Buprenorphine and Nausea

[davchar23]

Basically I successfully use buprenorphine (0.4mg/da) to block RLS but the resultant nausea is a serious well known side affect. I have been well guided by many on this site as to how to combat the nausea and have tried many of the suggested solutions except for me the last resort medical cannabis. I am currently using Zofran anti nausea tablets.

I am interested to know from fellow buprenorphine users what form their nausea takes and how they handle it.

For me I am woken between 4-6am with a sickly feeling in my stomach which makes me take several deep breadths to temporarily stop only to repeatedly return and keep me awake. it stops when i get up but as soon as i eat or drink anything i break out into cold sweats which last about 10/15minutes before subsiding to just a stomach discomfit which in turn slowly subsides by noon

I s this similar to many of you?

Regards

Davchar23

[Ticki]

well I’m not gonna be much help because I just get a tiny little sickening feeling and as long as I have some food in my stomach, it goes away with in a few minutes. It sounds terrible to have to deal with that. I hope you find something that helps. 💜

[Claire_1c]

I really think you should give medical cannabis oil a go. It completely stopped the nausea Jools experienced when she started taking Buprenorphine. Clinics such as Curaleaf and Releaf are staffed by specialist doctors who take your medical history and prescribe accordingly. The oil is great because you can take microdoses using a tiny syringe to measure the amount. You just drop it under your tongue and that's it. At those low doses you won't get high or addicted. Personally I'd rather use that than yet another pharmaceutical product. I hope this helps.

[davchar23 in reply to Claire_1c]

Claire,

Thank you for your reply and yes it reinforces Joolsg 's statements about cannabis oil which i have never doubted but i am working closely with an understand GP who i want to bring to the party!

Kind regards

Davchar

[Typicallygaslit]

Not like that, no. Mostly I just feel disgusted when I’m supposed to eat, and it’s difficult to get the food down. I would say this problem has lessened over the year and a half that I’ve been on Buprenorphine, also trying very hard to keep the dose low at max 350 mcg. I do get indigestion pretty badly. I don’t tolerate any anti-nausea medications. I also found that THC cannabis oil made me even more reluctant to eat and I actually lost weight very quickly.

[davchar23 in reply to Typicallygaslit]

Dear Typicallygasit,

Thank you for your reply. I also don't actually feel disgusted but do not have my normal healthy appetite. My real problem though is that the nausea wakes me. It eases when I take deep breathes or get up. After that and the "sweating" it is just a sickly feeling (not pain) in my gut. As the day goes on the feeling decreases and by evening has almost dissipated

i take 400mcg/ day and that just about blocks my RLS

Very concerned about your comments on cannabis oil. Do you mean it increased the sickly feeling or simply increased the reluctance to eat?

Best regards

Davchar

[Typicallygaslit in reply to davchar23]

Re cannabis, it made me feel more nauseous over time and I also suffered from even poorer motivation than normal. I really struggled to find it in myself to prepare food and eat it. So a combination of nausea and reluctance and an apathy… hard to explain. I think it also affects my appetite in a different way than the opioid which at least allows me to feel hungry enough to feel the urgency to eat.

[davchar23 in reply to Typicallygaslit]

Sory forgot to ask but what was your reactions with anti nausea meds. I am on Zoran and i seem to be much weaker and tired?

Davchar

[Typicallygaslit in reply to davchar23]

I have some kind of disorder which I’m not getting any expert help for as there isn’t any. But I’ve come to the conclusion that I suffer from serotonin toxicity/syndrome and it means I’m unable to tolerate the medications that are black listed for this issue (you can find articles and lists online). It includes ones that antagonise serotonin such as ondansetron. I don’t think I’m alone with this problem but it seems rare. I also think that some of us become more sensitive to meds that mess with serotonin as we get older, so maybe that’s what’s going on with you. Do you feel dizzy? Weak and tired could be signs. Many of the meds on the lists have that effect on me, some of them make me vomit and cause diarrhoea. opioids are also on the list unfortunately which is concomitant with my very troubled relationship with them. I think it may be a problem with the serotonin and dopamine transporters.

[Typicallygaslit in reply to davchar23]

Are you sure the nausea isn’t silent indigestion and that’s what’s waking you up, because it certainly wakes me up. But it’s noticeable of course when you burp up the acidity in your sleep :(. But it also sometimes just feels unpleasant in the chest area.

[Elisse3 in reply to davchar23]

Probably silly to ask but have you tried ginger helps with nausea

[davchar23 in reply to Elisse3]

Dear Elisse,

it is not a silly statement as i have already tried it but no joy. The trouble is with any such thing such as ginger or probiotics , how long does it take to see any effect and perhaps i didn't try it long enough

Kind regards

Davchar

[halperinchen]

Hi, Davchar23: How are doing now with the Buprenorphine induced nausea? I just saw your post now and I am also suffering from severe nausea from the same medication. I have been taking Suboxone film ( under the tongue) since last August, 2023 without too much side effects in the beginning, but since two months ago I started experiencing heart palpitation and severe nausea. The anti-emetic, Zofran has no effect on me. The nausea intensified usually in the early morning which is unbearable. Prior to Buprenorphine I had been taking oxycodone for almost 6 years as years go by I have to increase the oxycodone dosage from 5 mg to 20 mg so that my LA doctor, Dr. B changed to Buprenorphine. I am in a very much distress as what I do going forward. which medication I can switch to minimize such a unbearable side effects. May I ask you what has you come up? Have you changed to other medication? Thanks for your reply in advance.

[davchar23 in reply to halperinchen]

Dear Halperinchen,

Thanks for your replyand indeed your situation is very similar to my own. I was on oxycodone nd could not handle over 25mg (5x5m0 per day hence buprenorphine. i had some nausea with oxycodone but with buprenorphine (2x200mcgmcg sublingual tablets per day) the early morning nausea has become like your almost unbearable unless i get up and even then i feel rotten until about midday.

Zofran did not work for me, neither did several others anti nausea drugs or probiotics. I also tried other "remedies" reported on this site eg ginger, traveller sickness pills etc etc. No luck

My doctor has suggested another patch anit nausea drug and i am yet to get it. The forum experts say that the answer is cannabis and it looks like i will have to trial that as well

i am sorry i cannot be more helpful but let's make sure we keep in touch in case one of us finds an answer.

In the meantime "chin up" and perhaps like me vary the drug dose and time of use to try minimise the nausea. i finf100mcg about 7m and remainder about midnight is best. When I tried to reduce buprenorphine RLS returned quickly and that was not very nice.

Kind regards

Davchar

[halperinchen in reply to davchar23]

Dear Davchar: Thanks for your prompt reply. When I was on oxycodone I had no nausea, only physical tolerance I developed toward the dosage I was taking prompted me to switch to Buprenorphine, so I still have some supply of oxycodone I will try to switch to oxycodone tonight to see if the nausea will get better. By the way, Dr B indicates that after 12 hours of buprenorphine you can take any other opioid without problems. Just for your information if you'd like to try some other opioid. Do you know, by any chance any other opioids that causes less nausea?

[davchar23 in reply to halperinchen]

Dear halperinchen,

I was also going to go back to oxycodone/naloxone if I don't get some relief soon.

Am I right in saying oxycodone is also an opioid? I am afraid i do not know of any other opioid that does not cause problems. I even had some nausea with co-codamol

I have heard of the famous Dr B. Does he give any details on the half life of buprenorphine and when it reaches is most effective time period after taking (i have heard 6 hours and a half life of 24-36 hours)?

[halperinchen in reply to davchar23]

Dear Davchar23:

I switchedto oxycodone last night to see what happened. Unfortunately, I had to take much more than the dose I used to take, almost 25 mg last night without any relief from the dreadful symptoms of RLS. I also still experience the troublesome heart palpitation but much less nausea than buprenorphine though. I am in the cross road and don't know what to do next. I may have to email Dr. B for a more potent anti-emetic drug which is friendly to RLS. Going back to oxycodone don't make the quality of my life better because the RLS symptoms are more dreadful and I am also unable to sleep at all. By the way you may try Cannabis infused liquid to relieve your nausea, I purchased one for nausea but unfortunately the THC exacerbates my heart palpitation so I have to stop using it. Have you tried the patch anti-nausea drug yet? hope you feel better.

[davchar23 in reply to halperinchen]

Dear halperinchen,

I am so sorry to hear that going back to oxy meant RLS broke through even at 25mg. The highest dose i took was 30mg and that made me feel very "rough" but like you as i remember there was less nausea with it.

I haven't been able to get hold of (factory problem) the anti-emetic patches and I am waiting (bank holiday) for GP to suggest alternative. i will let you know what happens but in meantime why don't you email Dr B anyway.

I have ordered some CBD cannabis (not THC) but not yet arrived. I suspect I will (as with Joolsg) need 20%THC but lets see.

Davchar

[Huntingleroy]

Ah Ive found you ! Cant get my chat to work . I think its because my email is spelt wrongly ( maol instead of mail ) but it wont let me correct it . Ive contacted help again. No I totally understand . Ive still had no luck , Ive tried every Dr in next County as its not red listed but Im out of their catchment! One Gp here is going to take my case to their next meeting but I dont hold out much hope . So back to Dr M and what seems like a battle for a prescription . The nausea is ok , constipation bit of a problem but legs are 100% cured. Just stressed because Im going abroad and Im going to run out whilst Im away . Ive given them over 2 weeks notice to sort me out a script and apparently he has seen my email so watch this space as they say !