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  • Suboxone and weight gain

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    Old 03-31-2014, 11:19 AM   #1
    LadyBassPlayer
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    Suboxone and weight gain

    As most of you have read, I recently transitioned off Opana and on to Suboxone for pain management and relief of my fibromyalgia pain. It has been 2 months and I am happy to say that the Sub is controlling my pain such that I feel almost "all-over-body" pain free about 75% of the time! In the later afternoon/evening, I start to ache and that's why I say 75%, which is pretty good for pm.

    I know there are issues with Suboxone, like....what if I need acute pain control from a kidney stone, an accident, or I need emergency surgery? And the cost, and the stigma of "addiction" since that is what Suboxone is mainly used for. I get all that, and in my research and experience the past 2 months, I have found another issue with Sub that may be a deal breaker....

    Weight gain.

    It's not listed as a side effect of Suboxone, at least as far as I could find. BUT, there were more than several patients reporting significant weight gain after starting Sub (obviously after stopping other opiates) and more than can be accounted for from craving sweets (a common thing with and after withdrawal). I have experienced weight gain myself, and I can't afford to gain more, I have been trying to lose weight! I am pre-diabetic, have early heart disease in the family, I have high cholesterol (on medication)....it's actually metabolic syndrome without the high blood pressure...yet. So the LAST thing I need is to gain weight! But I have gained 10 pounds in the past 2 months without changing my eating habits or activity...if anything I have been slightly more active on the Suboxone because I feel better pain-wise, and I have been watching what I eat and eating healthier....

    SIGH....

    I guess nothing is perfect in this world. But like I said, this weight gain (many people reported gaining 40 pounds or more) may be a deal breaker, and I may have to consider going back to some other kinds of opiates. Geez, I feel SO stuck!!

    I see my doc who is prescribing the Sub in a couple weeks and will discuss it with her, and maybe I'll have to print out a number of these "patient" reports of weight gain to show the doc that it is happening, despite not being listed as a side effect. I don't really have a pain management doc right now, but can go back to my former one easily. <SIGH>

    Sorry for the long-ish post and the complaining, I'm just frustrated, and worried, and feel I am in limbo (which I don't handle very well) with pain docs, unsure of what to do, upset, did I say frustrated?, and feel like I can't "win" this balancing act we all call "pain management".

    Last edited by LadyBassPlayer; 03-31-2014 at 12:03 PM.

     
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    Old 04-07-2014, 12:31 PM   #2
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    Re: Suboxone and weight gain

    Hey LBP (Trisha)

    Sorry to have not gotten back yet, but I have been really watching my eating since you posted this. I have been waking up in the middle of the night and will eat something to help me get back to sleep. My weight, because of all the back issues, knee surgery, and now the Suboxone, is at an all time high and it frightens me! HOw have you been doing on the eating? I have made myself go from killing off a carton of ice cream to eating a bowl of Cheerios with a banana or something lower fat.
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    Old 04-08-2014, 07:39 AM   #3
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    Re: Suboxone and weight gain

    Hey there momz, thanks for replying, I was starting to hear crickets and wonder if I was all alone! Sorry you are struggling with weight gain, too. I am also at an all time high, and above my "panic point"
    I've been watching my eating as well... no sweets, less processed (white flour,etc) foods and I have still gained....so much that I had to go buy a larger size in pants until I can turn this around. From doing research, this is a common problem with people on Subs. Some people think it is from craving and eating more sweets as you are off other opiates, but not in my case. Some people reported gaining 40 pounds or more! I can't afford to let that happen as a side effect to a med when I do have other options. Sorry if I am repeating myself from my other post.
    I made an appointment with my previous pm after discussing this with the doc rx'ing the Suboxone...so hopefully I'll be on a different path soon.

    Last edited by LadyBassPlayer; 04-08-2014 at 07:43 AM.

     
    Old 04-08-2014, 08:04 PM   #4
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    Re: Suboxone and weight gain

    Trisha, sorry to hear about the weight gain! I know, these medication side effects can be SO frustrating!

    So you never gained weight while on Opana? Only since you've been on Suboxone?

    My personal experience with pain meds (morphine and dilaudid) is that I DID gain some weight while I've been using them. I would go through a 4-month long severe migraine, gain some weight, and then as soon as the migraine ended (and I tapered off the pain meds) I would start to lose weight.

    So I do believe that there might be something inherent in pain meds that makes certain people gain weight. It's weird, though, because other people report LOSING weight while on pain meds.

    During the marathon migraines, I was so incapacitated that I wasn't able to exercise as much as I ordinarily would, so I'm sure that played a role in my weight gain. Also, I was so overwhelmed with pain that I didn't have the energy to cook healthy meals as often as I'd like to. I ended up sometimes relying on packaged foods. I also developed a craving for sweets while on pain meds. Sometimes late at night I would console myself with cookies, because I felt so rotten from the constant pain. I would justify eating baked goods, since I was so miserable from the constant and severe migraine pain.

    Here's what's really strange: I've always been the kind of person who could eat whatever I wanted and never gain a pound. I was always naturally slim, and people envied me for that. Now that I've gained a bit of weight, I'm kind of embarrassed. I'm not obese or anything, but I do want to get this under control.

    Interestingly, my weight has 'plateaued", and it seems no matter what I eat (or don't eat) my weight won't budge. The same with exercise. It's got to have at least SOMETHING to do with the pain meds.

    I'm currently trying to get back to my once-slender figure. Maybe I have to cut out sweets completely and work out every single day now. That's really a pain, because NOW I am in CONSTANT migraine pain. All I want to do is rest in bed or on the couch. But I do force myself to take walks for exercise. I also am going to get more strict about cutting sweets from my diet. Oh, for the days of being pain-free and not having to worry about medication side effects!

    I just wanted to let you know that you're not the only one who has this problem. I don't take Suboxone; I take Dilaudid ER. But it certainly sounds like a similar problem. Best of luck to you!

     
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    Old 04-08-2014, 08:40 PM   #5
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    Re: Suboxone and weight gain

    Hey there Eva,
    Thanks for your reply and input, I appreciate your insight and am sorry that you are struggling with these side effects too. No, I didn't gain weight on the Opana, and I was on a decent dose of both the ER and IR.
    I don't get much exercise as it is with the fibromyalgia, any increase in activity is usually followed by a flare up of pain all over and exhaustion. It's a big negative reinforcement that I have yet to conquer!
    I am SO sorry that you get such protracted migraines....I used to get about 4 to 6 per month from age 8/10 to my 40's when I went through early menopause. Guess there was a hormonal component. I can't imagine how debilitating such long-term headaches would be. I am fortunate that my migraine headaches, now about once a month, respond well to an older drug called Midrin, if I take it soon enough. I pray that you find relief!
    As I hopefully switch off the Suboxone soon, the long acting dilaudid was one med I am hoping my pm will consider, as it is similar to Opana in strength. Do you happen to know the bioavailability of the LA dilaudid and the SA as well?

     
    Old 04-09-2014, 05:41 PM   #6
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    Re: Suboxone and weight gain

    Trisha, thanks for your message of support! So glad that Midrin works for your migraines.

    In over 20 years of getting migraines (since my teens) I have tried and failed to find success with every migraine treatment known to modern medicine. I've even gone into the hospital and had IV's of DHE-45---all to no avail.

    As the years have gone by, my migraines have progressively gotten longer and longer in duration. The pain is severe, and it would be positively excruciating without pain meds. In the past few years, the migraines have gone constant. If not for my pain management doctor, I truly think I would have gone insane by now.

    Exercise does tend to exacerbate my migraine pain, too. So I understand about being reluctant to exercise when you know it's going to make the pain worse. Plus, the migraines are so debilitating that I don't have much energy to do anything.

    I do know that the oral bioavailability of dilaudid is better than the oral bioavailability of morphine. I used to take long-acting morphine, and had terrible sweating as a side effect. When I switched to dilaudid ER, the sweating decreased a bit, but it can still get pretty bad. Yet another embarrassing side effect of the pain meds that I need in order to function. It's such a Catch-22 sometimes.

    I'm currently taking the lowest dose of dilaudid ER that works for my pain, in order to try to keep the side effects at a minimum. I could be taking a much higher dose, but then the side effects are worse. The dose I need to cover my pain is sort of on the higher end of the scale, I think.

    Exalgo (long-acting dilaudid) is super-expensive, so make sure that your insurance covers it. One months' supply is 5 thousand dollars! It's insane, but fortunately my insurance DOES cover Exalgo.

    I have looked for less-expensive alternatives. I've considered Opana. Did the Opana work well for your pain? (I know you had some problems with it, so it makes sense that you'd want to switch to something else). Morphine is inexpensive, but it has low oral bioavailability, which is why my sweating was out-of-control while on it. Exalgo provides good smooth pain relief. I hope your insurance covers it.

     
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    Old 04-09-2014, 06:17 PM   #7
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    Re: Suboxone and weight gain

    Thanks for the heads-up about the insurance and cost of Exalgo, that's good to know and a good reminder for me to check before my appt on the 18th. UGH....I have 9 more days before I see my pm and see what he thinks is best to do....it is UGH because I am tapering the Suboxone from 12 to 8 mg/day and I'm pretty miserable with the withdrawal and increased pain as I go down (currently at 9 for 2 more days) At least the floor of my mouth is less inflamed than it has been, thank God for small favors. I am prepared that this will get worse before it gets better....knowing it is time limited helps some.
    I've been getting quite a bit of sweating at night, and with any exertion, and I live in an arid climate! It is especially annoying because I have really thick (and long, past the waist) blonde hair, and I wake up with my head soaked about 2-3 inches out from my head. Sorry if that is gross....my Sub doc thinks the sweating is related to dose reduction/ withdrawal but I'm not sure. So I'll keep that in mind too when the pm and I discuss what we do from here. I don't remember the Opana causing much sweating. Oh! To answer your question... yes, the Opana did pretty well for my pain but the doc thinks I had hyperalgesia going on, based on the results of dose increases. It may just be the way my system reacts to strong opiates, in which case I may be in a bad pickle (I'd say something else but don't want any more infractions! LOL) when it comes to getting pain relief long term.

    Last edited by LadyBassPlayer; 04-09-2014 at 06:23 PM. Reason: silly auto spelling phone

     
    Old 04-10-2014, 01:34 PM   #8
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    Re: Suboxone and weight gain

    Have either of you had problems with swelling of feet. legs or hands? I have had the worst swelling issues since switching to Suboxone. I never had this problem before-I practically have CANKLES for heaven's sake. The tops of my feet look like little dough pillows by the end of the day. Maybe because I am NOT sweating? Maybe I am retaining what you all were sweating? Don't we have lovely conversations?

    I,too, and guilty of "rewarding" my pain with sweets or a bowl of cereal in the middle of the night. My PM nurse prescribed me some Intermezzo to help with waking up at night. It is made by Ambien, but is a small sublingal dose you take that lasts about 3-4 hours, or from the 2:00AM wake up sugar call till 6:00AM. It is helping me go back to sleep without all teh extra eating.

    Lord, love me this is a mess. Did you ever think this is what your life would look like at your age? I am 53, and I thought 53 would be much easier than it is. Stinks!
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    Old 04-10-2014, 03:47 PM   #9
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    Re: Suboxone and weight gain

    Amen to that, momz, some of life stinks! Makes me really look forward to a heavenly home!
    Yes, my feet and ankles have slight pitting edema....that's swelling that when you press your finger on it for a few seconds, your finger leaves it's impression or "pit" in your tissue. This started with the Suboxone, so some of the weight gain is from fluid retention.
    I'm definitely feeling the dose reduction today...each drop of 1mg takes about 2-3 days to show up symptomatically because of Sub's long half life (36 or so hours). Aching, back and feet really hurt....<sigh>. Plus the withdrawal anxiety, shakiness, and nausea. Geez....

     
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