Need some Belbuca advice

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pgwarren
Posts: 7
Joined: Tue Jun 02, 2020 1:23 pm

Need some Belbuca advice

Post by pgwarren »

I am hoping to try Belbuca soon. I've been taking methadone for a few years. It has worked very well for my RLS symptoms, but I have developed depression from it. From everything I hear from Dr. B. and many users, Belbuca seems to be the best form of buprenorphine. I have tried Subutex, the tablet form (like Suboxone, but with no naloxone). But I developed some side effects that led me to stop taking it. I understand from some of you and from Dr. B. that the side effects are fewer and milder with Belbuca than Subutex or Suboxone. This seems to be due to the much higher bioavailability of Belbuca, which means one can take a smaller dose for the same effect. And that would explain the lower side effects, too, I believe.

So my question is this: if you have taken, or are taking, Belbuca, how did you titrate up? Did you start with 75 or 150 mcg, then increase gradually? And if you needed multiples of those doses, did you or can you apply more than one film to your cheek at a time?
Or did you start with a higher-dose film, and cut it to get the dose you need? I thought that cutting the films is discouraged. But I read that some of you are doing this. So I'm open to it, if it is safe.

Thank you for any light you can shed on these dosing issues. I'll be seeing my neurologist soon and will ask for a prescription. So I'd like to know what dose I should ask for, when I'm starting out like this. (He is unfamiliar with Belbuca, but he is usually very willing to help.)

ViewsAskew
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Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Need some Belbuca advice

Post by ViewsAskew »

I hope someone has tried it and can help you.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Joined: Sat Sep 28, 2013 9:31 pm
Location: Colorado Springs, Colorado

Re: Need some Belbuca advice

Post by Rustsmith »

From everything I hear from Dr. B. and many users, Belbuca seems to be the best form of buprenorphine.
As you know, I do not have any experience with buprenorphine to share but I do have a question for you. When you spoke with Dr B, was anything said about how Belbuca compares with the buprenorphine patch? Both seem to be available in lower doses than Subutex or Suboxone. The patch is also rather attractive since it is left in place for 7 days. Taking a pill once/day is far better than trying to remember every 4 or 6 hrs for some other opioids, so only having to worry about it once/week seems even better to me.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

pgwarren
Posts: 7
Joined: Tue Jun 02, 2020 1:23 pm

Re: Need some Belbuca advice

Post by pgwarren »

Good question, Steve. My info from Dr. B. was only from email exchanges I had with him, and from his other comments on his rlshelp.org. web page. He did not mention the 7-day patch in those exchanges, but if you search the web site you might find something. Indeed, the idea of a 7-day patch is appealing. You might try emailing him directly about this at somno@verizon.net, or use the link on the web page, which is the same address.

I have a vague memory that some patch users reported having issues getting the patch to stay in place for the full 7 days. But I can't recall where I read that, so please don't take that as gospel. Perhaps Dr. B. could provide some insight on that issue as well.

pgwarren
Posts: 7
Joined: Tue Jun 02, 2020 1:23 pm

Re: Need some Belbuca advice

Post by pgwarren »

Steve, I found a reply from Dr. B. to someone's request for advice on the Butrans 7-day buprenorphine patch, which her doctor had prescribed:

"I do not use or recommend the buprenorphine patches (Butrans) as this is a very long acting medication and cannot be adjusted to accommodate the diurnal variation of RLS (it is usually worse in the evening so a higher dose can be given at that time with a lower dose earlier in the day).

My recommendation was for Belbuca which is a film (not a patch) that is placed on the inside of the cheek. Each film lasts 12 hours.

I therefore cannot really give you any advice since I have no experience with Butrans and it is quite different from Belbuca due to extremely slow release 7 day action."

Hope this helps.

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