Can You Take Methadone and Suboxone Together?

Methadone and Suboxone are two important components of medication-assisted treatment (MAT). Both of them are intended for the same purpose, which is why methadone and Suboxone cannot be prescribed together, let alone induced simultaneously. It can result in complications like arrhythmia, precipitate withdrawal, etc. If you have Suboxone pills lying around, do not take them with methadone or other medications without consulting your healthcare provider. 

Switch from methadone to Suboxone safely. Call 844.445.2565 or fill out this form to get in touch with substance abuse rehab in NJ rather than risking your safety. 

CALL NOW FOR FREE SCREENING

Does Suboxone Block Methadone?

Suboxone’s main ingredient is buprenorphine, which is an opioid agonist, and so is methadone. While buprenorphine and methadone work similarly, methadone is a stronger opioid in comparison to buprenorphine since both medications reach for the same opioid receptors. 

However, since methadone is a full opioid agonist, taking Suboxone over it can reduce its effectiveness. This means that Suboxone can bind itself more strongly to the opioid receptors, thereby displacing methadone. 

Why Can You Not Take Methadone and Suboxone Together?

There are several reasons why methadone and Suboxone cannot be prescribed together. The main reasons include:

Reason # 1: Similar Medications Not Required for OUD

The main reason why methadone and Suboxone will not be prescribed is because it is needless to prescribe or administer two similar medications. When it comes to FDA-approved MAT, it is recommended to use one out of these three medications:

• Buprenorphine (Suboxone, Subutex, Sublocade, Brixadi)
• Methadone
• Naltrexone (ReVia, Depade)

All the medications used to treat OUD are potent, which is why combining them has certain major risks. 

Reason # 2: Suboxone Hinders Methadone’s Effects

Buprenorphine in Suboxone lowers the effects of stronger opioids or agonists like methadone. Therefore, if you are prescribed methadone, it is important to remember that taking Suboxone on top of that will render methadone less effective. Taking Suboxone and methadone together will NOT improve withdrawal symptoms. It will only worsen them. 

Reason # 3: Precipitate Withdrawal

When Suboxone is taken with methadone, it can cause precipitate withdrawal. This happens because buprenorphine will attach itself to the opioid receptors and displace methadone. The symptoms of precipitate withdrawal are very uncomfortable. These usually include:

• Irritability
• Sweating
• Depression and anxiety
• Mood instability
• Body aches
• Fever
• Cramps
• Fever
• Twitching and kicking (involuntary)

In some cases, severe precipitate withdrawal also results in self-harming thoughts. It is important to be careful about what you are taking since medications can alter the way your brain works.

Online Suboxone Doctors in NJ

Reason # 4: Exaggerated Side Effects

The article on buprenorphine and methadone interaction says that any substance with sedative properties should not be taken alongside agonists. Both methadone and Suboxone can cause drowsiness. This means that the chance of increased side effects of the two similar medications also increases. 

Reason # 5: Fatal Risks

Prescription medications carry risks if they are not taken according to your doctor’s guidance. For instance, giving methadone or buprenorphine to patients with heart diseases like QT prolongation poses a great risk of arrhythmia. When the two are combined, the risk can be exacerbated. 

How Do I Switch From Methadone to Suboxone?

“It is weird switching from methadone to Suboxone. I have experienced extreme withdrawal. The sensation is so different. I don’t know how to cope with it.”, most people complain. Transitioning from methadone is, indeed, a feat because one can develop dependence on medications, and stopping them causes withdrawal. However, certain points can help you transition more comfortably.

• Slowly tapering off of methadone
• Taking buprenorphine at least 24 hours after methadone’s last dose

Tapering Off

If buprenorphine is taken when methadone is in the system, the precipitate withdrawal will be tough. Therefore, your doctor will slowly and gradually lower your dose. Over a few weeks, you will be switched to Suboxone. 

You should be mindful that initially, Suboxone will feel difficult from methadone. It may seem like it is not working. However, it is only a matter of time before your body loses methadone dependence and becomes accustomed to Suboxone. 

The withdrawal from methadone after taking buprenorphine is felt because even after 24 hours, some methadone is left. However, after a few days, withdrawal or other symptoms are stabilized.

Question/Answer Section

For more queries regarding “Can you take methadone and Suboxone together?”, we have answered some of the common questions. Check them out below:

How Long After Suboxone Can I Take Methadone?

It is recommended to wait until 24 hours have passed since your last dose of methadone before you take buprenorphine. Do not do it on your own. If you are switching from methadone to buprenorphine (Suboxone), do it after consulting your physician. 

Will Suboxone Help With Methadone Withdrawal?

Some doctors may also prescribe Suboxone to ease methadone withdrawal after someone is trying to get over methadone dependence. Methadone prescribed for chronic pain can cause dependence in some. The antidote to methadone can be Suboxone treatment. 

Suboxone VS Methadone: Which One Is Better, Short Term and Long Term?

While it depends totally on which medication suits you best, taking Suboxone long-term is considered better. This is because the potential for abuse is low, and it is not as potent an opioid as methadone. 

References

1. Wedam, E. F. (2007). QT-Interval Effects of Methadone, Levomethadyl, and Buprenorphine in a Randomized Trial. Archives of Internal Medicine, 167(22), 2469. https://doi.org/10.1001/archinte.167.22.2469
2. Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2009). Drug interactions involving methadone and buprenorphine. In www.ncbi.nlm.nih.gov. World Health Organization. https://www.ncbi.nlm.nih.gov/books/NBK143177/