Can Suboxone Cause High Blood Pressure? What Patients Should Know

If you take Suboxone and notice a change in your blood pressure, you may wonder whether the medication is responsible. Can Suboxone cause high blood pressure? High blood pressure is not a typical direct effect of Suboxone. In fact, buprenorphine-containing medications can sometimes cause orthostatic hypotension, which means your blood pressure drops when you stand up.

However, blood pressure can change for many reasons during opioid use disorder treatment. Opioid withdrawal, other medications, dehydration, anxiety, pain, existing high blood pressure, and other health conditions may all affect your readings.

Because several factors can affect blood pressure, talk with a healthcare professional about new or ongoing changes rather than assuming Suboxone caused them.

Does Suboxone Affect Blood Pressure?

Suboxone contains two medications: buprenorphine and naloxone.

Buprenorphine is a partial opioid agonist that helps reduce opioid withdrawal symptoms and cravings. Naloxone is an opioid antagonist included mainly to discourage misuse.

Suboxone can affect blood pressure, but its prescribing information specifically warns about orthostatic hypotension rather than high blood pressure as a typical effect. With orthostatic hypotension, your blood pressure drops after you stand up. This can cause dizziness, lightheadedness, weakness, or fainting.

If you feel dizzy while taking Suboxone, low blood pressure or a drop in blood pressure after standing may be one possible cause.

However, Suboxone does not cause every episode of dizziness. Dehydration, illness, other medications, changes in blood sugar, and other health conditions can cause similar symptoms.

Can Suboxone Raise Blood Pressure?

Suboxone does not commonly cause ongoing high blood pressure.

If your blood pressure increases while taking Suboxone, other factors may explain the change.

Possible causes include:

opioid withdrawal symptoms
anxiety or emotional stress
pain
caffeine or stimulant use
nicotine
certain prescription or over-the-counter medications
dehydration or illness
existing high blood pressure
missed doses of blood pressure medication
other health conditions

Blood pressure also changes naturally throughout the day. One high reading does not necessarily mean you have an ongoing problem.

A healthcare professional can review several readings along with your medications, symptoms, health history, and recent treatment changes to help identify the cause.

Opioid Withdrawal Can Increase Blood Pressure

It is important to separate the effects of Suboxone from the effects of opioid withdrawal.

Opioid withdrawal can activate the body’s nervous system. Symptoms can include sweating, rapid breathing, a faster heart rate, restlessness, and high blood pressure.

Someone who recently reduced or stopped opioids, missed treatment doses, or developed withdrawal symptoms may notice temporary changes in heart rate or blood pressure.

For this reason, it can sometimes be difficult to tell whether a blood pressure change comes from medication, withdrawal, or another cause.

Precipitated Withdrawal Can Also Affect Blood Pressure

The timing of the first buprenorphine dose matters. Taking buprenorphine too soon after certain opioids can trigger precipitated withdrawal.

Withdrawal can cause sweating, a faster heart rate, and changes in blood pressure. RCC’s guide to understanding and avoiding precipitated withdrawal explains why the timing of your first buprenorphine dose matters.

This is one reason a qualified healthcare professional should guide Suboxone treatment and major treatment changes.

Can Suboxone Cause Low Blood Pressure?

Yes. Buprenorphine-containing medications can cause a drop in blood pressure.

The current Suboxone prescribing information warns that the medication may cause orthostatic hypotension.

Orthostatic hypotension means your blood pressure falls when you change position, especially when you go from lying down or sitting to standing.

Symptoms can include:

dizziness
lightheadedness
weakness
feeling unsteady
blurred vision
feeling like you may faint
fainting

MedlinePlus also notes that buprenorphine or buprenorphine/naloxone may cause dizziness, lightheadedness, and fainting when you stand up too quickly.

Talk with a healthcare professional if these symptoms happen often, become severe, or cause you to faint.

Why Do I Feel Dizzy After Taking Suboxone?

Dizziness can have several causes.

For some people, blood pressure may drop when they stand. Buprenorphine can also cause drowsiness or lightheadedness.

Other possible causes of dizziness include:

dehydration
not eating enough
low blood sugar
anemia
illness
anxiety
other medications
changes in blood pressure
inner-ear problems
heart rhythm problems

Tell your prescribing clinician if the dizziness began after you started Suboxone or changed your dose. The timing of your symptoms may help your healthcare team find the cause.

Do not change your dose on your own because of dizziness. RCC’s overview of Suboxone treatment and potential side effects provides more information about symptoms that may occur during treatment.

Suboxone, Hypertension, and Other Blood-Related Issues

Having high blood pressure does not automatically mean Suboxone caused it.

High blood pressure is common and can exist separately from opioid use disorder treatment. It also often causes no obvious symptoms.

If you already take medicine for high blood pressure, make sure your Suboxone prescriber knows which medications you use.

Your full medication list can help your healthcare team understand possible causes of blood pressure changes, drowsiness, breathing problems, or other symptoms.

Tell your healthcare provider about:

prescription medications
over-the-counter medicines
vitamins and supplements
herbal products
alcohol use
other substances

This information can help your healthcare team review possible medication effects and interactions.

Buprenorphine and Blood Pressure

Buprenorphine is the main treatment medication in Suboxone.

High blood pressure is not its main blood-pressure-related concern. Instead, the prescribing information warns that buprenorphine may cause orthostatic hypotension.

Several factors can affect how someone responds to buprenorphine, including:

dose
other medications
recent opioid use
hydration
other health conditions
stage of treatment
withdrawal symptoms

A clinician should look at the full situation when someone develops a major or ongoing change in blood pressure.

Naloxone and Blood Pressure

The naloxone in Suboxone serves a different purpose from naloxone given by injection or nasal spray during an opioid overdose.

When you take Suboxone as directed under your tongue or inside your cheek, buprenorphine provides the main treatment effect. The medication also contains naloxone to discourage misuse.

Naloxone used to reverse an opioid overdose can trigger sudden withdrawal in someone who depends on opioids. Opioid withdrawal can cause a faster heart rate and changes in blood pressure.

This situation differs from taking Suboxone as prescribed for opioid use disorder.

Other Medications May Affect Blood Pressure

If your blood pressure changes while taking Suboxone, your clinician may also review your other medications and substances.

Some products can raise or lower blood pressure on their own.

Examples include certain:

blood pressure medications
stimulants
decongestants
antidepressants
sedating medications
pain medications
supplements

Medications can also interact with each other.

Do not start, stop, or change a prescription medication without discussing the change with your healthcare provider.

Should I Monitor My Blood Pressure While Taking Suboxone?

Blood pressure monitoring may be useful if you already have high blood pressure, have noticed unusual readings, or experience symptoms such as dizziness or fainting.

If your clinician recommends checking your blood pressure at home, try to take each reading under similar conditions.

General steps include:

Sit quietly before checking your blood pressure.
Keep your feet flat on the floor.
Support your arm comfortably.
Avoid talking during the measurement.
Record the reading.
If the reading seems unusually high, rest briefly and check it again.

One unusual measurement may not tell the whole story. Keeping a record of several readings can give your healthcare professional more useful information.

When Should You Contact Your Doctor About Blood Pressure Changes?

Contact your healthcare provider if you notice an ongoing or unexplained change in your blood pressure, especially if it began after you started treatment or changed your dose.

You should also discuss symptoms such as:

repeated dizziness
frequent lightheadedness
fainting
unusual weakness
a fast heartbeat that does not go away
recurring headaches with high readings
blood pressure that stays high
low blood pressure with symptoms

Your healthcare provider can review your medications, dose, hydration, withdrawal symptoms, and health history to help identify the cause.

When Is High Blood Pressure an Emergency?

Very high blood pressure can require urgent medical care.

The American Heart Association advises that if your blood pressure is higher than 180/120 mm Hg, wait at least one minute and check it again. If the second reading remains that high, contact a healthcare professional promptly.

If your blood pressure is higher than 180/120 mm Hg and you also have symptoms such as:

chest pain
shortness of breath
back pain
numbness
weakness
changes in vision
difficulty speaking

call 911. This may be a hypertensive emergency.

Do not assume these symptoms are simply a side effect of Suboxone.

Should You Stop Suboxone If Your Blood Pressure Is High?

Do not suddenly stop prescribed Suboxone just because you notice a high blood pressure reading unless a healthcare professional tells you to stop.

Stopping buprenorphine suddenly can cause withdrawal. If you want to stop treatment, work with your healthcare provider on a safe plan.

Withdrawal itself can affect heart rate and blood pressure. RCC’s guide to Suboxone withdrawal and what to expect explains what may happen when someone reduces or stops the medication.

Instead of changing your medication on your own, tell your healthcare provider about ongoing or concerning blood pressure changes. Your provider can look at possible causes such as withdrawal, medication effects, existing high blood pressure, other drugs, or another health problem.

Frequently Asked Questions About Suboxone and Blood Pressure

Does Suboxone cause hypertension?

High blood pressure is not a typical direct effect of Suboxone. Suboxone can cause orthostatic hypotension, which means blood pressure drops when you stand.

If high blood pressure develops during treatment, a healthcare professional can look for other possible causes, including withdrawal, stress, other medications, and existing high blood pressure.

Does Suboxone lower blood pressure?

Suboxone can sometimes lower blood pressure, especially when you stand up. This is called orthostatic hypotension. It can cause dizziness, lightheadedness, or fainting.

Can Suboxone make your blood pressure go up temporarily?

A high reading during Suboxone treatment does not necessarily mean the medication caused it.

Pain, anxiety, physical activity, caffeine, nicotine, withdrawal, illness, and other factors can cause short-term increases.

Talk with a healthcare professional if your readings stay high.

Can opioid withdrawal cause high blood pressure?

Yes. Opioid withdrawal can activate the body’s nervous system and may cause a faster heart rate, sweating, rapid breathing, and high blood pressure.

Why do I get dizzy when I stand up after taking Suboxone?

Suboxone can cause orthostatic hypotension, which means your blood pressure drops when you stand. This can lead to dizziness, lightheadedness, or fainting.

Standing up slowly may help, but talk with a healthcare professional if the symptoms continue or become severe.

Can Suboxone cause a fast heartbeat?

A fast heartbeat can have several causes. It may occur during opioid withdrawal. Anxiety, dehydration, stimulant use, illness, and other health conditions can also cause it.

Talk with a healthcare professional if you have an ongoing fast or irregular heartbeat.

Is high blood pressure a reason to stop taking Suboxone?

Not necessarily.

Do not suddenly stop Suboxone without talking with your prescribing clinician. Stopping it suddenly can cause withdrawal, which may also affect your blood pressure and heart rate.

What should I do if my blood pressure increases after starting Suboxone?

Keep a record of your readings and contact your healthcare provider, especially if your blood pressure stays high or you develop other symptoms.

Your clinician can review your medication, withdrawal symptoms, other medicines, and health conditions to help find the cause.

Can blood pressure medication be taken with Suboxone?

Some people take blood pressure medications while receiving buprenorphine/naloxone treatment. Whether a combination is appropriate depends on the medications and the person’s health history.

Some medicines can further lower blood pressure or increase drowsiness. Give your prescriber a complete medication list and follow their instructions.

Should I worry about one high blood pressure reading?

One high reading does not always mean you have ongoing high blood pressure.

When you get an unusually high reading, check it again and keep a record of your results. Talk with a healthcare professional if your readings stay high.

A reading above 180/120 mm Hg needs special attention. If it remains that high and you also have chest pain, shortness of breath, back pain, numbness, weakness, vision changes, or trouble speaking, call 911.

The Bottom Line: Can Suboxone Cause High Blood Pressure?

So, can Suboxone cause high blood pressure? High blood pressure is not a typical direct effect of Suboxone. A better-established blood-pressure effect of buprenorphine/naloxone is orthostatic hypotension, which can make blood pressure fall when you stand and cause dizziness or lightheadedness.

Blood pressure can still rise during treatment for other reasons. Opioid withdrawal, anxiety, pain, other medications, stimulants, existing high blood pressure, and unrelated health problems can all play a role.

Talk with a healthcare professional if you notice a new, ongoing, or major change in your blood pressure rather than changing or stopping Suboxone on your own.

Patients who receive Suboxone treatment through Recovery Care of Columbia can contact their treatment team with questions about symptoms or medication changes. For people looking for treatment in Tennessee, RCC provides online Suboxone treatment through telemedicine. Call or text us today at (931) 548-3062.

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