Buprenorphine withdrawal during day

[Ephemera]

Husband taking 0.4 Buprenorphine sublingual at night. Getting some sleep at last, approx 5/6 hours waking every 2 hrs but at least some sleep. Trouble is he is getting opioid withdrawal next day inc RLS. How do we get over this, anyone else had this problem. Do not want to take more opioid during day if possible.

[Joolsg]

Buprenorphine has a half life of 24/25 hours so if he takes the correct dose, it should cover his RLS 24/7.What time does he get the daytime RLS?

And what symptoms is he suffering as 'opioid withdrawals'? If anxiety, sweats those are common Buprenorphine side effects. The sweating can be helped by taking a safe anti histamine like cetirizine.

The anxiety/ panic can be helped by taking a small dose of pregabalin (25mg) at night.

To cover the daytime and nighttime RLS you could try splitting the dose, but some pills are too small ( Morningside brand).

I take 0.2mg at 9 pm and 0.2mg at midnight and that stops breakthrough RLS in the early evening.

If that doesn't help, he should ask for 0.6mg or 0.8mg. Both are still below the average for RLS.

How did he get Buprenorphine? I recall it was red listed in your area.

[Ephemera in reply to Joolsg]

Hi Joolsg. We managed to get one of our GP to let us have it on Private prescription. Only started it couple of weeks before Christmas. Tried 0.6 and 0.8 but did not help, strangely went down to 0.4 and he is starting to get some sleep (never thought that would happen again)!! He is suffering during the day, anxiety, sweating, shaking,. Hopefully if it is side effects they may ease? Nothing else works so praying he can stay on this.

[Joolsg in reply to Ephemera]

I had terrible daytime panic/anxiety on Buprenorphine.The 25mg pregabalin at night completely sorted it. I would ask for a small trial dose. It also helps RLS.

The sweating does settle, but is really helped by 10mg cetirizine.

I really hope the side effects settle.

[Marlayna67]

as a new joiner of the buprenorphine train, I’m very surprised to read this. I to get sweats during the day, but it attributed it to menopause. But I take .50 at around 8 PM at night with no breakthrough symptoms during the day. And no withdrawal symptoms during the day. I sure hope you can find an answer.

[LotteM]

I had mini-withdrawal during the day when on buprenorphine pills (0.2mg). It may have been due to the low dose, but it sufficed to control my rls so I didn't want to increase.

Initially I took half pills during the day to counteract the withdrawal, but that of course increased my total daily dose. Switching to the lowest 7d patch (5mcg/h) helped. No more withdrawals or RLS.

But do consider Joolsg' experiences first.