Suboxone

苏博诺（Suboxone）含有一组合欢碱（buprenorphine）和纳洛酮（naloxone）。

合欢碱是一种阿片类药物，有时被称为麻醉剂。

纳洛酮会阻断阿片类药物的效果，包括镇痛作用或产生幸福感，这些效果可能导致阿片类药物滥用。

苏博诺用于治疗麻醉剂（阿片类）成瘾。

苏博诺不可作为止痛药使用。

Suboxone 可能会减缓或停止你的呼吸，并且可能会使人上瘾。滥用此药可能导致成瘾、过量或死亡，尤其是对于儿童或其他未经处方使用该药物的人。

怀孕期间服用 Suboxone 可能在新生儿中引起危及生命的戒断症状。

如果你将此药与酒精或其他导致嗜睡或减慢呼吸的药物一起使用，可能会发生致命的副作用。

如果您出现对苏柏宁过敏反应的迹象，请立即寻求紧急医疗帮助： 荨麻疹；呼吸困难；脸部、嘴唇、舌头或喉咙肿胀。

苏柏宁可能会减慢或停止您的呼吸，甚至可能导致死亡。如果您呼吸缓慢且有长时间停顿、嘴唇发青或难以唤醒，照顾您的人应给予纳洛酮和/或寻求紧急医疗救助。

如果您出现以下情况，请立即致电医生或寻求紧急医疗救助：

• 牙齿或牙龈问题；

• 呼吸浅弱、睡眠时呼吸暂停；

• 头晕，感觉可能昏倒；

• 困惑、失去协调能力、极度虚弱；

• 视力模糊、言语不清；

• 肝功能问题 - 上腹痛、食欲不振、尿色深、大便颜色浅如泥土、黄疸（皮肤或眼睛发黄）；

• 体内血清素水平过高 - 激动不安、幻觉、发热、出汗、寒战、心跳加快、肌肉僵硬、抽搐、失去协调能力、恶心、呕吐、腹泻；

• 皮质醇水平低 - 恶心、呕吐、食欲不振、头晕、疲劳或虚弱加剧；或

• 阿片类药物戒断症状 - 寒战、鸡皮疙瘩、出汗增多、感觉冷热交替、流鼻涕、流泪、腹泻、肌肉疼痛。

老年人及体弱者或患有消耗综合征或慢性呼吸系统疾病的人更容易出现严重的呼吸问题。

常见的苏柏宁副作用可能包括：

• 头晕、昏昏欲睡、视力模糊、感觉醉酒、难以集中注意力；

• 戒断症状；

• 舌头疼痛、口腔内红肿或麻木；

• 恶心、呕吐、便秘；

• 头痛、背痛；

• 心跳加速、出汗增多；或

• 睡眠问题（失眠）。

这并非完整的副作用列表，其他副作用也可能会发生。请咨询医生以获得有关副作用的医疗建议。

如果您对丁丙诺啡或纳洛酮（Narcan）过敏，则不应使用Suboxone。

在使用Suboxone前，请告知医生您的情况，特别是以下情况：

• 牙齿问题，包括有蛀牙的历史；

• 呼吸问题，睡眠呼吸暂停；

• 前列腺肥大，排尿问题；

• 肝病或肾病；

• 影响呼吸的脊柱异常弯曲；

• 胆囊、肾上腺或甲状腺的问题；

• 头部受伤、脑肿瘤或癫痫；或

• 酗酒或药物成瘾。

如果您在怀孕期间使用Suboxone，婴儿可能会对该药物产生依赖。这可能导致婴儿出生后出现危及生命的戒断症状。出生时依赖于阿片类药物的婴儿可能需要数周的医疗治疗。

如果您正在哺乳，请在使用Suboxone前咨询医生。 如果您注意到婴儿有严重的嗜睡或呼吸缓慢，请告知医生。

如果您开始或停止使用某些其他药物，可能会出现呼吸问题或戒断症状。请告知您的医生您是否还使用了 抗生素、抗真菌药、治疗心脏或血压的药物、抗癫痫药或用于治疗 HIV 或丙型肝炎的药物。

阿片类药物可以与许多其他药物相互作用，并导致危险的副作用甚至死亡。 请务必让您的医生知道您是否还使用：

• 感冒或过敏药物、支气管扩张剂 哮喘/COPD 药物或利尿剂（“水丸”）；

• 治疗 晕动病、肠易激综合症 或 膀胱过度活动症 的药物；

• 其他阿片类药物 - 阿片类止痛药或处方止咳药；

• 像安定这样的镇静剂 - 地西泮、阿普唑仑、劳拉西泮、阿普唑仑、克诺平、艾司唑仑 等；

• 使您昏昏欲睡或减缓呼吸的药物 - 安眠药、肌肉松弛剂、治疗情绪障碍或精神疾病的药物；或

• 影响您体内血清素水平的药物 - 兴奋剂或治疗 抑郁症、帕金森病、偏头痛、严重感染或 恶心和呕吐 的药物。

以上列表并不完整。其他药物也可能与丁丙诺啡和纳洛酮相互作用，包括处方药和非处方药、维生素 和 草药产品。这里未列出所有可能的相互作用。

Use Suboxone exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Never use Suboxone in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.

Before taking a Suboxone sublingual film, drink water to moisten your mouth. This helps the film dissolve more easily. Place one film on the inside of your right or left cheek. If your doctor tells you to take 2 films at a time, place the other film on the inside of the opposite cheek. Keep the films in place until they have completely dissolved. If your doctor tells you to take a third film, place it on the inside of your right or left cheek after the first 2 films have dissolved.

While the film is dissolving, do not chew or swallow the film because the medicine will not work as well.

Suboxone sublingual tablets should be placed under the tongue until they dissolve.

Never share Suboxone with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine in a place where others cannot get to it. Selling or giving away Suboxone is against the law.

Rinse your mouth with water after the Suboxone tablet dissolves. Wait one hour after the medicine dissolves to brush your teeth to prevent damage to the teeth and gums. You should receive regular dental checkups while using Suboxone.

If you switch between medicines containing buprenorphine, you may not use the same dose for each one. Follow all directions carefully.

Do not stop using Suboxone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

You will need frequent blood tests to check your liver function.

All your medical care providers should know that you are being treated for opioid addiction, and that you take Suboxone. Make sure your family members know how to provide this information in case they need to speak for you during an emergency.

Never crush or break a Suboxone sublingual tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death.

Store Suboxone at room temperature, away from moisture and heat. Store the films in the foil pouch. Discard an empty pouch in a place children and pets cannot get to.

Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, remove any unused films from the foil pack and flush the films down the toilet. Throw the empty foil pack into the trash.

Usual Adult Dose for Opiate Dependence - Induction:

INDUCTION: For those Dependent on Heroin or Other Short-acting Opioid Products:
-INITIAL DOSES should begin when objective signs of moderate opioid withdrawal appear and not less than 6 hours after the patient last used opioids to avoid precipitating an opioid withdrawal syndrome:

Suboxone Sublingual Film:
Day 1: up to 8 mg/2 mg sublingually; administer as an initial dose of 2 mg/0.5 mg or 4 mg/1 mg with titration in 2 or 4 mg increments of buprenorphine at approximately 2-hour intervals
Day 2: 16 mg/4 mg sublingually as a single dose

Comments:
-Patients dependent on heroin or other short-acting opioid products may be inducted with combination buprenorphine/naloxone or buprenorphine monotherapy; to avoid precipitating withdrawal during induction, initiation should occur when clear signs of withdrawal are evident, preferably when moderate objective signs of opioid withdrawal appear, and no sooner than 6 hours after last use of heroin or other short-acting opioid.
-Suboxone sublingual tablets are not indicated for induction therapy; Suboxone sublingual film for sublingual or buccal use should only be administered sublingually for induction to minimize exposure to naloxone.
-For patient's dependent on methadone or long-acting opioid products, buprenorphine monotherapy should be used during the induction phase as naloxone may be absorbed in small amounts and could precipitate or prolong withdrawal during induction.
-Maintenance treatment begins on day 3.

Use: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support.

Usual Adult Dose for Opiate Dependence - Maintenance:

MAINTENANCE Treatment:
-Doses of buprenorphine/naloxone should be adjusted to a level that holds the patient in treatment and suppresses opioid withdrawal signs and symptoms; doses should be titrated to clinical effectiveness as rapidly as possible as gradual titration may lead to higher drop-out rates.

SUBOXONE Sublingual Film and Sublingual Tablets:
-Progressively adjust in increments/decrements of 2 mg/0.5 mg or 4 mg/1 mg to a level that holds the patient in treatment and suppresses opioid withdrawal signs and symptoms
-Recommended target dose: 16 mg/4 mg sublingually (film, tablet) or buccally (film) once a day; dose range 4 mg/1 mg to 24 mg/6 mg
-Maximum dose: 24 mg/6 mg per day

Comments:
-Following induction, maintenance therapy is provided to hold a patient in treatment and suppress opioid withdrawal signs and symptoms; there is no maximum recommended duration for maintenance treatment and some patients may require treatment indefinitely.
-There are multiple buprenorphine/naloxone products available for maintenance treatment; these products are not bioequivalent and dose adjustments may be necessary when switching products; e.g., Zubsolv 4.2 mg/0.7 mg buccal film provides equivalent buprenorphine exposure as Suboxone 8 mg/2 mg sublingual tablet.

Use: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support.

尽快服用药物，但如果接近下次服药的时间，则跳过漏服的剂量。不要在一次服用两剂。

请立即寻求紧急医疗救助。 阿片类药物过量可能导致死亡，特别是在儿童或未凭处方使用该药物的其他人中。 过量症状可能包括严重的嗜睡、瞳孔缩小、呼吸缓慢，甚至停止呼吸。

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