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Restless Legs Syndrome

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buprenorphine and dry mouth leading to difficulty swallowing

Drls profile image
Drls
19 Replies

hello - since taking sublingual buprenorphine I know I have a tendency to have a dry mouth - I have recently noticed feeling like my food has got stuck in my throat and worrying that I might choke.

I realise this is helped by regularly drinking water / sucking sweets / chewing gum etc however I wondered if other people had experienced this and if so what they have done to help.

I don’t think I have any other medical conditions causing this I truly think it is the dry mouth / throat especially if I have not been drinking water. However it is a frightening occurrence that I feel I need to get on top of because it could have more serious consequences.

Any comments would be helpful. Thank you.

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Drls
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19 Replies
Joolsg profile image
Joolsg

It's very common. My theory is that Buprenorphine dry mouth is what causes tooth decay/loss for people. The FDA issued a warning about tooth loss on pills/film, but the patch has also caused tooth problems. That's why I'm absolutely convinced it's dry mouth. And not 'acid'.Treat it as though you have Sjogrens disease.

I use special dry mouth toothpaste, mouthwash, sprays and lozenges. Pharmacists are very helpful.

Chewing gum throughout the day as well.

It is a concern though. This is the ONLY treatment that has worked for my severe RLS. I am concerned about the long term.effects on my teeth and mouth health.

Drls profile image
Drls in reply to Joolsg

thank you Jools - what are the spray and lozenges called? I’ll see if I can get hold of some …

Joolsg profile image
Joolsg in reply to Drls

biotene.com/dry-mouth-produ... use biotene products, but there are many different brands. Just search 'dry mouth sprays and mouthwashes.

If they don't help, you could ask for cevelimine, as advised by KSD2.

K2D2 profile image
K2D2

I suffer from dry mouth due to Sjogren’s Syndrome. Tried all the things Joolsg recommends with very limited relief. There are a couple of prescription drugs I’m aware of that can help. One of them is called Cevelimine. That’s what I take and it has been life-changing for me.

teakabeagle profile image
teakabeagle

Dry mouth is part of the opiods side effects. I use Cylitol spray during day and xylimint tablet at night. Dry mouth cam cause difficulty swollowing, but so can some other bad stuff. You need to check in with your PCP. You might need an endoscopy to further evsaluate

Elisse3 profile image
Elisse3

I got some dry mouth lozenges from my pharmacy after dry mouth from taking dihydrocodeine worked a treat on my dry mouth

SleeplessinOR profile image
SleeplessinOR

I don’t have any experience with Buprenorphine but I get very dry mouth from tramadol. I use Biotene mouthwash and spray and it helps a lot.

RLSofManyYears profile image
RLSofManyYears

My dentist recommended GC Dry Mouth Gel. I used it initially but the problem is that my whole mouth gets dry and this can be at any point in the day. So I now keep a bottle of water by my bed and usually have a fruit tea either last thing at night or if I'm up in the middle of the night. I use Temgesic, which does help the RLS, but the dry mouth and the opioid itching are a problem.

BettyRae profile image
BettyRae in reply to RLSofManyYears

Have you tried XyliMelts by OraCoat ? They are perfect for nighttime. They stick to your gums.

TeddiJ profile image
TeddiJ

I have this dry mouth issue overnight and in the a.m. from Suboxone ( BUP) and now that I am taking Trazadone at night to try to sleep better, it seems much worse than the SUB alone. Good luck and thanks for posting.

Jelbea profile image
Jelbea

I am so sorry to hear of your difficulties in swallowing. I also suffer from this and no cause has been found. I therefore assume it is from the buprenorphine. I take sublingual bup in a total of 800 mcg daily in divided doses. I was on bup patches to start with for almost a year but they were increasing useless and eventually I ended up on the above sublingual dose. After being on it for a few months I started to get hoarse noted in the morning and which wore off as the day progressed. Then I noted difficulty in swallowing some things and became a bit alarmed. My GP red-flagged me to have a tube inserted to examine my throat and vocal cords. All was well but the difficulty with swallowing progressed and I had to be sure to drink a lot while eating. You have to drink plenty anyhow on buprenorphine and I am also on other medications which make dry mouth more of a problem. My doctor then suggested a gastroscopy but the waiting time was dreadful so I went privately. Again nothing was noted except some reflux - I would get heartburn from time to time but not frequently.

After that I was sent for a test known as FEES where a tube is passed down your throat and you have to eat different things whilst the operator views all this on a screen. I was told that they only saw some reflux. They said to drink plenty whilst eating and to avoid crumbly things or anything I found difficult. Wholemeal bread was difficult and I now take 50/50 with plenty of spread. Boiled potatoes are bad but I smother then with gravy!

The whole situation is very worrying and I know how you feel panicked. I have got used to it and only occasionally gag on something. My mouth is very dry and I use all the suggested treatments. No-one seems able to help and when I suggested it might be the buprenorphine nobody took this up or seemed to agree. I have had this for well over a year now and just do not know what to do.

Unfortunately for me buprenorphine was my last drug for RLS - everything else has been tried - so if I tried to get off bup I then face what to do for horrendous RLS. At present I feel I would rather be RLS free and manage the swallowing difficulties but I fear for the future.

I am sure all this is not what you want to hear but may set your mind at rest regarding a more sinister cause. Saying this obviously you should get checked and I wish you all the best. Please feel free to private message me if I can help further.

Drls profile image
Drls in reply to Jelbea

Thank you Jelbea ( and every body else ) for your comments. I feel convinced it is the buprenorphine - combined with the pregabalin and thyroxine that I take. I am going to proceed with caution, taking more notice of what and how I am eating, drinking more consistently and using some of the products suggested. If it still persists I will run it past my gp however I don’t want to have any unnecessary tests which are stressful and intrusive.

Unfortunately the combination of drugs I am taking still does not control my rls although it is a lot better than before. I’m still up several times a night. I take between 0.6 and 1mg buprenorphine a night depending on how bad the symptoms are. Like you Jelbea I have tried everything else so this is my best scenario it would seem.

Best wishes to everyone and thank you again x

Toypoodle123 profile image
Toypoodle123 in reply to Jelbea

I am on Buprenorphine and I suffer terribly with the dry mouth and can hardly open my mouth to talk,my doctor said try chewing a peice of chewing gum,it realy did the job

Jelbea profile image
Jelbea in reply to Toypoodle123

Hello Toypoodle - Lovely to welcome you to the group and thank you for contacting me about the chewing gum. It does work really well and of course you can use the unsweetened version. I did not think that at 81 years old I would still be chewing gum 😃😃. Anything with xylitol in it will boost saliva production and the only thing to be careful about is that xylitol is very poisonous to dogs. even a small amount. Other things which help me are Biotine toothpaste for dry mouth as well as Biotine mouth wash. There are other makes. Any mouthwash with alcohol in it is bad for dry mouth. There are lots of dry mouth products to be found on Amazon.

How do you find the buprenorphine otherwise? Are you on patches, sublingual tablets or something else? Is it controlling your RLS symptoms well? We would love to hear from you as every new member brings something more to the group.

Thanks again and good wishes

BettyRae profile image
BettyRae in reply to Toypoodle123

I have terrible dry mouth, too! Have you tried XyliMelts, by OraCoat? You can use them anytime, but they are great at night

Toypoodle123 profile image
Toypoodle123 in reply to Toypoodle123

I am on Buprenorphine,it was the last thing on the list of medications that I had not been given,once taking it,I have had much better nights,I have had my R,L,S flare up quite often,but it it so much better,I do not like the idea of taking an opioid,but I have to manage the consequences later,right now sleep is my number one priority,never been getting much for 3/4 of my life,and I,m 76,so if this Buprenorphine helps me,I can certainly put up with a very dry mouth,there is nothing else out there,,hang in there,getting on to this chat line has made me feel better in itself,I,m not alone

BettyRae profile image
BettyRae in reply to Jelbea

Have you tried XyliMelts by OraCoat? They stick to your gums. Work well at night, but can be used anytime.

Jelbea profile image
Jelbea

In reply to BettyRae - Yes I have used XyliMelts and found them to work well but a couple of times I wakened and the Xylimelt had come unstuck. Fortunately I did not choke but because I have some difficulty in swallowing I decided against using them again. For others they are probably a great idea. I now stick with an Oralieve mouth spray when I awaken with dry mouth and also a good drink of water before the spray.

Good Wishes

Narcis profile image
Narcis

Very helpful comments. I'm in Buprenorphine patch since two year's and suffer also of dry mouth. Thanks for the post

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