Working out on Suboxone®: what to expect and how to start safely

You may be wondering whether taking Suboxone® (buprenorphine-naloxone) affects how you exercise or what you can do during a workout. For most people, staying active can remain a normal part of everyday life while on treatment.

We’ll cover how Suboxone may affect your energy, workouts, and body, along with what’s worth discussing with your QuickMD doctor.

Is it safe to work out while on Suboxone?

Yes. For most patients on a regular dose, exercise can remain a normal part of your routine. Being on Suboxone (buprenorphine-naloxone) doesn’t mean you need to step away from the activities that are important to you. Staying active can continue to be part of your day-to-day life, including going to the gym.

As a partial opioid agonist, buprenorphine has a ceiling effect on respiratory depression, so its effects on breathing tend to level off rather than continuing to increase with the dose.

Serious breathing problems tied to Suboxone (buprenorphine-naloxone) are almost always connected to combining it with benzodiazepines, alcohol, or other substances that also slow breathing, or to someone who already has reduced lung function. Outside of that, a workout on a regular dose isn’t something to be afraid of.

There are a few common Suboxone (buprenorphine-naloxone) side effects worth knowing about before you head to the gym:

• Feeling lightheaded or dizzy. Suboxone can cause dizziness or a drop in blood pressure when you stand up, which may be more noticeable when you’re moving between exercises.
• Sweating more than usual. Because exercise already makes you sweat, you may notice this side effect more during a workout
• Headache. A headache can make exercise uncomfortable, especially during more straining activity.
• Constipation. Staying active may actually help with this common side effect, along with drinking enough water and getting enough fiber.
• Nausea. If you’re feeling nauseated, you may want to ease up on your workout until it passes.

If you have a heart or lung condition or have had a change in your Suboxone dose, mention exercise at your next visit. Your QuickMD doctor can help you determine whether you need to make any adjustments to your routine.

How Suboxone can affect your energy and stamina

A lot of patients on Suboxone say their workouts don’t feel the way they used to, that their energy feels flat or limited, or that they tire out sooner than before. If that’s you, you’re not alone.

• About 1 in 7 people report feeling weak or low on energy while taking Suboxone, and roughly 1 in 20 report drowsiness.
• People taking a placebo (meaning no real medication at all) have reported the same weak, low-energy feeling just as often.

So Suboxone may be part of what’s draining your energy, but it’s not the only reason. Poor sleep, not eating enough, stress, and other health factors can also leave you feeling tired.

If low energy is getting in the way of exercise, it may help to understand why. Feeling tired on Suboxone or having changes in your sleep can both affect how much energy you have for your workouts.

Why a workout may feel different

You may notice that a hard workout doesn’t leave you feeling as good afterward as it used to. That doesn’t mean exercise isn’t helping. The benefits may show up in other ways, like having more energy, sleeping better, or feeling more balanced throughout the day.

You may also go through periods when you feel emotionally flat or notice changes in how you feel, including during exercise. If that happens, talk with your QuickMD doctor. Staying active can still be an important way to support your physical and mental health, even when every workout doesn’t feel great.

Why you may feel a cold chill or sweat heavily when you work out

If a light workout leaves you soaked through, or you go from sweating heavily to freezing cold the second you stop moving (in a way that feels a lot like withdrawal, even though your dose hasn’t changed), you’re describing something a lot of patients on Suboxone report. You’re not imagining it.

Sweating is a documented side effect of Suboxone and has been reported by about 12% to 14% of patients. About 10% of people on a placebo reported sweating, too. So, some of what you’re feeling is a side effect, and some of it is just that exercise raises your body temperature on its own.

Exercise can sometimes leave you feeling chilled as your body cools down, especially if you’ve been sweating heavily. A few simple changes can help you stay more comfortable:

• Bring a change of clothes; a dry shirt makes a real difference once you’ve stopped moving.
• Dressing in layers means you can shed one before you’re drenched and add it back once you cool down. 
• Skip the spot right under a fan or vent until you’ve dried off. 
• Let your cool-down run long instead of stopping the second you’re done. 
• Sip water the whole way through rather than making up for it after. 
• Try swimming or another water-based activity if it feels more comfortable.

If sweating or chills are making it harder to exercise, talk with your QuickMD doctor. They can help you look at what may be contributing and find ways to keep you active and comfortable.

When can you start exercising during Suboxone treatment?

You don’t have to wait a fixed number of days before working out on Suboxone. If you’re feeling up to it, you can start right now.

As you get moving, pay attention to how you feel. Suboxone can affect alertness and thinking, particularly when you’re starting treatment or adjusting your dose. While this is most important when driving or operating machinery, it’s also worth paying attention to how you feel during exercise and taking it easier if you feel dizzy or drowsy.

Steps to start:

1. Talk about exercise at your next visit, especially after a dose change or if you have other health conditions that may affect your workouts. Your doctor can help you decide what level of activity makes sense for you.
2. Start with something light, like walking, rather than jumping back into your previous routine.
3. Build up gradually as you see how your body responds.
4. Treat dizziness, a pounding heart, or breathlessness that doesn’t settle as a reason to stop and check in with your QuickMD doctor.

Once you feel comfortable, staying active can be a healthy part of your routine. A 2022 review of more than 1,200 people in treatment found that exercise improved fitness and helped reduce substance use, with no serious problems linked to exercise.

You don’t need to jump back into your old routine or start an intensive one right away. Starting small gives your body time to adjust while still getting the benefits of movement.

Should you work out before or after your dose?

There isn’t a set rule for whether you should exercise before or after taking Suboxone. What matters most is finding a routine that works with your dosing schedule and how you feel.

Some people prefer to work out before their dose, while others take Suboxone in the morning or evening and exercise later without an issue. If you exercise around the time of your dose, make sure the film has dissolved completely and follow the instructions for eating and drinking around your dose.

Don’t change or skip your dose to make a workout feel easier. Changing your Suboxone dose on your own can leave you feeling unwell and interfere with your treatment.

If your dosing schedule is making it harder to exercise, talk with your QuickMD doctor. They can help you find a schedule that works without changing your treatment on your own.

Building strength and muscle: what the testosterone research shows

Long-term opioid use can lower testosterone. This is called opioid-induced androgen deficiency, and it can affect your energy, muscle strength, body fat, sex drive, mood, and bone health. Hormone changes in men and women can also be a factor behind weight changes during Suboxone treatment.

Buprenorphine may have less of an effect on testosterone than some other opioids. In one small study, men taking buprenorphine had higher testosterone levels than men taking methadone, with levels similar to men who were not taking either medication.

The study was small and included only 17 men taking buprenorphine, so there’s still a lot we don’t know, especially about how Suboxone may affect hormones in women.

If you’re noticing ongoing changes in your energy, mood, sex drive, or strength, talk with your QuickMD doctor. They can help determine whether your hormone levels or something else may be contributing.

Building muscle and strength is still very much on the table. Patients on Suboxone put on muscle, train for races, and reshape their bodies all the time. It may just take longer to see it than it used to.

How exercise supports your treatment and long-term recovery

Exercise can support your treatment, but it doesn’t replace it. Staying active can give you another healthy way to manage stress, cravings, and difficult days while you continue your medication, counseling, or other parts of your treatment.

Research suggests that exercise can help. People who stay active during treatment may see better fitness and less substance use. And it doesn’t always take a long workout to feel a difference. In one study, a 20-minute bike ride helped ease cravings during and shortly after exercise.

You also don’t need a perfect workout routine to benefit. Start with an amount of activity that feels manageable and build from there. Research has found fitness can still improve even when people aren’t able to stick to every planned workout.

The same idea applies to treatment: progress doesn’t depend on doing everything perfectly. If you have questions about exercise or staying on Suboxone long-term, your QuickMD doctor can help you make a plan that supports your health over time.

How much you can exercise, and where to start if you have no energy

You don’t need a long or intense workout to benefit from being active. Federal guidance recommends 150 to 300 minutes of moderate activity a week, which can also support your mood and mental health.

Think of that as something to work toward, not where you need to start. If your energy is low, even a few minutes of movement can be a good first step.

Starting small

Just like fitting treatment into your routine, adding movement to your day doesn’t have to mean making a big change:

• Step outside for five minutes.
• Pedal a stationary bike for ten slow minutes.
• Take the stairs once instead of the elevator.
• Take a short splash in a pool.
• Park a little farther away to add some extra steps.

These may not feel like full workouts, and that’s okay. Start with what feels manageable and build from there as your energy allows

Building up

Once your routine starts to feel comfortable, you can gradually add more activity. You might work toward:

• 20 minutes of moderate cardio, three times a week.
• Two short strength-training sessions a week.
• Regular stretching to support flexibility and movement.

As you become more active, make sure you’re eating enough to support your energy and strength goals. If Suboxone affects your appetite and full meals feel difficult, smaller meals, snacks, smoothies, or shakes can be easier ways to get the nutrition you need.

Lower-stakes swaps

If your usual workout feels like too much right now, try a simpler version:

• A walk somewhere flat and familiar instead of a run.
• A stationary bike instead of a road bike.
• A lap in the pool instead of a packed group class.
• Half an hour instead of a full one.

The toughest part of getting moving is the first stretch. Once you’re a few minutes into your routine, resistance tends to let up on its own. And if some days you only get through a few minutes, that’s still a day you showed up, not a day you failed.

Warning signs to stop, and when to call your doctor

Exercise can be a healthy part of your routine while taking Suboxone, but it’s important to pay attention to how you feel. Knowing when to stop or slow down can help you exercise more safely and confidently.

Stop the workout right away if you notice:

• Chest pain or pressure
• Breathlessness that doesn’t settle with rest
• Feeling faint, or actually fainting
• A heartbeat that stays racing or feels irregular
• Confusion

Mention these at your next visit instead of stopping what you’re doing:

• Sweating or chills that are bad enough that exercise doesn’t feel worth it
• Dizziness every time you stand up quickly
• Energy that hasn’t improved after a few weeks of a steady routine
• A workout injury you didn’t feel happen
• Strength that keeps going backward instead of forward

If you’re not sure whether something’s worth mentioning, read when to call your doctor about a side effect for more guidance. Mentioning any of this won’t put your treatment at risk.