A Guide for Patients Beginning Buprenorphine Treatment at Home Before you begin you want to feel very sick from your withdrawal symptoms It should be at least . . . You should feel at least three of these symptoms . . . • 12 hours since you used heroin/fentanyl • Restlessness • Body aches • Goose pimples • 12 hours since snorted pain pills (Oxycontin) • Heavy yawning • Tremors/twitching • Stomach cramps, nausea, • 16 hours since you swallowed pain pills • Enlarged pupils • Chills or sweating vomiting or diarrhea • 48-72 hours since you used methadone • Runny nose • Anxious or irritable Once you are ready, follow these instructions to start the medication DAY 1: DAY 2: 8-12mg of buprenorphine 16mg of buprenorphine Most people feel better the first day after 8-12mg. (Dosing depends on how early on the first day you started) Step 1. Step 2. Step 3. Take one 16mg dose Take the Wait 45 Still feel sick? Wait 6 Still Stop Most people feel better first dose minutes Take next dose hours uncomfortable? with a 16mg dose Take last dose 6 45 4mg 4mg hours 4mg Stop 16mg minutes • Put the tablet or strip under your tongue Most people feel better • Stop after this dose Repeat this dose until your next • Keep it there until fully dissolved after two doses = 8mg • Do not exceed 12mg on Day 1 follow-up appointment (about 15 min.) • Do NOT eat or drink at this time • Do NOT swallow the medicine If you develop worsening symptoms while starting buprenorphine before your scheduled outpatient appointment return to the emergency department