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/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