Suboxone® dosage guide: how to know if you’re on the right dose

Starting Suboxone® can feel overwhelming. You’re taking a big step toward recovery, but you might catch yourself wondering: Am I on the right dose of Suboxone? Should I feel this way? What if I’m taking too much, or too little?

These questions are completely normal. Finding the right Suboxone dosage isn’t like taking a pain reliever where one size fits most people. Your ideal dose depends on factors like your opioid use history, withdrawal symptoms, body weight, and how your system responds to buprenorphine treatment.

Here’s what many people don’t realize: Suboxone dosage isn’t just about eliminating withdrawal symptoms. The right dose should help you feel stable, reduce cravings, and allow you to focus on your recovery without feeling sedated or experiencing breakthrough opioid withdrawal signs, ultimately improving your treatment outcomes.

At QuickMD, we regularly work with opioid dependent patients going through treatment. We’ve seen how the right dosage can be life-changing and how confusing it can be to figure out what “right” actually means for you.

Finding your dosage may take time and patience. Most people don’t land on their perfect dose immediately. It’s a process that requires close communication with your provider and an honest assessment of how you’re feeling on a day-to-day basis.

In this guide, we’ll walk through everything you need to know about Suboxone dosage, from how doctors determine your initial dose to recognizing signs that an adjustment might be needed. We’ll also explain why it’s never safe to adjust your dose on your own, even when you’re frustrated or uncomfortable. Let’s start with the basics.

What is Suboxone, and how does dosing work?

Suboxone is a combination drug containing buprenorphine and naloxone, designed specifically for Medication-Assisted Treatment (MAT) for opioid use disorder. MAT is a proven approach that combines medication to treat opioid use disorder. It includes counseling and support, and helps most people stay off opioids long-term. Understanding how this medication works can help you better understand why dosage matters so much.

Buprenorphine and naloxone

Buprenorphine is what’s called a partial opioid agonist. This means it activates the same brain receptors as other opioids, but only partially, giving you enough effect to prevent withdrawal without the dangerous high. It’s also different from full opioid agonists (like heroin, fentanyl, or oxycodone) in that it has a “ceiling effect.” A ceiling effect means there’s a limit to how much it can affect you. Even if you take more, you won’t get higher effects, which makes it much safer.

Naloxone is the second ingredient in Suboxone. It’s an opioid blocker that’s included as a safety feature. When you take Suboxone film under your tongue as prescribed, the naloxone doesn’t really affect you. But if someone tries to inject Suboxone, the naloxone kicks in and blocks the opioid effects, which helps prevent misuse.

When you place Suboxone film under your tongue, it goes directly into your bloodstream instead of through your stomach, allowing for more predictable absorption and effectiveness. When your provider prescribes Suboxone, they calculate your starting daily dose based on what opioids you were using, how severe your withdrawal symptoms are, any previous addiction treatment, and your overall health.

The induction dosage of Suboxone

Your first few days are called “induction.” Induction is essentially your body’s adjustment period to the new medication. During the induction dosage phase, your provider prescribes a starting dose, usually around 2-4 mg of the active ingredient, buprenorphine, and closely watches how you feel and respond. The goal during these first days is simple: stop severe symptoms (like nausea, muscle aches, and anxiety) without making you feel too drowsy or uncomfortable from the medication itself.

How providers determine your right daily dose of Suboxone

Finding your best Suboxone dosage isn’t guesswork. QuickMD providers use proven guidelines and keep a close eye on how you’re doing to figure out what a stable dose looks like for you.

When a doctor recommends Suboxone, they look at a few important factors that affect how much medication you’ll need. Your history with opioids is the biggest factor. Someone who was using strong street drugs like fentanyl will probably need a different amount than someone who was taking prescription pain pills.

The first few days on Suboxone

Most doctors start patients on 2-4 mg on day one. If you’re still having withdrawal signs and symptoms like restlessness, nausea, or strong cravings, your doctor may slowly increase your dose, usually adding 2-4 mg at a time, until you feel stable.

Maintenance dosage: your long-term dose of Suboxone

Once you’re stable, you’ll settle into what’s called a “maintenance dose.” This is the amount you’ll need to take every day to stay comfortable and focused on your recovery. Research shows most people do well on somewhere between 8-24 mg of buprenorphine daily, though everyone’s different, and some people need more or less.

What your maintenance dose should do:

• Stop or greatly minimize withdrawal symptoms
• Minimize cravings for other opioids
• Let you function normally in your daily life
• Keep you feeling stable between doses
  

For a smooth maintenance treatment, the key is finding the lowest dose that keeps you comfortable and stable throughout each day.

Signs your Suboxone dose might be too low

If your dose is too low, you’ll likely experience ongoing symptoms and possible adverse reactions that interfere with your recovery and quality of life.

Persistent withdrawal symptoms

The most obvious sign of your Suboxone dose being too low is continued opioid withdrawal syndrome. Watch for ongoing issues like restlessness or anxiety, sleep problems, muscle aches and joint pain, nausea or digestive issues, runny nose or flu-like symptoms, and mood swings or irritability.

These intense acute withdrawal symptoms should start getting better within the first few days of taking Suboxone. If you’re still dealing with this after your first week or so, you probably need a higher dose.

Opioid cravings and breakthrough symptoms

When your Suboxone dose is right, you should notice that you’re not thinking about using other opioids nearly as much. If you’re still having frequent thoughts about using or dealing with strong urges, it usually means your dose isn’t quite doing its job.

Some people have what’s called breakthrough symptoms. This is when you start feeling withdrawal-like again before it’s time for your next dose. For example, you might feel sick or uncomfortable in the afternoon even though you took your Suboxone that morning. If you regularly start feeling worse several hours before your next dose is due, you might need a higher daily amount.

Signs your Suboxone dose might be too high

Taking more Suboxone than you need can create its own set of problems, too. Knowing what to watch for helps make sure you’re getting the right amount. Not too little, but not too much either.

Sedation and drowsiness

The biggest red flag that your dose might be too high is feeling constantly tired or drowsy. It’s normal to feel a bit sleepy during your first few days on Suboxone, but if you’re still struggling to stay awake weeks later, that’s usually a sign your dose needs to come down. You might find yourself having trouble staying awake during everyday things, feeling like your brain is in a fog, dozing off when you shouldn’t be, or having a hard time focusing at work or during conversations.

Other signs of high buprenorphine doses

Taking too much Suboxone can also cause bad constipation, ongoing nausea or throwing up, big changes in how hungry you feel, sweating more than usual, or headaches that keep getting worse.

Remember that more Suboxone doesn’t necessarily equal better. Finding the right dose means taking just enough to feel balanced and comfortable as you go about your day.

What to do if you miss a dose of Suboxone

Missing your Suboxone dose can be nerve-wracking, especially if you’re already worried about feeling sick again. But don’t panic. Here’s what to do, depending on how much time has passed:

• Less than 12 hours: Take your regular amount as soon as you remember. Don’t take extra to make up for lost time. Just stick with your normal dose and get back on your usual schedule.
• 12-24 hours: Go ahead and take your missed dose right away. Keep in mind that you might start feeling some mild withdrawal symptoms.
• More than 24 hours: Don’t try to “catch up” by taking twice as much. Just take your regular single dose and call your QuickMD provider to let them know what happened.
• When to call your provider: Reach out if you’ve missed several doses in a row, you’re feeling withdrawal symptoms, or you’re having strong urges to use opioids again.
  

When you’re going through withdrawal symptoms or not feeling right, it might be tempting to change your dose. But there are some serious reasons why adjusting your dose on your own is not a good idea, including the risk of precipitated and prolonged withdrawal and respiratory depression.

Why you shouldn’t adjust your Suboxone dose on your own

Never adjust your Suboxone dose on your own. Changing your dose on your own can trigger sudden, severe withdrawal symptoms, cause you not to get enough medication to protect you from relapse, create dangerous drug interactions with other medications you’re taking, or mess with how your body responds to the medication.

Your QuickMD provider understands how well your body absorbs buprenorphine, the safest ways to change doses, what warning signs to watch for, and how to make sure Suboxone works well with any other medications you’re taking.

Instead of trying to fix things yourself, book a visit with your QuickMD provider to discuss how you’re feeling and get professional guidance on next steps. Don’t hesitate to ask questions about your treatment plan, and try to be patient with the process. Finding a stable dose sometimes takes a little time to get just right.

How QuickMD supports your Suboxone treatment

At QuickMD, we know that figuring out the right Suboxone dose is just one piece of getting your life back on track from opioid addiction. Our addiction treatment services start with an induction appointment where a licensed provider will evaluate your individual needs and prescribe an initial 7-day supply of buprenorphine-naloxone.

We start with your first appointment, where one of our licensed providers will get to know your situation and give you a week’s worth of medication to get started. That first visit is $99, which includes a follow-up visit within two weeks to see how you’re doing. After that, we’ll check in with you once a month to make sure everything’s going well. Our providers will see how your current dose is working for you, make changes if needed, and help you work toward your recovery goals.

Want to learn more about recovery? Check out our Learning Center, where we cover topics like creating effective relapse prevention plans and debunking common myths about opioid use disorder treatment.