Buprenorphine – Starting Your Treatment


Before taking your Buprenorphine tablet/film (Suboxone or Subutex), you want to feel lousy from your withdrawal symptoms. Very lousy. It should be at least 12 hours since you last used heroin or pain pills (Oxycontin, Vicodin, etc.) and at least 24 hours since you last used methadone.



When you start to feel lousy, you will start noticing “flu-like” symptoms. Do not be scared, this is your body’s normal response to the process. Wait it out as long as you can. The worse you feel when you begin the medication the better it will make you feel and the more satisfied you will be with the whole experience. You should have at least 3 of the following feelings as shown below:


Important: Put the tablet/film under your tongue. If you swallow the tablets/films, they will NOT WORK. The medication will only work if you allow it to absorb under your tongue.
  1. Once you start to feel lousy as shown above, this is when you will start your Buprenorphine medication. You will be given a 3-day supply of Buprenorphine, each tablet/film is 8mg.

  2. Start by placing ½ a tablet/film (4mg) under your tongue. It takes 20-45 minutes for the medication to be absorbed and have an effect. After this time, you may either swallow or spit out the remaining/leftover medication – do not worry, this leftover substance is now inactive. Do not eat, drink, or smoke for 15 minutes before and 15 minutes after you take your medication and do not lie down immediately after your dose, otherwise you will not get the full effect.

  3. If you feel good after ½ tablet/film (4mg), don’t take anymore, this may be all that you need.

  4. After 1-2 hours, if you are having withdrawal feelings (like the pictures above) and still feeling lousy, don’t worry, you just need more medication. Take another ½ tablet/film (4mg).

  5. You may repeat this process of taking 1/2 tablet/film (4mg) every 1-2 hours until you do not feel lousy anymore.

  6. You should not take more than 2 tablets/films (total of 16mg) on Day 1 during this initial process.

Note for pain patients: if you are taking Buprenorphine to also manage your pain, for some of you, your pain may not yet be fully under control, but you should notice that you are no longer in withdrawal and should not feel lousy. Do not worry, we will adjust your medications to control your pain in the coming days and weeks.


You may now start taking the full tablet/film twice a day (8mg twice a day for a total of 16mg in a day).


STEP 1:​

Continue at the same dose as Day 2: (8mg twice a day for a total of 16mg in a day).

STEP 2:​

Please fill out our online medication update form on our website by clicking here: https://www.careclinicmd.com/medupdate. If we need to adjust your dose or medication, we will discuss this with you at this time.


In addition to the Buprenorphine, we have also prescribed you other medications to help cope with the transition process. This will be sent to your pharmacy with clear instructions. You may take these medications on any day during this 3-day process, and may continue them for the remainder of the week if you wish. You are not required to take these medications unless you need to.

If you need any attention at any time during this process, you may always call/message us and we will get back to you ASAP. We will be with you throughout the process. YOU ARE NOT ALONE!

We will see you soon!

Skip to content