Buprenorphine film

[dancer2]

My saga continues. As I have posted before, I am trying to recover from hip replacement surgery about 4 months ago. The inflammation resulting from the surgery has caused my RLS to increase terribly. I currently take Belbuca . Because of the cost of Belbuca, I want to try to change to Buprenorphine - either film or tablets. My question is what is an effective dose? How many times a day do you take it? What time of day do you take it?

[Joolsg]

In the USA, the sublingual pills start at 2mg. That is above the average effective dose.In the UK and Europe, the sublingual pills start at 0.2mg.

I take 0.2mg at 9pm and 0.2mg at midnight. It completely covers all my symptoms. No RLS ever and I sleep 8 hour's every night.

The 2mg pills are difficult to cut so in the USA, many people use a pill cutter and start with a ¼ pill.

The Mayo Clinic Algorithm sets out tye average effective dose as 1 to 1.5mg.

[dancer2 in reply to Joolsg]

Thank you so much.

[707twitcher]

what dose Belbuca are you on? I think you can use that same dose with sublingual buprenorphine. It should at least be a good starting point. One good thing with sublinguals is they act fast (generally within 30 minutes +/-), so you can take more if needed. So start low if in doubt.

If your dose is lower than 1 mg, I’d recommend using the sublingual strips - suboxone or generics. I believe it works just like belbuca, except you put it under your tongue instead of the side of your mouth. It is much easier to cut the strips than the pills. I’m currently using .2mg, which is one tenth of a strip. It’s hard to get exact cuts, but I don’t find small variations bothersome. For some reason, the strips are drastically cheaper than belbuca. With insurance I pay $17 for 15 2mg strips (which will last me 5 months using .2mg).

[dancer2 in reply to 707twitcher]

I take 150mcg of Belbuca at 1530 and 300mcg at 2000. I just paid$244 after insurance for 120 buccal patches. My dose is much less than 1mg. Thanks

[707twitcher]

I'm not sure why you need the belbuca twice a day? Most buprenorphine meds are used just once a day because of their long life. But certainly experiment with timing to see if it makes a difference for you. With 450mcg of belbuca, that is a bit less than 1/4 of a suboxone 2mg strip. Maybe start a little less than that and see how it goes. Keep ramping up every 30 minutes if you need more to get complete relief.

Buprenorphine supposedly has about a 12 hour effective life. I generally take mine around 8pm. But on days when I need a nap, I sometimes need to take it at naptime (and sometimes I don't 🤔). Generally when I take a naptime dose, I don't need to take any more that night (and sometimes I do...). Lots of variance in how we react to meds, not only person-to-person, but also day-to-day for me.

So I gather you are using three 150mcg patches per day? So you get 40 days out of a $244 Rx? Suboxone (or generic) costs much, much less.

[dancer2 in reply to 707twitcher]

If I don't take the dose at 1530, I will have terrible RLS in the afternoon and evening.

[707twitcher]

one more reason to consider switching: there have been numerous cases of tooth problems with buprenorphine strips. While this is likely related to much higher doses used in opioid withdrawal applications, I feel a little better with the suboxone being a little farther away from my teeth than belbuca.