There are many reasons one would start a taper of their buprenorphine dose. Some may begin a taper in hopes of getting to a point where they can "jump" and stop dosing all together: essentially quitting. Others may have decided they want to maintain at a much lower dose, to save money or for other reasons. Let's note that buprenorphine is used to control pain in opiate-naive individuals at doses well under 1mg. Going above 2-4 mg daily is where most find that the analgesic properties begin to fade away completely.
Tapering all depends on what kind of dose you are currently maintained on. Unfortunately, most doctors begin patients at much to high of a dose than what is needed. Unless a patient was a very heavy heroin user, doses above 8 mg are kind of silly to be maintained on. Sure some patients may need to start at a high dose, but staying at such a high dose will only make things worse when it is time to taper or stop.
FILMS
Tapering on Suboxone Film can be a much easier task, as the films can be cut into half, and half again, etc. With 8 mg films you can easily cut your strips into .25-.5 mg pieces, and know that the dose is accurate. It may be worth asking your doctor to switch to films to begin a taper, but they are more costly for those paying out of pocket.
TABLETS
Tapering with tablets can make things a little more interesting, but still very possible. The best way I would suggest tapering with tablets is to make a water solution with the tablets. Go buy a liquid syringe for children's medicine, and make a solution. For example, with 8 mg tablets, you could add 20 ml for every tablet. In this example, 5 ml would equal 2 mg of buprenorphine, 2.5 ml would equal 1mg, and so on. You don't want to use to much water because you still need to allow this to be absorbed through your mucous membranes in the mouth. This will be absorbed in your mouth as long as it is in there for a good 5-10 minutes just as you would do normally with a tablet. You will want to move the solution around in your mouth every so often to help absorption.
TAPER SCHEDULE
The tricky part is finding a tapering schedule that works well for you. Granted, this won't be a walk in the park for some, but you do not want to be facing full on withdrawals. The best rule is to be aware of what your body is feeling and trying to tell you. A good rule of thumb is to drop your dose by a 1/4 or 25% every 4 days. This may seem like it will take forever, but it will take time because of buprenorphine's seriously long half-life.
Learn about half-lives and the drugs path through the body from dose taken to elimination
Here -
Pharmacokinetics 101 (LADME)
So, an example I will post is an individual who is being maintained at 8 mg/ day (Towards the end the 25% doesn't apply)
Day 1-4 Drop to 6 mg
Day 5-8 Drop to 4.5 mg
Day 9-12 Drop to 3.3 mg
Day 13-16 Drop to 2.5 mg
Day 17-20 Drop to 1.8 mg
Day 21-24 Drop to 1.3 mg
Day 25-28 Drop to 1 mg
Day 29-32 Drop to .75 mg
Day 33-36 Drop to .5 mg
Day 37-40 Drop to .25 mg
Day 41-
"JUMP" and stop dosing buprenorphine all together
Again, this is just and example and always understand your body and if you need a little more, than go for it. But the worst mistake you can make is being low in your dosing and feeling bad, so you decide to take a whole 8 mg strip or tablet. That will throw you schedule all off.
Also you can easily do the math on a calculator for your tailored dose, maybe 20% is better for you, maybe 33% is better if you are hoping to make it happen quicker. These are only suggestions.
Take Care
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