Hmm, I'm not very experienced with either tbh.
Tramadol has a history of causing anxiety, so I would try to taper that out. See how you feel. Talk to your doctor. You taking 8 mg bup/sub a day?
alprazolam ↔ buprenorphine
Applies to
anax (alprazolam) and Suboxone (buprenorphine/naloxone)
Using buprenorphine together with other medications that also cause central nervous system depression can lead to serious side effects such as respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
buprenorphine ↔ gabapentin
Applies to:Suboxone (buprenorphine/naloxone) and gabapentin
Using buprenorphine together with other medications that also cause central nervous system depression can lead to serious side effects such as respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
buprenorphine ↔ tramadol
Applies to:Suboxone (buprenorphine/naloxone) and tramadol
Ask your doctor before using buprenorphine together with traMADol. This can increase the seizure risk if you are taking other opioids. Contact your doctor if you experience extreme drowsiness, shallow breathing, slow heartbeat, extreme weakness, cold or clammy skin, feeling light-headed, fainting, or seizures. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely use these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Those are just the interactions with each drug and suboxone. I'd be really careful if I were you. Again, the Tramadol would be the first thing I cut. Then I would talk to your doctor about what he thinks is absolutely necessary for you.
How do you feel on all of these things? How do you feel without them?
Obv the sub is going to be a thing for a bit, and I think that is the most important one, as long as you are under Dr. supervision. Just be careful not to stay on it too long if you can. While maintenance treatment is a good thing I think, it can very easily replace a dope habit and the long lasting half life makes it a real pain in the ass to get off of.
I don't think anyone should be on any substance for extended periods of time.