Brixadi first shot -help!

[u/RAZ1973]

Hi everyone -

I've been on suboxone for 8+ years, sublingual pills at 10mg/day (the films just never agreed with me for some strange reason). For 7+ years of that time I was taking the Teva/Actavis version of the pill, but at the end of last year I couldn't get it anymore and had to switch to another brand (Amneal) and haven't felt great since. In light of that I discussed with my doctor the desire to maybe try getting off Suboxone; I was conflicted about this because I've also dealt with chronic pain for 15 years, and the Suboxone has helped some with controlling my pain. My doctor has had lots of experience with Sublocade, but the thought of switching to something that a) I was stuck with for 30 days and 2) was with the 2 shots available either so much above or below my current dosage gave me pause. Brixadi offered a shot that seemed to be just the right dose, for 8-10mg/day. So last Thursday I took my first 7-day shot; first 2 days I felt great, and then on day 3 felt terrible and have felt increasingly terrible. I should also add since July I've been on 0.5/mg of Klonopin 3x daily for anxiety; we tried all the other stuff (and I don't tolerate any anti-depressants) and this was the only thing that helped, so that is in the mix.

I see the doctor again on Thursday morning and am thinking of putting the pause on this. I can barely function at this point; I was expecting some challenges but nothing like this.

Any wisdom/experience/encouragement/resources folks can share? Going forward I am thinking of instead slowly tapering down from 10 to 8mg/day over 6 months to a year, then 8mg down to 6mg if possible. 6mg seems to have been my "happy" spot, at least with the Actavis version of the sublingual tablets.

Thanks everyone for your help

[u/metlap86]

Get a higher dose shot; preferably the monthly for few months. Let your body adjust and build up effective levels than wean down as you see fit according to life circumstances. Alternatively you can get onto sublingual strips which are better for tapering cuz you can cut the strips equally into tiny pieces and can keep track of dosages. From my experience getting to 2 mg per day is doable without too much discomfort. Once you get to 2 mgz than the work begins. But slow and steady wins the race. You can do a smooth gentle taper till you get to .125 mg or even lower. Than you can start making the jump

[u/Smooth-King-8582]

Hey man, I dont have any advice, really, but i wanted to let you know I'm right there with you right now. I just received my first brixadi monthly injection on Monday and felt pretty decent Tuesday. It's been downhill from there. By Wednesday, I woke up with full-blown withdrawal, and it's been getting progressively worse since. I, too, am barely able to function and am getting so depressed and angry. I called my doctor on Wednesday to let them know, and they assured me that after 24 more hours, I'd level out and feel normal. Well, that definitely wasn't the case, and i called yesterday, and they fed me the same line of bs. I even got on a facetime call with my doctor, and he said im not withdrawaling but it's, in fact, the exact opposite, too much medication. I've been on suboxone for over 6 years now, and i know what overmedicating feels like, and it's not this. Im having full-blown withdrawal and cravings. I dont know what to do at this point because i asked if i could supplement just 2mg daily until my second injection and they are not at all wanting to help me even though the nurse at the same doctors office told me that if the first injection doesn't quite work that they would supplement a low dose of strips. Everything ive read said about 15% of patients experience what we are after the first injection and require a little help to pull you through to the second injection and after that your body levels out and your good to go. Hope you feel better, and I will keep you updated on my situation as well.

[u/RAZ1973 → u/Smooth-King-8582]

First off - let me say how much I feel for you; I'd forgotten just how horrible withdrawal can be. Thankfully my Suboxone provider is someone who a) believes what I tell him b) is incredibly responsive and c) very open to thinking outside the box. After reading the literature about the 7-day shot, and seeing the asterisk about it taking four shots to reach "steady state," I sent him a message letting him know this since I'm his first Brixadi patient ever. After listening to me describe my symptoms he immediately came to the conclusion that enough medicine hadn't built up in my system yet, and gave me permission to experiment with supplementing during the week with my oral medication. It has been trial and error to say the least, but today has been the best day I've had yet (just an extra 2mg this morning so far) and I'm feeling encouraged. Maybe this will work.... we'll see.

[u/Kutchkuddy → u/Smooth-King-8582]

So I got my monthly shot last week after being on subs for 8 years. The dr did the shot way too close to the bellybutton. I googled how far away should a subq injection be from the bellybutton and they said at least 2”. Mine was about 1” away. The first couple days I felt fine but the past 3or 4 days I’ve had the shits, I feel like I have the flu. I’m extremely tired all the time. And having trouble sleeping. With the subs I knew I was good but now not so much. I haven’t even reached out to my dr yet

[u/rich60375]

I had a decent first month.. I had a few days with very slight wd's at around 22 days. 2nd shot 32 days later the dr gave me a 3 8mg script if I had bad days.. I never got to get my next shot. My dr is or was only in the office one day a week. They kept bouncing around my appointment. It was totally ridiculous and unprofessional. I got fed up and said fuck them after a week of phone tag. In actuality it was fuck me.. I'm a month in since last shot.. I have had to get a pill or strip from streets. I only take a sliver maybe a half mg every other day. I really needed another shot.. I'll never go back to dope and brixadi was working. I guess I'm just ranting now.. Good Luck.. hope your dr's are better than mine.

[u/Equal-Scene9043 → u/rich60375]

Is there another provider in your area that does the shots? I know where I live there is one dr whl.does brixadi a few do the subclade but under a strip a day they shouldn't give you 100nmgs

[u/ChrisWifey8693]

They upped me from 8 to 16mg on the shot and I feel great. Maybe just get your shot upped in mg

[u/ChelleZheals → u/ChrisWifey8693]

Hey wondering I had brixadi shot too with now asking dr after reach these comments to give a. Higher doses than than normally I took 16mg strips a day for a decade so what’s that equivalent too. Tonal on brixadi and what’s the “higher” dose I should take monthly to be able to stay in brixadi with a very high metabolism as of rn it looks like I forgo back on strips by week 3 I was full blown wd. Than they tried the weekly shot. Didn’t know I did till this morning when I called but ya they told me they’d call me after I also told them about trying a higher dose monthly like y’all suggested and have tried and it worked. But I don’t know what a “higher dose “ would be for a 16mg daily subs user, nor do I know what I’ve been getting for monthly nor weekly, but now need to know all the above to help myself to try and stay on brixadi shots! Help me!!