed wasn't. She'd used the previous night, IV. She took her first 8mg the following day,16 hours after her last pure agonist. Needless to say she lay in bed in horrible w/d's for 3 days. After those three horrid days she finally felt ok then to feeling great.

After much research I told her doc that she should have started my friend on Subutex for the first 48 hours and then changed her over to suboxone. this (know it all) doc told me that there was NO difference between suboxone and subutex!

When I started my treatment program I called several doctors and after explaining my particular situation asked the doctor what his protocol would be considering my situation.
After three doctors I finally found the one that suited my taste. He prescribed 2mg of subutex (NOT suboxone) for the first two days at 2mg to start and titrate to the necessary dosage, then switched me over to suboxone on the third day to 2mg every 6 hours. But had found my optimal dose at 1mg every 12 hours.
After four days I cut my dosage in half and felt much better but told the doctor 8mg 3x's per day worked the best so I could have extras in case of emergency.
I'm finding that 1/3 of a 2mg 2x's per day (at most) works the best.

Hence;With buprenorphene "less is best".
And make sure your doc starts you out on subutex rather than suboxone for at least the first two to three days before switching you over to suboxone.

Although suboxone will work ok at first dosing as long as you've given enough time between last full agonist and suboxone!(24 to 36 hours clean)..

I still wish they would legalize temgesic (.2mg) and .3mg buprenex IV in this country!
But we all know this country will never approve of subscribing an injectable (.3mg buprenex).

my doctor knew i took hydros the day before taking the suboxone no wonder i got so darn sick 8mgs at once, i never finished them or went back and i did real good for like 4 weeks then i got real depressed and went back to my old ways and its worse than ever, maybe i should talk to the doctor about the subutex what exactly does that do and what are the side effects from it??

Believe me SJZ I know exactly what you're going through.

Hang tight until someone answers your post. I'm sure there are many qualified members that can help you.
I will give you my advice tomorrow night, I have to be somewhere an hour ago. But you will be ok.
Hang in till someone gives you good advice. I'll answer your post tomorrow night.

Luck be with you, just hang tight.

Well, with premise out there that this stuff reacts differently to everyone, I offer another experience.

I've found that I can take an 8mg dose of Suboxone only 8 hours after the last dose of DOC...being Hydro. This is done with zero ill effects at all. I imagine that part of it is due to the fact that my tolerance to my DOC is so high, that withdrawls set in (albeit very very subtle withdrawl symptoms - the very first stages) only 8 hours after doses....so perhaps this is why the Bupe is able to get to the receptors and cling on very easily, as the remnants of the DOC are gone by that point, and therefore there is no fighting for the receptors.

Again though, this is only my experience.

Also, personally, my understanding of and personal experience with Suboxone is that the Naloxone truly is rendered totally ineffective when taken orally(sublingually). The naloxone in Suboxone is only triggered when taken IV, and therefore, I've never had a problem with it. I think a lot of people attribute these types of problems(Suboxone causing people to get sick i.e. throwing into withdrawls) to the Naloxone alone. But what you have to keep in mind is that Buprenorphine is itself a mixed agonist and antagonist, depending on the amount taken and the opiate-tolerance of the user. If you take Subutex in high enough doses and your tolerance to opiates is at the "right" level for this to occur, you'll get thrown right into withdrawl...or have the ability to.

Of course, again, Bupe does in fact react differently to each person who takes it. There is no across the board definitive way to predict how each person will react to whatever dose of whatever form of Buprenorphine.

But what is a rule that can apply across the board is that "less really is more" with Bupe. Of course, as Bone said, this doesn't mean that taking more is going to be harmful or anything. But starting low allows users to find the lowest possible dose that is going to work for them which cuts down on costs, and on these instances of forced-withdrawl...for the most part.

Warning: I am barging in here!

Dmg and Bone~~I missed it if you even posted but I am curious to know if either of you posted about your experiences with suboxone when you first started using it or even deciding to use it?

Yes, I could use search and go back and back but that to me just doesn't seem right. I know I have searched people before for other reasons but unless you tell me a date to start looking for and to search that way, I would rather not.

Did either of you document your experiences here? How about on the VIP side? UI would LOVE to read it if you did.

Twins,

No, I didn't document it really in detail or anything, just random posts where people had questions or comments and I felt my experience applied, so I shared.

But I'd be more than happy to recount the experience, the ongoing experience, as its still relatively recent and on my mind.

I believe that Bone did document some of his experiences...and they are great posts...

Okay, I lied, and I found a thread I started back in October about the beginning stages of my treatment....and like I said, I'd be more than happy to fill in how its gone since!

http://www.epharmacywatch.com/freeboard/...true#Post334755

Twins--I know I did document some here and there. I cannot for the life of me remember what thread it was in. Probably several, to be honest. But I too, would be happy to "re-tell"my experience. Ill come back this evening and post it.

From day 1 to current. It was all relatively easy and smooth transition. Ill keep it rather short.


Paullblack--yes, that must be it, that oxytrex. I have done zero research on it thus far. I just remmeber reading something about it was all. Suboxone is kind of tricky but sucessful. Im thinking they are trying to smooth out the edges with this type of wonder drug. It would be great to have a drug with this type of success and yet be very easy to get off of at the same time. Or just something that did the job in a quicker manner and allows the user to take without fear of withdrawls from competition--no matter what opiate they are/were taking. I need to do some reading on the oxytrex. Would be very interested. Ill recollect my days tonight. Hopefully it can help someone. take care bone

thank you for your sincerety and concern, i definately do not want to join a government clinic place. I tried different doses of suboxone but every time i got sick. I went to the ER where the gave me 2 methadones to take I felt great withdrawl symptoms were gone, I was calm and happy,pain free. At my worst I take about 150mgs of hydros a day. I need to get away from it. Thank you for any ideas

Well Twins--this is how it was for me. I took my last dose of hydro on a Sunday at like 11am or something(I cant remember, ive told this before, but somewhere around 11) anywhoo, then Monday morning at 1030am I took my first dose of suboxone. It was 2mg. He had me hang around(I just drove around town)for 3 hours and then came back to the doc office and he gave me another 2mg at 130pm. I still had 2 more of the 2mg pills left and he told me I could take them at night if I felt discomfort. That night at like 7 or so I did take another 2mg. He had sent me home that day with another script. So that night I also filled it. I came back on Tuesday at 10am and he gave me 4mg. 3 hours later another 4mg. I had some more and he said the same thing if I felt discomfort. I did not take any that night. So, Wednesday comes--Im there at 10am again and he gives me 8mg. then sends me home. with a new script and all.

The first day of suboxone was ok. I still had minimal aches and pains. But on Tuesday after I took that first 4mg, felt perfect and have remained that way since. Its just truly amazing how effective the suboxone is/was.

After trying over and over to taper and go CT and feeling those withdrawls each time, I just couldnt believe how good I was feeling from the suboxne. oh well, the rest is history for now. take care, bone

Bone,
I never get tired of hearing success stories with Suboxone/Subutex/Bupe.

I've never seen nor heard of anyone where some form of Buprenorphine didn't help "tremendously" people stop all forms and doses of full agonists. I've heard of people with 500mg Oxycontin Monkeys on their back and after two to three days on Suboxone/Subutex/etc they all feel/felt like they were (re)born into a new young body. And all felt wonderful after the first couple of days on Bupe.

I believe it really is a miracle drug.

It's all in finding the correct dose.

Now, "PAWS", coming off bupe can be as bad as with a full agonist. But there are new drugs and methods out there today that will help getting off the bupe also. These drugs and methods were not around until a year,or so ago.

Good luck to all who are either on or try Bupe to get off Opiate agonists.

Quote:

---

I have tried to stop taking bupe MANY times and its 75% as bad as methadone. (this is after a couple of years of using bupe)

well, I can only hope that coming off the suboxone is NOT that way for me. Everyone is different, so I dont worry too much. Regardless of what I hear or read. So, I will take is very very very slow to step off this drug. Ill expect maybe some discomfort but for the most part if you step so slowly off you shouldnt expeience too much. and Ill keep that frame of mind too. thanks! bone

---

I think the key is don't stay on it for very long. It's such a long acting drug, the real problems don't start for a good week after the last dose. Not too many claim to succeed remaining drug free after subutex/suboxone. Don't get me wrong I really hope it all works out exactly as you want. I posted a link for some accurate info.


Bupe info

heres some information ive found- http://opioids.com/buprenorphine/buprev.html ..my question would be coming off of hydro and using the .02 buprenorphine[which i have],what would be a good starting dose and how to step down from there?approx how long would the step down take? any info would help..thanks p.s. i do believe i have enough .02 to follow some sort of regimen.

A little off topic but, does nubain have any of the properties that bupe or subutex has?

yes, it does. nubain attaches to kappa receptors in the stomach, and it has some agonist properties. it also has been shown to work much better for women than for men.

that is all i know; there are folks here who know the chemistry of these drugs much better than i do.

Does anyone know where/if you can get Suboxone online? I've used it before through a doc and it worked wonders, but made a stupid mistake and here I am again... It would be alot easier to just order it with my hectic schedule, if anyone knows a reputable place, I would much appreciate it. Thanks guys!

I'm sure that day will come when you can purchase it online but today is not that day. TheMedMan

ps...If you would like to find a doctr in your area then try this link locater.

www.suboxone.com

Good luck... :thumb-up:

I am new to temgesic, i am a chronic pain suffer and have neck and back injuries from a car wreck and have to have doulbe shoulder surgery next week{{one at a time}, after that is over i want to quit for a while, i take at least 100mg of hydro a day and have been for a while, i got some .02 temgesic to help me with WD, i am SO confused about dosage and is this enough mg wise, how many .02's equal 1 mg 5? i have 130 count of them, what i need help is a sernario of what how and dosage, sounds like i wait 24 hours then take can someone please take a moment to help me with a simple plan, as this is very confusing and a lot of mis info on the net. My plan is to get thru the WD from hydros then quit the temgestic when it is ok to do so, they see were my pain is out without. please help me with a plan! i did read all 3 pages, but still need help..

I think you got the 0.2mg, which is 200 micrograms. So 5 of those makes 1mg. So you got it right in the end!

So perhaps take 2 - .02mg after 24 hours or so then wonder how many more a day, i have been a somewaht heavy user, or since it works so fast you take 1 or so and if you dont feel well you take another and it works that fast? i am just worried, any sort of basic week or more plan would be great, thanks all.

Are you really sure it is 0.02mg and not 0.2mg? Because that would be an exceptionally low dose of buprenorphine.

this is what it is,USA Brand Name : Temgesic
Generic : Buprenorphine
Indian Brand Name : Buprenorphine
Dosage : 0.2mg

sorry i had it wrong this is from Raj with online solutions

the reason people get sick from suboxone induction is because they are being ODed on buprenorphine! Unless you are on a long acting opiate, you really don't need to be in withdrwal, as long as you take only a small amount,i.e. less than 2mg.

The technical protical for doctors is to start a patient with 4mg. That is what they teach the docors to do. THIS IS REDICULOUS! (Apparently they havn't heard of Temgesic and its effectiveness at only .2mg for curbing WD symptoms)

But the reason they use such high doses is because they are more concerned with bupe blocking the effects of other opiates, as opposed to simply preventing withdrawal. But they don't undestand how strong those doses are, especially to someone who is only used to taking hydros. This is why people sick, it is not precipitated DT symptoms, they are sick because they are on to much. Waiting longer than 12 hours won't do you any good. If you take 8mg for your first dose, and you only have a common hydro dependancy, you will get very sick

ok here is my plan? Like i said i use at least 100mg a day or more and have been for a few years of hydro, going to wait about 12 hours, then take 1 .2mg and go from there with the thought of maybe 4-5 -6 a day total taken. maybe every 5-6 hours does this sound like a fair plan? The hydros i use are the compound 15/200 type, and i have a high tolerance , i am nervious about this, but yet i am wanting to do it, but i dont want to over do it, or underdo that is why i thought i should come here and ask for some dosage help, i will only have about 130-40 of these , so if i do 6 or so a day i will have about a 20 days supply, and other times i quit on my own it seemed most the physical wd stuff only lasted 6 days or so, with the 5,6, day seeming the worse then getting better. I hope with taking this temgesic that the hydro leaves your body at the same rate of time, so after 20 days i should be ok at least with the physical withdrawl symtoms???
anyone?

I have been on Suboxone for about 7 months. I started because my Hydro use was out of hand. My tolerance was through the roof and so I was forced to take a break.

For a while i was using 16 - 20 mgs of Sub per day. This turned me into a zombie with absolutely no emotions. Over time, I was able to taper down to 2-3mgs of Suboxone a day.

Now, I am using Hydro again for back and shoulder pain. It workes the best. However, I usually run out of meds before my refills are due. I try not to, but I do. I am not going to run the risk of Double Dipping so I typically must go through WD once every 25 days and substitute an OTC pain med. This is actually good for me. it is about 5-6 days off.

So, now when I run out of Hydro, the first thing I do on my first morning W/O hydro is take a SMALL CRUMB (less than 1/2 of a mg) of Suboxone. Then I take another crumb about 3 in the afternoon. At night, I take 15mgs of valium. Total intake of Sub is less than 1mg.

The next day, I take just 1 crumb (just less than 1/4 mg) of Sub and the same 15mg valium program at night. Total days Sub intake approx .5mg.

On day three i take no Sub. I have almost ZERO W/D effects except for a little diarrhea (easily controlled with Immodium). For pain, I resort to advil (about 1200mgs per day). I begin valium taper this night. Down to 10mgs. By day 6, I am off Valium, Hydro and Sub with very little W/D symptoms. Then my meds come and cycle begins again. Hydro allows me to sit comfortably at work and focus. If I did not have it, I am NEVER comfortable sitting and it makes focusing on work very difficult.

With Sub, LESS IS MORE!

JMHO
~ Swizzel

If anyone has a good source for the 0.2mg tablets please pm me with some details if possible thanks so much.

Subutex/ suboxone saved my life.

If you have a PCP then go in and tell him you saw online that any doctor that can write a prescription can write a script "off Label" for Suboxone. I did this in Florida. My PCP wrote me a script for Sub 8mgs twice a day with 4 refills and my insurance paid for the meds. It would hurt to ask. Most docs do not know that they can write the suboxone script off label. Mine didnt until I told him I did research online and found out he didnt need the special DEA # to prescribe it, so he did. He just wrote that it was for pain and depression

I wish I could find a doctor that wrote Subs for depression.

Where do you live again?

This is my first post, so I hope I'm doing this right.
I feel that I am in the same "boat" as Swizzlestick.
I am going to switch from .02 mg of Temgesic, to Percocet5/500. I took my last Temgesic at 12pm today. Does anyone know how long I should wait to take my Percocet. I feel that if I do not wait long enough, the Temgesic could block the effects of the Percocet.

Any responses will be greatly appreicated!!

How much Temgesic where taking per day? If you were taking more than 5 (1mg of Bupe), and had been doing that for a while, then it will take a couple days before the percocet will help.

You might find yourself taking excessive amount of Percs to offset the Bupe WD's.

All depends on how much you were taking.

Thank you for your quick reply.
I've been taking the 2mg pills four times a day. I have only been taking them for 7days. I am planning on taking 2 percocets at midnight. And then go to my normal 3 percocets per day. Do your think midnight is too soon?
Thank you!!

Hi all... I have a few questions that don't seem to be mentioned in the thread yet.

I have NO opiate tolerance right now, on account of the stupid OCS situation generally, and what they have sent lately is total S, so called "hydro" but actually does little for my pain. (Those white mallies and those godforsaken pink things are extremely weak and not worth paying for, really.)

For the past few weeks I have been ODing on OTC meds, just starting with Kratom and Soma, to at least *some* result in pain management. The only "real" medication I've been able to acquire lately is the buprenorphine 0.2 mg, the Indian "Temgesic," which I guess is indicated for pain.
(I don't know how this is possible, that I am a genuine CP patient who can't get actual medication, only a med intended for addiction to the substance that I cannot even
get? What is that about?? It is F'ed up, is what!)

Anyway, I have been taking it 90% for pain control and maybe 10% to treat the minor hydro withdrawal, which is over now since it has been a couple weeks since my last (very weak and yet still so expensive!) hydro dose.


So, if you have no/little opiate tolerance, do you think buprenorphine can work for pain? And what would be an average dose? So far, I have been taking 3-4 of the 0.2 (So about 0.5 altogether) in doses a couple times a day. It has been providing some pain relief, but I am still having to chug Advil in dangerous amounts to keep the pain down that I can do anything or be active. I am a little nervous about taking more of the Buprenorphine, because...


It causes severe nausea. SOMETIMES. I can't figure this out. I have been taking it for several days in a row, and it seems like if I take it *with* food, it makes me really sick.

Has anyone else noticed this? That if you eat (at any time, really) while you are taking this, it makes you sick? I don't mind some weight loss (I have a college wardrobe waiting to be fit into again), but it's getting hungry over here on water and maybe 500 calories a day...

Also, someone mentioned that the pain relief lasts for only a week or so and then it stops working. Has anyone else had that experience, too?

I have been really careful with this med, as I read up on it and took note of its many horror stories.
I started with just one 0.2 and have gradually gone up as needed for pain. Yes, it is the 0.2 in little white tablets, and they are not sublingual.

That is annoying how they have a 0.2 and a 2 mg standard dose that seems to beg for confusion and overdose... And I DID wait until mild w/d set in before I took it. (It did relieve the w/d immediately, so it is doing something obviously.)

Anyway, I would really like to NOT die via Advil, am trying to reduce the anti-inflammatory use at least a little bit. If you take a higher dose of Buprenorphine, does it work better for pain. (At 1 mg or maybe 1.5 mg?)

The ER uses it forkidney stones at times and it knocks off my socks thru a iv there and doesn't effect the hydro i take until i jurt so nad it foesn'f work so er here i come!lol

I'm not into reacreational use, so I feel sub would be a waste on me.

I tried upping my dose to about 0.8, but still got very little pain relief. And it caused side effects like nausea. Can't imagine why it didn't have at least some benefit as an analgesic, which is how it is marketed.
A bummer and a waste of money. It's a complicated one, too, with all of this "Half Life Math" you have to do and
it potentially interferring with other pain meds.
I will not be taking this one again.

This thread hasn't been used for a while but it is right on topic with a question that I have been unable to answer after hours of searching. I have read several posts (on this site and others) saying that Temgesic is not nearly as good for opiate withdrawal as suboxone or subtex. I have also read several posts saying Temgesic is just as good if not better for Opiate withdrawal. So which is it??? I have used Suboxone to detox from opiates once before and what people say about less being more is very much true. I was just fine using 0.5 to 1mg per day (one dose in the morning).

I since had to go back on opiates but am ready to detox again, this time using Temgesic. With all this mixed informaiton I am wondering if it will be as effective as the Suboxone was. My instincts tell me that buprenorphine is buprenorphine and there should be no difference, however I've read in many places that this is not the case.

Anyone have personal experiences using Temgesic specifically for opiate withdrawal??

Buprenorphine is indeed buprenorphine but pay attention to the dosages. The most typical dosage unit I have seen for Temgesic is .2 mg. So, 5 of those would be equal to your previous treatment to get off of opiates.
I assume you are comparing the overall cost of Suboxone treatment with a US doctor to ordering Temgesic from a foreign online dealer?
I don't know how that expense compares but the opiate users I have seen switching from their drug of choice to buprenorphine would not be very happy facing the uncertainties of receiving drug shipments from some illegal off-shore shipper.
You should consider that lack of reliablity when deciding how you want to proceed with opiate replacement therapy. It can be a rocky road to try and self-medicate.

Thanks for the feedabck. Bottom line is it will take me a 2 weeks tops to be opiate free using bupe as a substitute. If I am able to acquire this minimal dosage from an online pharmacy it will save me a trip to the doctor, who in my opinion have less knowledge about bupe to begin with and prescribe way too much. Overall it would be a more streamline and cost effective process.

Temgesic = Subtex. good to know

i have severe refractory depression. i am considering opiate therapy. been looking at dried poppy tea. then started looking at buprenorphine.there have been numerous studies demonstrating it's effectiveness in treatment resistance depression. i know you need to stay on a low dose indefinitely. maybe i could take breaks and then take benzo's. is there an addiction at low doses-.02-2mg? forgive me if i seem a little naive about opiates. i've only tried Tramadol 50-100mg to no avail. my days are numbered, the depression and anxiety are horribly unbearable. would i be selling my soul to the devil for a few moments of peace? please help. ernie

You won't be able to dose at 0.02mg; the lowest unit doses are 0.2mg and are tiny sublingual pills.

Always lead; never follow.

But, poppy tea isn't a great idea since accurate dosing is impossible. The dose of buprenorphine required to treat depression I'm not sure about. Then there's finding a doctor willing to follow that route. An online source is fraught with problems since if they go under, you're going to be faced with withdrawal and rebound depression. So yes, there are addiction/dependence issues.

Have you ever tried tianeptine?

thanks for response. there's no online sources available. even at a low dose of 0.2, wouldn't the wd's be minimized. what about taking breaks/cycling before your body would get used to it and prevent wd's. i suppose it would be easier said than done but it has been done successfully before. how long does it take for the body to become dependent on opiates/ i've tried 90% of every ad, anti-anxiety and sleeping out there.nothing works. even the benzo's are not working anymore.i'm suffering from a severe endorphin deficiency. it's been like this for 2 years nonstop. i feel like i hold the world record for still being alive with no pleasure receptors. i'm in an impossible place, against the wall with a gun at the back of my head. i need emergency measures, there is no more time. i'm going to have to go the opiate route or experience the wisdom of the grave very, very soon. sorry for rambling. i don't have too many people to talk to. thank you for your kind response, ernie
ps by the way, how do i know if i received a response?

Click on My Stuff, and choose Posts. Then click each one to see who's responded. You may be able to set up e-mail notification, but I don't know how to do it.

As for how long to get tolerant/dependent, how long is a piece of string? All you can do is notice yourself when a medicine is losing its effectiveness, and try to lay off it a bit. The problem with these 'drug holidays' is that they can lead to rebound problems and other drug use.

I really do wish I could give you an easy answer, but there isn't one.

Anyway, have you ever tried tianeptine? I ask because it works in an exact opposite fashion to SSRIs, and is claimed to be more effective. If I was depressed, I would seek out this drug before any other.