buprenorphine side effects

[Marlayna67]

hello all, so I’ve been on buprenorphine and naloxone sublingual film for a couple weeks now.

I also recently went back on a low-dose of statins as after being off them for six months as my cholesterol shot up 100 points.

I take one quarter of the film at night around 6 o’clock. I sleep all night which has been amazing as the oxy was wearing off in the middle of the night.

I’m also taking one 5 mg oxy mid morning. As I’m a writer, sometimes I have to sit for a lot of hours and I don’t want the RLS to kick in during the day when I’m on a zoom call with a client. Watching me squiggle around in a chair is no fun for my clients.

Yesterday afternoon, I noticed I was having trouble breathing. It was a case of air hunger where it felt like I just could not get air into my body. If I took too much air, I felt like I was going to pass out. My pulse ox was saying my blood oxygen was high 80s low 90s.i’ve long had tinnitus, but it’s gotten really loud now to the point where it’s starting to bother me.

I went to the ER today as I really felt something was wrong. Some things showed up on an EKG but not enough to concern them and they’ve asked that I come back next week and do a stress test. I also had high blood sugar which I’ve never had before.And I felt incredibly nauseous.

I’m wondering if I made a mistake switching from oxy to buprenorphine. Or if I’m making a mistake taking 15 mg tablet of oxy the next day after the buprenorphine should’ve worn off. Or if I’ve got some entirely different going wrong.

all thoughts welcome!

[SueJohnson]

Buprenorphine can definitely cause breathing problems. I suspect this is the cause.

On the statin, they can make your RLS worse. If you haven't noticed this, then you may be the exception. If you have Nexlizet (Nustendi (UK) is a cholesterol lowering drug that is not a statin, but I don’t know if it exacerbates RLS symptoms. Ezetimibe (Zetia) - reduces cholesterol although It doesn't reduce cholesterol as fast as the statins, but according to Chris Columbus it didn't trigger his RLS and then there is Triglide which seems safe. You might want to discuss these with your doctor. A more difficult way to reduce cholesterol is to go vegan. My husband lowered his cholesterol from 221 to 131 this way.

[RLSLearner]

Bupe has a long half life so often just once daily. Opiates reduce the impulse to breath, so remove "air hunger", but if your respiratory effort was low enough eventually your CO2 goes up enough to drive breathing. I think managing RLS more important than cholesterol so if statin's are causing an issue stop them, there are other ways to lower if you need.

[Drls in reply to RLSLearner]

I’m pretty sure both buprenorphine and oxycodone compromise the breathing so you shouldn’t be taking both. Buprenorphine has a 24hr half life so you are effectively taking them together. Plus buprenorphine stops other opiates working because it has been developed to help people come off of opiates so you are more likely to get withdrawal symptoms if you mix the two. Since buprenorphine is really working for you by stopping symptoms at night I think you need to work out another way of minimising your risk of symptoms in the day. Maybe doing some stretches / walking at intervals between zoom sessions. Good luck - i hope you work it out .

[Munroist]

I have mild tinnitus which I felt got worse after being on pregabalin but i can’t be sure. I also tried cannabis once but stopped immediately because my tinnitus seemed louder and more insistent. I suspect there’s something else going on and it may be that you become more alert after changing medication and just notice it more. I did read somewhere that a lot of people become aware of tinnitus after a major life event or injury which seems consistent with the idea that it may be heightened awareness or sensitivity.

[Joolsg]

I wouldn't take Oxycontin with Buprenorphine. Buprenorphine knocks other opioids off the opioid receptors.

The 0.5mg of the film should cover you for 24 hours.

You seem to be taking the 15mg Oxycontin 'just in case' you get daytime RLS.

I would stop the Oxycontin.

Buprenorphine, like all opioids, can affect breathing. If ER weren't concerned by your breathing, that's reassuring.

However, if it continues, ask for more tests.

Nausea is common on Buprenorphine. Kwells, ginger tea, cannabis or zofran will help, but it does settle after a few weeks.

Statins do tend to worsen RLS for most, so follow SueJohnson suggestions.

[Marlayna67]

I haven't taken the Bup. for a few nights now and feel much better. Went back to one tablet of 5 mg oxycodone. Not sure what I want to do next. The last few interactions I've had with Dr. B. haven't been entirely pleasant so I hesitate to contact him, and medical care in my small mountain town is nil.

[UsableThought]

I sympathize with you - the breathing issue sounds scary.

As others have mentioned, combining oxy with bup. is a very bad idea - look up any decent reference source for bup. and you will find very strong warnings against doing so - for example ncbi.nlm.nih.gov/books/NBK4...

If I were in your shoes, even if my past interactions with Dr. B weren't pleasant, I would still speak or meet with him again & explain the situation, both your mistake in taking the two opioids together & also the concern about breathing & about possible daytime RLS issues. I say this with some personal experience - I too had issues with my current RLS specialist, but since she is the only game in town near me, I have chosen to stick with her even if I am not 100 percent happy with some of her decisions. She does know enough to make it worthwhile to continue with her given that I don't want to travel long distances to find someone else.

Also, with opioids, it takes time to work things out. I am taking methadone which like bup. is long-acting, and I have had to learn how it works and not to expect it to work like other, faster-acting opioids. Plus, trying to change opioid doses too rapidly, or mixing opioids when that is warned against, is just not a good recipe. So again I suggest being patient and listening to your provider even if the interactions aren't great. If he gives advice you're not sure about you can ask here; but see how far you can get with him.

[Marlayna67]

thank you all. I have not been feeling well in the week since this happened I’m not sure whether it’s related or not. Lots of stomach issues loss of energy, etc. I have not taken the bup and cut down to just 2 5 mg tablets of oxy a day. I am planning to try the Bup again and not take any oxy. Let’s see how I feel. The strange news is, I have had no breakthrough RLS even with my schedule that I have messed up.