What?Taper already?

[Sub.saved.me]

I have been on 2 5.7mg doses of zubsolv for 5 months i see my doctor at every 28 days and i live in central Pa. At my last appt 3.1.17 my doctor asked if i was ready to begin tapering off. What?i said i just started sleeping as insomnia was part of getting started. What do you think sooner than later?idk as zubsolv seems to be newer i havent seen it mentioned much if any. I switched to this from methadone for 2 yrs so i di did not have any ws from the methadone except maybe sleep issues as mentioned. Any advice would be welcome

[NancyB]

Hi Sub.saved.me, did the doctor explain anything about the taper - like is s/he just talking about lowering your dose a little to see how you'd do? 5.7mg of Zubsolv is said to be the equivalent of 16mg of Suboxone. With the ceiling being around 12mg, maybe s/he wants to see if you'll do ok on a lower dose and do a slow taper?

Ceiling effect: http://www.naabt.org/glossary.cfm#C
Because of the limited intrinsic activity of buprenorphine at the receptor and the finite amount of receptors, there is a limit as to the opioid effect one receives. The increasing effects of partial agonists reach maximum levels and do not increase further, even if doses continue to rise. With most patients this occurs at about 12-16mg of sublingual buprenorphine. As the dosage is increased beyond the ceiling no difference in euphoria, analgesia, or respiratory depression will be felt.


Does this doctor have a time limit for bupe patients? Is there a set 'schedule' for tapering? Maybe ask at your next appointment so you're clear on what to expect.

In my opinion, a dose reduction might be a good thing to try after 5 months at 5.7mg. A lot of people can reduce a little after the first few months of treatment. BUT I would add the stipulation that you can go back up if you feel uncomfortable with any reduction. Then it's really up to you and how you feel.

This is a good thread about the phases of treatment:
http://addictionsurvivors.org/vbulle...ad.php?t=23809

Maybe it can help you to see how you feel about tapering.

Hope this helps!

Nancy

[Sub.saved.me]

Thank you. Wow i wasnt aware of the strength of this medicine. Perhaps i should start tapering myself at 1 and half pills. Ive done so in the past with no ill effects and stick ahead of the doctors taper so i still have some of the decision making in my hands. Ill do that along with the 12 step mtgs i attend. Just dont want a difficult taper at the doctors hands. If your aware of any zubsolv posts on this site id be interested. Im new and havent come across any. Your knowledge is very well taken
Thank you

[NancyB]

Hi again, you could try taking 1.5 pills instead of the 2. Just be mindful that because of the long (around 37 hours) halflife, you may not notice anything for a couple/three days. If you start to feel kind of crappy, then that reduction was too much and maybe 1 3/4 pills would be better. What time of day do you take the medication?

Unfortunately there really isn't that much on Zubsolv here, mostly people asking about switching from Suboxone to it, not tapering off of it. Since it's the same medication (bupe and naloxone), it's just the number of milligrams that varies. So just go slowly, try not to think about that you are reducing, and go about your day.

This is a good thread by someone who tapered off of bupe:
http://addictionsurvivors.org/vbulle...ad.php?t=29803

This one has taper stories - good and bad - because something can be learned from both:
http://addictionsurvivors.org/vbulle...ad.php?t=16678

Nancy

[Sub.saved.me]

I usually take one around 7am half at noon and a half at bedtime around 10 pm. Thanks for the input

[Crazycajun88]

Post moved to new thread:
http://addictionsurvivors.org/vbulle...ad.php?t=30599