Doses for Buprenorphine

[debbluebird]

I need help with deciding when to take the buprenorphine film. Currently I take .5 mg at 2:30pm to prevent insomnia. I need to increase it to 1 mg, dividing the dose into two times. My injections are no longer working. The RLS is increasing. I'm now having RLS one to three times a night, so I'm sleeping less.
Should I take .5mg in am and .5mg in pm? What times?
Thanks

[ViewsAskew]

I wish I had an answer, Deb. What have you been doing? I have never used it.

[debbluebird]

I tried taking an extra 1/8th in the morning. But my RLS has been increasing, so I was still having trouble.

Today the RLS hit me at 4:45pm, which is rare. I didn't take the 1/8th this morning because it wasn't helping, or it seemed. I took another 1/4th, so now I'm awake. Also with the increase tonight, I was nauseous and itchy. I took meds for both of those.

There have been times, where I was sleeping great. The universe is against me from sleeping. Needless to say, I'm exhausted.

I don't get another back injection until March 7th. Will see how long it helps.

[ViewsAskew]

Ugh - sounds miserable.

[debbluebird]

I was able to sleep last night. I took.the extra 1/4th again at 5. Not itchy or nauseous tonight. I am hopeful.

[debbluebird]

I also want to add, that I used to take 15mg of methadone. That's the same as 2mg of buprenorphine.
I decided to just leave the times alone. I wrote the other post when I was taking less.
I now take 1 mg at 2pm and 1 mg at 5pm. It's working.
I'm sleeping with no RLS. 9 hours

[Polar Bear]

That's a great result. 9 hours sleep is bliss.

[SquirmingSusan]

Today I finally got in to see the pain doctor I used to see years ago before Dr. B took over my care and then my local neurologist, who can no longer prescribe methadone.

He said he would put me back on methadone and also asked if I was interested in Belbuca. I said I would happily give it a try. I'm always a bit scared of trying new medications but I'll see how it goes.

When I saw him previously I had to educate him on RLS, and bought him the "Clinical Management of RLS" book. He remembered me and was a lot more familiar with RLS this time.

He's a good guy but the pain clinic is a pain! I'll have to go in every 3 months and pee in a jar. Plus it's attached to the hospital where my daughter tried to die from ulcerative colitis, and my hubby tried to die a couple times during his treatment for acute leukemia. I usually hate driving into St. Paul but my stress level was off the charts today.

Anyway, I'm hoping for some more solid nights of sleep. Kratom makes it possible to sleep for 2 -4 hours and then I have to take more.

[SquirmingSusan]

Oh for goodness sakes. My doctor thought my insurance might hassle me about about the Buspar, so he sent off a prior auth form immediately. The pharmacist says that's where my prescription is stuck. He said it would cost $500 without insurance, so not paying out of pocket. We'll see if I ever get to try the stuff or if I just go back on methadone.

[debbluebird]

Buspar is for anxiety. I doubt it would help RLS.
Belbuca is another name for buprenorphine. I have to be drug tested at my pain clinic and so does my husband, who goes to a different pain clinic. It's a law in our state.
Good luck

[SquirmingSusan]

I meant Belbuca. I said it right the first comment. It's all approved now by my copay will be $250 this month, and $160/month after that. On a Medicare Advantage plan so no help from the coupon program.

How does anyone afford this stuff? My pain doctor offered me the choice between Belbuca and methadone. I put in a phone call to switch me to methadone.

[debbluebird]

I don't have an advantage plan. I have the medicare plan F, plus a drug plan. Mine cost $20 last time, for 23, 2mg strips.

[SquirmingSusan]

Plan F is no longer available. I'll be shopping around for a different Advantage plan when open enrollment comes around.

The thing that blows my mind is that apparently there is a generic buprenorphine for opioid use disorder, but isn't available for chronic pain.

[EdSoFlo]

I take 2mg sublingual tablet 2x daily, one late AM and one before bedtime, and have for about three years now. It controls my severe refractory RLS wonderfully, and with a very low side effect profile and thus far zero loss of efficacy. I've had absolutely no insomnia from it, indeed if anything the opposite. I will say the brand of generic makes a huge difference...one brand specifically is far superior, one is alarmingly useless, and a couple are OK but have various downsides (burning sensation, vile taste, less efficacious, some anxiety and nausea. I've been fortunate that my local Walgreens is terrific (something of a miracle) and the pharmacist orders my preferred brand for me. Although it's recently become very difficult for them to source (I believe has to do with the ridiculous settlement with various pharma manufacturers/distributors re: the 'opioid crisis' restricting all controlled meds to most surely absurd and arbitrary numbers to pharmacies. Don't get me started on the madness that is medication regulation...)

Best of luck to you!

[debbluebird]

That's what I have, the generic buprenorphine films. No problem getting it.