January 25, 2008 - 7:53pm
Hello all, i have a pretty interesting piece of information, I cannot confirm this but what i was reading is that a pill manufacturer that puts a line on the pill to be used to break the pill in half have tested random pills to determine that breaking it in half is half the dose ie you take a oxycodone hcl 15mg tab and break it in half you are taking 7.5mg of oxycodone and so on. Suboxone has a sword logo on the pill and as myself and many people who are instructed by their prescribing dr to be dosing with half pills. I thought about it for a minute and can personally say that there have been times that in the morning I take 8mg most of the time but there are some mornings that i take 12mg ok'd bye my dr. He gives me 3 8mg pills a day and doesnt care how i take them just not to relapse he is very strict on urines and relapses, he strait to my face told me i am not a pill mill or a way for you to take a break from doing oxycontin. Back to what i was saying that sometimes taking 12mg has a huge effect and sometimes not as much. I get alot of energy from suboxone and puts me in a super good mood. Just one of those things to ponder. So taking a 8mg pill in half one half potentially could contain fillers flavoring and nalaxone and the other half could have all the buph. So why do they only make a 8mg and a 2mg formulation when myself and soooo sooo many people that i know and chat with take 4mg or 12mg and so on?????it was really a slow day today and had alot of thinking time hahahah
January 25, 2008 - 8:03pm
#2
the mixture is consistent
the mixture is consistent thruought the pill so if broken exactly in half you are getting half fillers and med.
January 26, 2008 - 12:08pm
#3
A stong immediate
A stong immediate antidepressant effect from Suboxone is well documented.
Although Suboxone can be dosed once a day for prevention of withdrawal symptoms, I too find patients prefer more frequent (4x a day) dosing for pain, mood effects, and to prevent craving. It will be interesting to see if people switch from 4x a day dosing to once a day dosing after 6 months to a year on Suboxone, as their central nervous system recovers from chronic opiod agonist stimulation.
While half a pill will undoubtedly contain half the dosage of Suboxone (Buprenorphine and naloxone), absorption can vary with sublingual administration. Absorption may be affected by mouth temperature, acidity, and frequency of swallowing.
January 27, 2008 - 2:44am
#4
Hello
Hey Dr. Lois! I was wondering if I could get your two cents on something. I too am on suboxone for opioid dependence. I also am an alcoholic and used other drugs as well. I was in inpatient and intensive outpatient treatment for a month. I have 68 days tomorrow. I go to AA meetings everyday, I have changed all my friends, and kept sober. I take antabuse for alcohol and am subject to random drug testing. None of this was court ordered, I used for over fifteen years and think I just may have it licked this time. I was originally placed on 12 mg a day of subutex. 4mg in the morning, 4mg in the afternoon, and 4 in the evening. When I was released to outpatient I was given suboxone. I truly think this is a remarkable drug. It keeps my mind off the opiates, and keeps me active. Once I was released from outpatient treatment, my family wanted me to start tapering from the sub as soon as possible. The problem is, that I am deathly afraid of the cravings for opiates. I shot dilaudid. That was my choice of poison. As you well know, this is a VERY potent painkiller when taken IV. I have an appointment with my doctor soon. I have tapered down to 8 mg a day and have also recently started to take chantix to quit smoking. I have started to have craving now that I have dropped to 8. I would like to stay on the sub for a longer period of time to be able to quit smoking and to keep my cravings for opiates at bay for a while. My family seems to think that since sub is an opiate, it is me trying to hang on to the way I used to be. I have tried to tell them that I don't get high on the suboxone. It just keeps me feeling ok and reduces my cravings to nothing. I know I can't stay on the sub forever, I just want to stay on a while longer. It's funny! they want me to stay on the antabuse for a year, to prevent me from taking alcohol, but when it comes to the one that my mind actually SCREAMS for, they want me to get off of it as quick as possible. Any advice would be appreciated.
PS. I know my doctor would say it was ok for me to stay on it, I just want to know how to approach them about it and help to make them realize that it's just to keep cravings at bay.
January 27, 2008 - 3:04am
#5
I don't mean to be too blunt
I don't mean to be too blunt in my reply but why is it their decision at all if you stay on it or not? When they tell you they want you off just reply "Thank you for your concern and opinions, I will keep it in mind when I speak with my doctor".
It is obvious you are not ready to be off the medication yet, and that is what matters. You should not stop taking it until you feel you are completely ready. Ask your family if they would rather you be on the suboxone therapy or if they would prefer you start taking the opiates again? If you stop the sub before you are ready there is a very high risk that you will go back to the opiates since you are not fully recovered or rehabilitated.
I wish you good luck in your rehabilitation, and success with the suboxone. Stay on it, you know you need it.
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
January 28, 2008 - 12:52pm
#6
You are the type of patient
You are the type of patient that may need to be on Suboxone for life (poly-substance abuse, long history of drug abuse, high dosages of abused drug, previous inpatient treatment, and history of relapse. The only risk factor you do not mention is psychiatric disorder.) The target dosage is 12 -16mg a day. A lot of the Suboxone failures have been in patients who were underdosed or who tried to taper and go off Suboxone too early. There are a lot of sources out there to help your family understand that proper treatment is to stay on an adequate dosage of Suboxone to suppress cravings totally, for at least a year if not longer.
Congratulations and good luck!
January 28, 2008 - 2:11pm
#7
I would venture to guess
I would venture to guess that if a pill is marketed as being splitable, like Suboxone is, the manufacturer has to provide data to the FDA that a pill split in half delivers half the dose of a full pill.
January 29, 2008 - 12:38pm
#8
Thanks
I appreciate everyone's comments. You werent too blunt Js. The reason that they havesome say over the suboxone thing is that I have no insurance and can't afford to pay 300 dollars for the prescription. I am a student, so I can barely afford rent and those sort of things. I have however, left my doctor a message letting him know that I don't really think I am fully ready. Hopefully I will get a call from him soon, and we can talk about it. At the same time, I will start to talk to my family about the possibility of staying on the sub for a longer term. I hopefully can at least get them to the point to where if the doctor agrees with it they will. Thanks for you input too Dr. Lois. I have known several people who are on it for a long term kind of thing. If I had the money, it would be a no-brainer for me. Hopefully I can convince them. When they put me into treatment, they said that every penny was worth it if I would finally stay clean. I will ask them if that still applies. and tell them that taking the suboxone is a safety net that helps me stay clean. Sure it's an opiate, but which is the lesser of two evils? Simple answer. They seem to think that meditation and EFT are the answer. These techniques help, but the craving for opiates is unlike any other I have ever had. Once again, thanks for your opinions, I will start a new thread or PM you guys and let you know how it goes. I see him on Feb 5th. Thanks
January 29, 2008 - 6:01pm
#9
Each physician who is a
Each physician who is a registered suboxone provider can have two patients that recieve free suboxone from the drug company(Reckitt Benckiser). It is worth asking if you doctor has any slots available for in this program. Ask them if they would call 866-512-2216 for the company to send the application to them.
February 1, 2008 - 1:24pm
#10
I am about to graduate with
I am about to graduate with a Associates Degree in Medical Assisting, and we were taught in pharmacology that as long as a pill is scored, and you break it on the score, you will have half a dose. However, pills that are not scored you may end up with all med or all filler or anything in between.
February 1, 2008 - 1:40pm
#11
So technically breaking
So technically breaking suboxone in half you could end up with all filler in one half, or all the naloxone in one half, and so on. They have a sword which the doctors say is sort of a score but not really, just a good half way indicator. However, I think suboxone pills are fairly consistent and I have never had any problems breaking 8's in half, although I did ask the doc if he would prescribe the 2 mg so I could be sure of the dose but he said those would have to wait until the dosage comes down.
Check with a licensed MD before you take any suggestions!
February 6, 2008 - 10:46am
#12
No....
NO--breaking a suboxone pill does not mean that you could end up with all filler in one half and all naloxone in the other. The mix that they use to mold the tabs is a consistent mix. As someone (I think it was Dr. Lois) said above, the pharmaceutical company most likely must prove this to the FDA as part of the approval process. It's not like going to a bakery and getting a muffin with 5 blueberries in it while your friend gets one with 30!
There are meds that have one active ingredient in one part of the capsule and another in the other side, but they are manufactured this way purposefully.
I don't know the answer to your question... BUT I also break my pills in half sometimes and now i wonder if it is the same for Lortab...could I be taking all fillers one time and the next time taking all the narcotic? I wonder....