What are the side effects of methadone and Suboxone?

During stabilization or induction patients might feel high, energized, sedated or nauseated. These symptoms should be discussed with the BMC physician as they can be symptoms of too much methadone or Suboxone.

During stabilization or induction patients might feel typical symptoms of withdrawal including, stomach cramps, nausea, diarrhea, lethargy, restlessness, irritability, anxiety, depression, disrupted sleep, muscle or joint aches, stiffness, chills, sweating  etc. These symptoms should be discussed with the BMC physician as they can be symptoms of too little methadone or Suboxone. These should resolve as the correct dose is reached.

It is important to realize that long term treatment with methadone and Suboxone is safe. There are no effects that are not resolved by stopping the medications – they do not cause permanent damage to organs or tissues. 

Once you are at the correct dose you may experience some side effects. It is also worth remembering that the side effects are usually dose related – lower dose means less side effects. 

Only some patients get one or more of these symptoms. The most common side effects methadone patients complain of:

  • Weight gain. May be related to eating habits. Some patients have obvious weight gain and some none.
  • Sweating. Not related to other withdrawal symptoms and may occur at any time of the day. A couple of different medications often help and will be prescribed if desired.
  • Constipation. Several different medications often help and will be prescribed if desired.
  • Sexual side effects. Opiates block testosterone production. This can affect libido (sexual drive) in both men and women. Other symptoms may develop in men such as decreased energy or strength. If this is determined to be the result of low testosterone we can prescribe a replacement treatment in men (delatestyrel).
  • Decreased saliva (spit). This happens with all opiates and many other drugs. Long term effects of decreased saliva include gum disease and tooth decay. This is usually managed with proper dental hygiene, staying hydrated and chewing gum. Methadone and Suboxone do not directly damage teeth – this is an effect of methamphetamine (crystal meth).

In general side effects are less common with Suboxone than methadone. Only some patients get one or more of the following symptoms when taking Suboxone:

  • Constipation. Several different medications often help and will be prescribed if desired.
  • Sweating. Not related to other withdrawal symptoms and at any time of the day. A couple of different medications often help and will be prescribed if desired.
  • Headache. May be present for the first few days but often resolves.
  • Nausea. May be present for the first few days but often resolves.

Note that if patients are unable to tolerate one medication we will try to use the other however it is much easier to switch from Suboxone to methadone than from methadone to Suboxone.

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