How do You Calculate Your Buprenorphine Dose?

[Phil.McKeer]

I can't believe I never really thought about this before, but...we all know that the BA of sublingual buprenorphine (suboxone, subutex, zubsolv, etc) is around ~30%, and subutex taken intranasally increases BA slightly to around ~45% (right?).

So my question is, when y'all taper down and are taking ~0.5mg, are you literally taking 1/16th of your sub (literally 0.5mg BEFORE absorption/BA) or are you taking 1.5mg's and calculating that you've absorbed 0.5mg?

I've been taking 0.5mg every day since I tapered down (I tried to jump off but the depression - which existed before abusing H - was too much when compounded with PAWS and I started taking literally 1/16th of a subutex intranasally everyday, which has worked very well). So that means I've really been taking ~0.2mg after BA is factored in.

How do you calculate how much you've taken? By weight, or by bioavailability after absorption?

 

[chelle216]

I've never factored in the bioavailability while taking suboxone.
I guess I should add that I don't really understand why this is necessary if you're trying to get off of it. Has this made your taper easier?

 

[Phil.McKeer]

Not really, just thought about it and am wondering how people figure how much they're ingesting. I assumed most people just calculate it based on actual mass before BA but was unsure.

I'm not really tapering at this point, it's more maintenance I suppose.

 

[chelle216]

It's certainly an interesting question. I've never even thought about this until you asked. It's one of those things that might come if considering a conversion to another opioid, for me at least.

 

[Crack'r]

You just take what you take, how you take it. If tapering you just decrease the amount and take it how directed.

You don't go to the Dr and say you prescribed 4mg dilaudid but the BA is only 20% so you need to give me 20mg instead.

 

[manboychef]

I always injected mine so I really don't know.

I believe this thought is a nonissue though considering your ROA is not changing.

 

[tightlywound]

^well his ROA did change from sublingual to intranasal.

I IV mine and observe literally no difference between that and taking them sublingually. well actually ...in the case of bupe/naloxone I've always kind of been under the impression that SL is a little more effective than IV despite what the BA reports say and that theoretically and obviously anything that you IV would have practically full BA ...maybe just because it lasts way longer SL, or because you lose a good deal of the bupe in the spoon? I don't know but it does seem that way. unfortunately I have a bad needle fix so that doesn't really matter. JME.