What You Should Know About Buprenorphine Side Effects

Buprenorphine is one of the most important medications for treating opioid use disorder (OUD) and certain types of chronic pain. It's effective, it's safer than many alternatives, and it saves lives. But like any medication, it comes with side effects.

Most Buprenorphine side effects are mild and manageable, especially once your body adjusts. However, some are serious and require immediate medical attention. This guide covers what to expect, what's normal, and when to call your doctor.

What Is Buprenorphine?

Buprenorphine is a partial opioid agonist — meaning it activates opioid receptors in your brain, but not as strongly as full opioids like Oxycodone or Heroin. It's available under brand names including Suboxone, Subutex, Sublocade, Brixadi, Zubsolv, Butrans, and Belbuca. It's classified as a Schedule III controlled substance.

For more details about what Buprenorphine is and how it's used, see our complete guide: What Is Buprenorphine?

Common Side Effects of Buprenorphine

These side effects are reported frequently in clinical trials and FDA labeling. They're usually mild to moderate and often improve within the first few weeks of treatment:

• Headache — one of the most commonly reported side effects
• Nausea — especially during the first few days of treatment
• Vomiting — may occur alongside nausea
• Constipation — a common opioid-class effect; staying hydrated and eating fiber can help
• Dizziness — be careful standing up quickly or driving until you know how it affects you
• Drowsiness — may affect your ability to drive or operate machinery
• Sweating — increased sweating, especially at night
• Insomnia — difficulty falling or staying asleep
• Dry mouth
• Muscle aches
• Application site reactions — redness, itching, or irritation where Butrans patches or Belbuca films are applied

Most of these side effects are not dangerous. They're your body adjusting to the medication. But if any side effect is severe, persistent, or significantly affecting your daily life, talk to your prescriber.

Serious Side Effects: When to Call Your Doctor

Some Buprenorphine side effects are serious and require immediate medical attention. Call your doctor or go to the emergency room if you experience:

• Difficulty breathing or slow, shallow breathing — respiratory depression is the most dangerous opioid side effect. This risk increases significantly if you combine Buprenorphine with benzodiazepines (like Xanax, Klonopin, or Valium) or alcohol.
• Severe allergic reaction — hives, swelling of face/lips/tongue/throat, difficulty breathing
• Signs of liver problems — yellowing of skin or eyes (jaundice), dark urine, light-colored stools, severe stomach pain, persistent nausea
• Precipitated withdrawal — if you take Buprenorphine too soon after using a full opioid agonist, it can trigger sudden, severe withdrawal symptoms including severe cramping, diarrhea, agitation, and sweating
• Severe dizziness or fainting — could indicate low blood pressure (hypotension)
• Signs of serotonin syndrome — agitation, hallucinations, rapid heartbeat, fever, muscle stiffness, twitching, loss of coordination. This can occur when Buprenorphine is combined with serotonergic drugs like SSRIs or SNRIs.
• Adrenal insufficiency symptoms — unusual fatigue, weakness, dizziness, nausea, vomiting

Buprenorphine carries a boxed warning (the FDA's most serious warning) about the risk of respiratory depression when combined with benzodiazepines or alcohol, risk of addiction and misuse, and the danger of accidental exposure in children.

Side Effects in Specific Populations

Pregnant Women

Buprenorphine (specifically Buprenorphine without Naloxone, such as Subutex) is actually the preferred treatment for pregnant women with opioid use disorder. However, babies may experience neonatal opioid withdrawal syndrome after birth and will need monitoring. Do not stop Buprenorphine during pregnancy without medical guidance — withdrawal can be dangerous for the fetus.

Older Adults

People over 65 may be more sensitive to Buprenorphine's effects, especially drowsiness, dizziness, and respiratory depression. Lower doses and closer monitoring are typically recommended.

People with Liver Problems

Buprenorphine is processed by the liver, and it can cause liver damage in rare cases. If you have hepatitis or other liver conditions, your doctor will likely order regular liver function tests and may adjust your dose.

People Taking Other Medications

Many drug interactions can increase the risk of side effects. For a complete list, read our guide on Buprenorphine drug interactions.

How to Manage Common Side Effects

Here are practical tips for dealing with the most common Buprenorphine side effects:

• For nausea: Take Buprenorphine with an empty stomach (sublingual forms), eat small meals throughout the day, and ask your doctor about anti-nausea medication if needed.
• For constipation: Drink plenty of water, eat high-fiber foods, exercise regularly, and consider an over-the-counter stool softener (talk to your doctor first).
• For headaches: Over-the-counter Acetaminophen (Tylenol) is generally safe to take with Buprenorphine. Avoid NSAIDs unless your doctor approves.
• For insomnia: Practice good sleep hygiene — consistent bedtime, no screens before bed, cool dark room. Avoid caffeine in the afternoon.
• For dizziness: Stand up slowly from sitting or lying positions. Stay hydrated. Avoid driving until you know how the medication affects you.
• For sweating: Wear lightweight, breathable clothing. Stay in cool environments when possible.

Important: Do not stop taking Buprenorphine suddenly because of side effects. Abruptly stopping can cause withdrawal symptoms. Always talk to your doctor before making any changes to your dose.

Final Thoughts

Buprenorphine side effects are real, but for most people they're manageable — especially compared to the risks of untreated opioid use disorder. The benefits of Buprenorphine treatment typically far outweigh the side effects.

Talk to your doctor about any side effects you're experiencing. They can often adjust your dose, switch formulations, or suggest strategies to help. And if you're having trouble finding Buprenorphine at your pharmacy, Medfinder can help you locate it in stock.

To learn more about how Buprenorphine works in your body, check out our guide on Buprenorphine's mechanism of action.