Usual Adult Dose for Opiate Dependence - Maintenance:
SUBLINGUAL Tablets: Following a 2-day induction:
-Adjust dose in 2 to 4 mg increments/decrements to a level that holds patient in treatment and suppresses opioid withdrawal signs and symptoms
-Target dose: 16 mg sublingually once a day; range 4 to 24 mg/day
-Maximum dose: 24 mg/day; higher doses have not shown a clinical advantage
Comments:
-Buprenorphine with naloxone is the preferred drug for maintenance treatment; unsupervised maintenance treatment with buprenorphine should be limited to those who cannot tolerate buprenorphine-naloxone.
-When determining prescription quantity for unsupervised administration, consider the patient's level of stability, the security of his or her home situation, and other factors likely to affect the ability to manage supplies of take-home medications.
-Monthly doses should allow for a minimum of 26 days between doses; occasional delays in dosing of up to 2 weeks are not expected to have a clinically significant impact on treatment effect.
Usual Adult Dose for Opiate Dependence - Induction:
Treatment should be initiated when objective and clear signs of moderate opioid withdrawal appear, and
-at least 4 hours have elapsed since last use of heroin or other short-acting opioids
-at least 24 hours have elapsed since last use of methadone or other long-acting opioids
INDUCTION:
Day 1: 8 mg sublingually once a day (may give in 2 to 4 mg increments, if preferred)
Day 2: 16 mg sublingually once a day
Comments:
-This drug should be used as part of a complete treatment plan to include counseling and psychosocial support.
-Buprenorphine (without naloxone) is the preferred drug for induction; following induction, unsupervised administration should be limited to those patients who cannot tolerate buprenorphine/naloxone.
-Adequate treatment doses should be given as soon as possible as gradual induction over several days has led to higher dropout rates.
Uses: For the treatment of opioid dependence and is preferred for induction.
 Detailed Subutex dosage information
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A Subutex overdose can be fatal, especially in a child or other person using the medicine without a prescription.
Overdose symptoms may include extreme drowsiness or weakness, cold or clammy skin, pinpoint pupils, slow heart rate, weak pulse, very slow breathing, or coma.
