In the United States alone, 3 million people struggle with opioid use disorder. Medication-assisted treatment (MAT) with buprenorphine and naloxone — best known under the brand name Suboxone — can play an important role in a treatment plan. However, some people hesitate to pursue it due to concerns about side effects, including feeling sick, nauseous, or fatigued. The good news is that the most common Suboxone side effects are generally mild and manageable, and understanding what to expect can make a significant difference in how you approach treatment.

How Suboxone Works

Suboxone is a dissolvable film placed under the tongue that combines two medications: buprenorphine and naloxone. Buprenorphine stimulates the same receptors in the brain as opioids, but to a lesser extent and over a longer period, easing physical withdrawal symptoms without producing a high. Naloxone discourages misuse by blocking opioid effects if the medication is injected rather than dissolved under the tongue as directed. Suboxone is also available under the brand name Bunavail.

Buprenorphine is also available on its own as an injection (brand name Buprenex) or a skin patch (brand name Butrans), both of which require visits to a healthcare provider for each dose.

Treatment typically happens in two phases. During the induction phase, Suboxone reduces withdrawal symptoms that begin 2 to 3 days after stopping opioids such as oxycodone, morphine, codeine, or heroin. Once through withdrawal, the maintenance phase involves a steady dose to manage cravings during ongoing recovery. How long someone takes buprenorphine varies — some are ready to taper within a few months, others may need it for several years, with a minimum treatment period of around 8 weeks. Your doctor will guide the tapering process; do not stop Suboxone abruptly, as doing so causes withdrawal symptoms including aching muscles, sweating, nausea, runny nose, and restlessness.

It’s important to provide a full medical history before starting Suboxone. The drug can be dangerous for people with a history of opioid overdose, chronic obstructive pulmonary disease, liver disease, or seizures, and should not be taken by people who are pregnant or breastfeeding.

Common Side Effects of Suboxone and Buprenorphine

The most common side effects of Suboxone and standalone buprenorphine are similar and include:

  • Nausea and vomiting
  • Constipation and diarrhea
  • Headache
  • Dizziness and fainting
  • Drowsiness and fatigue
  • Dry mouth
  • Sweating and chills
  • Trouble sleeping
  • Back pain
  • Anxiety, nervousness, and depression
  • Pain while urinating
  • Heart arrhythmia

Some side effects are specific to the form of the medication:

  • Mouth tingling, numbness, and pain from the sublingual Suboxone film
  • Pain at the site of buprenorphine injections
  • Skin irritation where buprenorphine patches are applied

Suboxone also produces a relaxed feeling that can leave some people feeling unmotivated. In some cases, people may develop a dependence on the drug itself. Talk to your healthcare provider if this is a concern.

Feeling Sick on Suboxone: Managing Nausea Specifically

Nausea is one of the most commonly reported reasons people feel sick on Suboxone, especially in the early weeks of treatment. Most cases resolve within a week or so as the body adjusts. If you’re struggling with nausea, these strategies can help:

  • Take over-the-counter nausea medications (ask your provider which are safe alongside your other medications)
  • Eat mild foods like bread, plain rice, or crackers 15 to 20 minutes before taking your dose
  • Drink cool water or a hydrating beverage such as Pedialyte
  • Spit out — rather than swallow — any residue left after the Suboxone strip dissolves
  • Step outside for fresh air for a few minutes after dosing
  • Stay upright (sitting or standing) and avoid exercise right after eating
  • Try ginger or peppermint herbal tea
  • Use meditation or breathing exercises to help your body relax
  • Distract yourself with a book, podcast, or TV show while symptoms pass

Less Common But Serious Side Effects

While not common, serious adverse reactions are possible with Suboxone and buprenorphine. These include:

  • Liver problems
  • Low blood pressure
  • Central nervous system depression
  • Adrenal gland dysfunction
  • Severe allergic reactions

MAT with buprenorphine may also cause complications in people with certain preexisting conditions, including asthma, lung or liver disease, heart problems, gallbladder disease, pancreatic disease, seizure disorders, brain tumors, or a history of head injury. Disclose your full medical history to your provider before starting treatment.

In rare cases, Suboxone can cause liver damage. Your provider may order blood tests during treatment to monitor liver function. Signs include yellowing of the eyes or skin, fatigue, and stomach pain.

Suboxone Emergencies: When to Call 911

If you suspect someone has overdosed on Suboxone, go to the emergency room or call 911 immediately. Signs of overdose include unusual fatigue or weakness, pinpoint pupils, blue-tinged skin or fingernails, shallow, fast, slow, or irregular breathing, and confusion or blurred vision.

Suboxone can also cause severe allergic reactions. Call 911 if someone experiences swelling of the throat, tongue, or lips, hives or rash, or difficulty breathing after taking the medication.

Combining Suboxone with other substances can be life-threatening. Never take it alongside street drugs, alcohol, other opioids, or benzodiazepines (such as Xanax, Valium, or Ativan).

When to Seek Medical Help (Non-Emergency)

Contact your healthcare provider as soon as possible if you experience any of the following:

  • Yellowing of the eyes or skin
  • Dark urine or light-colored stools
  • Pain in the upper-right abdomen
  • Severe drowsiness, weakness, or fatigue
  • Shortness of breath
  • Swelling of the face, lips, or tongue
  • Blurred vision or confusion

Tips for Managing Side Effects Day-to-Day

  • Use your medication exactly as prescribed. If using Suboxone at home, follow directions carefully. For injections or patches, keep all provider appointments and stick to your dosing schedule.
  • Time your doses strategically. If possible, schedule injection or patch appointments so you have at least one rest day afterward. Consider starting Suboxone when you have time off from work or school in case early side effects are disruptive.
  • Ask for help. If side effects make daily tasks difficult, lean on trusted friends or family. Having someone pick up groceries or help around the house during the adjustment period is practical, not a burden.
  • Follow your full treatment plan. MAT addresses the physical side of addiction, but not the emotional or psychological dimensions. Counseling, support groups, cognitive behavioral therapy, and other complementary treatments are essential parts of recovery — not optional add-ons.
  • Keep your provider informed. Report any side effects that cause discomfort or interfere with daily life. Your provider can suggest over-the-counter or prescription remedies and adjust your dosage if needed.

Is Suboxone Worth It?

For most people, yes. Research has shown that people treated with buprenorphine were 1.82 times more likely to remain in treatment for opioid addiction than those who received a placebo. Weighing short-term discomfort against the long-term consequences of untreated opioid dependence is an important conversation to have with your healthcare provider. Methadone is one alternative, but it carries a higher risk of abuse and dependence and must be administered at a designated clinic rather than at home.

Frequently Asked Questions About Suboxone Side Effects

  • Why does Suboxone make me feel so sick at first?
    Feeling sick when you first start Suboxone is common and usually temporary. Your body is simultaneously adjusting to a new medication and recovering from opioid dependence, which is a significant physiological shift. Nausea, headaches, and fatigue are the most frequent complaints and typically improve within one to two weeks as your system adapts. Taking your dose after a small snack, staying hydrated, and avoiding exercise right after dosing can help reduce the intensity. If you’re still feeling sick after a few weeks, talk to your provider, a dosage adjustment may help.
  • Can I stop taking Suboxone if the side effects are too uncomfortable?
    You should never stop Suboxone abruptly, even if the side effects feel unmanageable. Stopping suddenly triggers withdrawal symptoms, including aching muscles, sweating, nausea, and restlessness — that can be more uncomfortable than the side effects you’re trying to avoid. If you’re struggling, contact your healthcare provider. They can adjust your dosage, suggest remedies for specific symptoms, or create a gradual tapering plan if discontinuing the medication is the right decision for your situation.
  • How long do Suboxone side effects last?
    Most mild side effects, nausea, headaches, dizziness, and fatigue, improve significantly within the first one to two weeks as your body adjusts to the medication. Some effects, like constipation or dry mouth, may persist longer but are generally manageable with over-the-counter remedies and lifestyle adjustments. Serious side effects such as liver problems or severe allergic reactions are rare but can occur at any point during treatment, which is why ongoing communication with your healthcare provider throughout the course of treatment is important.

Start Your Recovery Journey

With the right treatment plan, recovery from opioid addiction is possible. The team at Sunlight Recovery can help you explore options including medical detox, individual therapy, group therapy, and MAT, and create a plan tailored to your specific needs. Contact us today and take the first step.