Buprenorphine & Nausea

[davchar23]

As some of you on the forum will know from my earlier posts I have been able to successfully block my severe RLS with buprenorphine patches (10-15mcg/hr). What I have not been able to prevent has been the nausea side effects.

Initially I seemed to have found a way to block the nausea by halving the 15mcg patch and staggering the two halves by 3 days in the 6 day cycle but over last few days this routine has gradually failed and i am having serious problems trying to get back to where i was with 2x 7.5mcg/hr staggered patches topped up as necessary with a small amount (100mcg) of sublingual tablet once or twice a day.

I wondered whether anyone else from the forum has had a similar experience and how they overcome it. I have in vain tried several anti nausea medications and also medical cannabis.

i also wondered what are the symptoms of withdrawal ie if the patch runs out prematurely but there is still enough buprenorphine in the body to prevent RLS as I believe that the nausea could be caused by this?

RLS is bad but quite frankly the nausea I get from the buprenorphine is very debilitating and also makes sleeping a problem!

Davchar23

[userotc]

Sorry youre having this problem, thanks for advising. For my mum, we are currently trying to treat her via Nutritional Therapy, without drugs 🤞Its helped with previous medical issues.

[Joolsg]

I'm so sorry you are still experiencing nausea Davchar.Nausea is MOST definitely one of the main symptoms of opioid withdrawals. But you would only experience it when the Buprenorphine patch was losing effectiveness, I think. Not every day like you are experiencing now.

As you've tried medical cannabis oil with at least 20%THC, I am out of ideas.

I know you tried taking the pill alone. And the nausea was still bad.

What does your GP think? Any ideas from him?

The only other possibility I can suggest is adding a good probiotic each day. Something like Symprove or VSL. It MIGHT help prevent the constant nausea.

I know how that feels. I only had it for 10 days, but it was awful.

It's totally unfair to find a drug that stops RLS but to have terrible side effects.

[davchar23 in reply to Joolsg]

Dear Jolson,

Thank you for your reply and I hope you are having a better time of late?

My GP said the nausea would best be tackled by reducing the amount of buprenorphine in my system and hence reduction from 15mcg/hr to 10mcg/hr patches. This may have caused (a) withdrawal symptoms or (b) simply a change of routine giving a problem.

Sue J has listed a mountain of side effects from withdrawal and of course nausea is just one. 707 twitcher believes I am compounding the problem by trying to top up in an attempt to stop yesterday’s almost constant nausea. Normally the nausea is only early morning (wakes mr about 5am)

I changed from pills to patches at the GP’s suggestion because he said that at their peak a tablet will exceed the concentration level causing nausea. I am very fortunate with my GP who is using me as a guinea pig for his RSL cases. Of course the problem is getting an appointment to see him with regular feedback! Now i just takes day half a tablet (100mcg) when RLS break through.

My strategy now is to stick with this 10mcg/hr patch and hope i can stick the nausea until things get rebalanced.

Kind regards

Davchar

[Joolsg in reply to davchar23]

Yes. The patch will release a steady amount over 24 hours. The pills release most of the active ingredient in the first 11 hours. Playing around with doses and timings seems the only way to resolve it.I do hope you find a solution.

I'm recovering well from my gallbladder operation, thanks.

[davchar23 in reply to Joolsg]

Sorry Jools my IPad decided to call you Jolson I do apologise

[Joolsg in reply to davchar23]

🤣You're clearly psychic Davchar. I was just trying on a Gatsby/20s fancy dress outfit on.

[SueJohnson]

I would suggest asking your doctor for zofran for the nausea.

[davchar23 in reply to SueJohnson]

Sue,Thank you for your reply but I have tried so many anti nauseas medications all failed to help including zofran.

Could you be so kind as to tell me if you have any information on low level buprenorphine withdrawal symptoms ie for instance when a patch runs out prematurely or you forget to take a sublingual etc etc?

Regards

Davchar

[SueJohnson in reply to davchar23]

Just about everything. For example these have all been mentioned: Headaches, Nausea, Appetite change, Mood swings, Cold Sweats, Flu like symptoms, Muscle aches, Insomnia, Anxiety, Irritability, Vomiting, Diarrhea, Sweating, Chills, depression

[davchar23 in reply to SueJohnson]

Sue,

Yes and i think I can support several of these. I have reached a point with my buprenorphine use (which successfully blocks RLS) where my GP told me to reduce from 15mcg/hr patches to 10mcg/hr patches to eliminate the nausea but by reducing the dose I think I get withdrawal symptoms such as nausea, appetite change, cold sweats, anxiety, irritability, depression and diarrhoea!!! I do not know how to differentiate!

Davchar

[SueJohnson in reply to davchar23]

You might try to eliminate or reduce the withdrawal effects by reducing the dose slower by cutting the 15 mg patch.

[davchar23 in reply to SueJohnson]

Sue,

Sorry but not sure what you mean as I currently use a 10mcg/hr patch as the GP said but i still get nausea etc. I am not sure whether this is still caused by the buprenorphine dose exceeding the nausea level OR the withdrawal from 15 to 10 causing the nausea?

Kind regards

Davchar

[SueJohnson in reply to davchar23]

I was thinking if you didn't previously have nausea before you increased from the 10 mcg patch or at least had less nausea that the withdrawal might be causing the nausea so withdrawing more slowly by using the 15 mcg patch and cutting it might help.

[davchar23 in reply to SueJohnson]

Thanks for reply and now I understand what you mean and yes that would be another option ie reduce from 15 to 10mcg/hr slowly. I have been struggling to find a solution to the nausea for so long now that i cannot really remember whether the nausea was less before I went from sublingual tablets to patches. The first patch the GP recommended was 15mcg.

Another option is to go back onto tablets but i worry that the realise from them into the system would exceed the nausea level

Thank you for your suggestions and support

Davchar

[Typicallygaslit]

I can’t remember if we talked about ginger, but ginger is an old remedy for nausea. Have you tried it?

I personally find ginger a bit strong for me as I have IBS but what I do use is related to ginger. It’s a root called Ashwagandha. I can’t remember if I mentioned it to you but it suddenly occurred to me that it could be helping me with the nausea. I really take it for joint problems (for which it’s very helpful). I buy bulk (big bags of 1 kg) and take 1 teaspoon twice a day. It took a month to take effect. I have had no problem tolerating it (I don’t tolerate most herbs and supplements).. Just another supplement idea from me 😅.

[davchar23 in reply to Typicallygaslit]

Dear Tyoicallygaslit,

\Thank for your reply and suggestions about ginger. I did try it in the past but not for the period you mention ie a month and so I think I need to try again if i cannot get my routine on buprenorphine patches & tablets sorted. Thank you again for your support

Kind regards

Davchar

[Typicallygaslit in reply to davchar23]

I don’t know how quickly ginger works so it’s something you have to try for yourself. I used to put a whole 1 cm piece of raw ginger in my daily smoothie but I didn’t suffer from nausea then.

Ashwagandha may well be a different matter so perhaps I shouldn’t have mentioned it as it’s just confusing!

[amrob123 in reply to Typicallygaslit]

Ginger is great for nausea but personally I can't take it after midday as it causes insomnia if I do. Which is a pity as I love the flavour!

[Typicallygaslit in reply to amrob123]

Does it, really? It’s so hard to know with herbs! I find that the older I get the fewer herbs I tolerate as they are all stimulating in one way or another.

[davchar23 in reply to Typicallygaslit]

Dear Typicallygaslit

I found I had previously tried 550mg ginger root tablets but as i said for a short time and did not seem to reduce my nausea. i have therefore decided to try them again for longer. i will try anything as quite honestly the nausea is nearly as bad as RLS and that is saying a lot!

Davchar

[Typicallygaslit in reply to davchar23]

I wish I had better ideas. I’ll let you know if I come across anything.

[amrob123 in reply to Typicallygaslit]

Yes, i too seem to have a hyper-response to stimulating foods. I mentioned it to an Asian friend and she said that in her particular culture, ginger isn't typically eaten at night because it's considered stimulating.