Living with opioid use disorder (OUD) can be a challenging journey, and finding the right treatment is a big step. Buprenorphine is a medicine that helps many people with OUD, but it comes in different forms, and each form can have its own set of side effects. It’s very important to understand these differences so you can talk with your doctor or care team and find what works best for you.

Some people get it as an injection, like Sublocade. Others take it by mouth, like Suboxone or Zubsolv. But which is right for you? This article will help to break it down. You’ll learn about the possible side effects of buprenorphine injections versus oral medications, and what to do if you’re having a tough time. The goal is to help you feel informed, not overwhelmed.

Why do people use buprenorphine?

Before we dive into side effects, let’s quickly explain what buprenorphine does. Buprenorphine is a special kind of medicine called a partial opioid agonist. That’s a fancy way of saying it acts a bit like other opioids in your brain, but not as strongly. This helps to:

• Lessen cravings — It makes you want opioids less.
• Stop withdrawal symptoms — It helps prevent those really uncomfortable feelings you get when you stop using opioids.
• Block other opioids — It can make it harder for other opioids to get you high, which can help prevent using again.

Buprenorphine is a key part of medications for opioid use disorder treatment. This means it works best when combined with other support, like counseling and therapy.

The different ways to take buprenorphine

Buprenorphine comes in a few main forms for treating OUD:

• Oral medications

These are usually taken every day as a film or tablet put under your tongue or in your cheek. Common brand names you may hear are Suboxone, which has buprenorphine and another medicine called naloxone, and Subutex, which is just buprenorphine.

• Injections

These are usually given by a nurse, doctor, or other health care provider once a month or sometimes once a week. Common brand names are Sublocade, a monthly shot, and Brixadi, a weekly or monthly shot.

Each form works in a slightly different way, and because of that, the side effects can also be a little different.

Side effects you may feel: Injections vs. oral medications

It’s essential to remember that not everyone gets side effects, and if you do, they may be different from what someone else feels. Also, side effects can be strongest when you first start taking the medicine and get better over time as your body adjusts to it.

Common side effects for both oral and injection buprenorphine

Many side effects are common to all forms of buprenorphine because of how the medicine works in your body. These can include:

• Headaches
• Sick to your stomach or throwing up
• Sleepiness or fatigue
• Dizziness
• Constipation
• Clamminess or sweating more than usual
• Trouble sleeping
• Muscle cramps or aches

Most side effects are strongest during the first few weeks of treatment and typically improve as your body adjusts to the medication. If side effects persist beyond 4-6 weeks or worsen over time, contact your healthcare provider.

Side effects unique to oral buprenorphine

Because you put these medicines in your mouth, some side effects are specific to that:

• Mouth numbness or redness

The area where you put the film or table may feel numb or look red.

• Tongue pain

Your tongue may feel sore. This soreness happens because of the way oral buprenorphine is absorbed and interacts with the tissues that make up your tongue.

• Tooth problems

Over time, buprenorphine that dissolves in your mouth can sometimes cause cavities, infections, or even tooth loss. This is why good dental care is important if you’re taking oral buprenorphine. You should talk to your doctor and dentist about ways to protect your teeth. Some tips include:

• Swishing water in your mouth after the medicine dissolves.
• Not brushing your teeth for about an hour after taking the medicine.
• Avoiding sugary drinks or foods right after taking the medicine.

Side effects unique to buprenorphine injections

Since these medicines are given as a shot, there are some side effects related to where the shot goes:

• Pain, itching, swelling, discomfort, or a lump at the injection site

This is very common, as the medicine forms a small lump under your skin that slowly releases the buprenorphine over time. It’s usually not serious and will get smaller, but it can be annoying. However, an abscess or ulceration requires medical attention.

• Redness or bruising

The area where you got the shot may look red or have a bruise.

Why side effects can be different for everyone

You may be wondering why some people get certain side effects and others don’t, or why they feel stronger for some. Here are a few reasons:

• Your unique body

Everyone’s body is different. What affects one person may not affect another in the same way.

• Other health conditions

If you have other health problems, like liver issues or breathing problems, you may be more likely to have certain side effects.

• Other medicines you’re taking

Some medicines interact with buprenorphine and make side effects worse. Always tell your doctor about all the medicines you’re taking, even over-the-counter ones.

• How long you have been taking it

As mentioned, side effects often get better as your body gets used to the medicine.

• Your dosage

The amount of buprenorphine you take can also play a role. Your doctor will work with you to find the right dose.

Serious side effects you need to watch for

While many side effects are mild, some can be serious. It’s crucial to know what to look out for and when to get help.

Call your doctor or 911 right away if you have any of the following serious side effects:

• Slow or very shallow breathing — This is a big one and can be very dangerous.
• Extreme sleepiness or trouble waking up — If you’re unusually drowsy and hard to wake, get help.
• Blue lips or fingernails — This means you may not be getting enough oxygen.
• Confusion or hallucinations — Seeing things that aren’t there.
• Stomach troubles — This can include severe stomach pain or throwing up.
• Yellowing of your skin or eyes — Jaundice can be a sign of liver problems.
• Swelling — If you’re experiencing swelling in your face, lips, tongue, or throat, or you’re having trouble breathing, these can be signs of an allergic reaction, and this is a critical emergency.

Never try to deal with serious side effects on your own. Your health care team is there to help you stay safe and healthy.

What if the side effects are too much?

The most important thing to remember is that you have choices. If the side effects of one form of buprenorphine are making it too hard for you to stay on track, it’s OK to switch to something else. Everyone’s recovery journey is different. What works for one person may not work for another, and that’s completely OK.

• Talk to your recovery care team

They are your best resource! Don’t be afraid to tell them exactly how you’re feeling. They can:

• Adjust your dose

Sometimes, even just a small change in the amount of medicine can make a big difference.

• Switch to a different form of buprenorphine

If the oral form is causing tooth problems, an injection may be a better fit. Or, if the injection site reactions are too much, switching to an oral form may help.

• Suggest ways to manage side effects

For example, if you’re constipated, they may suggest making sure you drink more water, eating plenty of fiber, or taking a mild laxative. For nausea, they may suggest you take your medicine with some food.

• Explore other medications

In some cases, buprenorphine may not be the right fit, and they can discuss other treatment options for OUD.

• Remember the big picture

While side effects can be uncomfortable, remember why you’re taking buprenorphine. It’s a powerful tool to help you recover from opioid use disorder and live the life you want. For most people, the benefits of buprenorphine greatly outweigh the potential side effects.

• Don’t stop on your own

Never stop taking buprenorphine suddenly without talking to your recovery care team. Stopping suddenly can lead to very uncomfortable withdrawal symptoms and increase your risk of using again. Your doctor can help you safely reduce your dose if needed.

• Lean on your support system

Talk to your counselor, therapist, friends, or family about how you’re feeling. Having people who support you can make a big difference.

Recovery is personal, but you don’t have to do it alone; Groups can help

At Groups, we make it easier to manage your care in a way that works for you. Whether you’re feeling tired, dealing with mouth irritation, or wondering if a different medication may help, we’re here to talk it through with you. Our care team can help you find the right dose, the right format, and the support you need to feel better, physically and emotionally.

Give our Recovery Support Specialists a call today for more information or to begin your recovery. We provide treatment across the country — and we’re always expanding. See if we offer care in your state, either online or at one of our 130+ local offices. If Groups does not offer treatment in your area, you can locate other treatment options here.