Can You Take Suboxone While Pregnant? Safety, Risks, and Treatment

Pregnant and concerned about continuing Suboxone? Explore your Suboxone treatment options.

Yes, some patients can continue taking Suboxone while pregnant under medical supervision. Buprenorphine, one of Suboxone’s active ingredients, is a recommended treatment for opioid use disorder during pregnancy. However, the decision to use Suboxone, which contains buprenorphine and naloxone, or a buprenorphine-only medication depends on individual circumstances. Stopping treatment suddenly can increase the risk of withdrawal and returning to opioid use, which may create additional risks during pregnancy. Understanding the benefits, potential complications, and available treatment options can help you make informed decisions with your healthcare providers.

Medical reviewed by Dr. Bethany Berrios, DNP, Chief Nursing Officer at DevotedDOc. This article is for educational purposes only and is not a substitute for personal medical advice. Always follow your healthcare provider’s instructions, and never start, stop, switch, or change your Suboxone dose during pregnancy without medical guidance.

Is Suboxone Safe During Pregnancy?

Suboxone may be an appropriate treatment option for some pregnant patients with opioid use disorder. Although no medication is completely free of risks during pregnancy, continuing effective treatment can be safer than experiencing uncontrolled opioid use, repeated withdrawal, or a return to illicit opioids.

The CDC recommendations for opioid use disorder treatment during pregnancy identify buprenorphine and methadone as recommended medications for pregnant patients with opioid use disorder. These treatments help stabilize opioid dependence, reduce withdrawal symptoms, and support ongoing recovery.

Suboxone contains both buprenorphine and naloxone. While buprenorphine has an established role in pregnancy treatment, the combination product requires an individualized discussion. Available research on buprenorphine-naloxone during pregnancy has been reassuring, but healthcare providers must still consider the patient’s treatment history, other medications, and prenatal health.

If you become pregnant while taking Suboxone, do not stop the medication on your own. Contact your prescribing healthcare provider and prenatal care team to review your treatment plan.

Buprenorphine and Pregnancy: What You Should Know

Buprenorphine is a partial opioid agonist that attaches to opioid receptors in the brain. It helps reduce cravings and withdrawal symptoms without producing the same degree of opioid effects as full agonists such as heroin or fentanyl.

For pregnant patients with opioid use disorder, maintaining a stable medication regimen can reduce cycles of intoxication and withdrawal. Treatment may also make it easier to attend prenatal appointments, maintain daily routines, and participate in counseling or other recovery services.

The American College of Obstetricians and Gynecologists (ACOG) recommends opioid agonist pharmacotherapy for pregnant patients with opioid use disorder rather than medically supervised withdrawal in most circumstances. Withdrawal alone is associated with high rates of returning to opioid use and does not provide the same ongoing protection against cravings.

Understanding Suboxone and buprenorphine can help explain how the medication supports recovery and why maintaining treatment may be important during pregnancy.

Suboxone vs. Subutex During Pregnancy

Suboxone contains buprenorphine and naloxone, while Subutex is a brand name historically used for buprenorphine-only tablets. Generic buprenorphine-only formulations are also available.

Buprenorphine-only products have traditionally been preferred during pregnancy because they avoid fetal exposure to naloxone. However, growing research on the buprenorphine-naloxone combination has found reassuring pregnancy outcomes, and some healthcare providers may recommend continuing Suboxone when it is already working well.

Naloxone is included in Suboxone primarily to discourage certain forms of medication misuse. When the medication is taken as directed under the tongue, naloxone has low systemic absorption. Still, its presence is an important consideration when evaluating treatment during pregnancy.

The MotherToBaby information on naloxone exposure during pregnancy provides additional context about available pregnancy safety information and the limitations of existing research.

There is no universal rule requiring every pregnant patient to switch from Suboxone to buprenorphine alone. Your healthcare provider should weigh the benefits of maintaining a stable regimen against the potential risks and practical considerations of changing medications.

What Are the Risks of Taking Suboxone During Pregnancy?

Suboxone treatment during pregnancy requires monitoring, but the risks should be considered alongside those of untreated opioid use disorder. Continuing a prescribed medication may provide important stability, while stopping or changing treatment without guidance can create additional complications.

Possible concerns include medication-related side effects, interactions with other substances, and the possibility of withdrawal symptoms in the newborn after delivery.

Maternal Side Effects and Medication Interactions

Suboxone may cause nausea, constipation, dizziness, headache, or drowsiness. Some symptoms can overlap with common pregnancy discomforts, making it important to tell your healthcare provider about any new or worsening effects.

Combining Suboxone with alcohol, benzodiazepines, or other sedating medications can increase the risk of respiratory depression and overdose. A medication review is particularly important during pregnancy because both maternal safety and fetal well-being must be considered.

Our guide to Suboxone drug interactions explains why certain medications and substances require additional precautions.

Can Suboxone Affect Your Baby After Birth?

Babies exposed to opioids during pregnancy, including prescribed buprenorphine, may develop neonatal opioid withdrawal syndrome (NOWS) after delivery. This condition occurs when a newborn experiences withdrawal symptoms after prenatal opioid exposure ends.

Possible symptoms include:

• Increased irritability: Frequent crying or difficulty settling.
• Feeding difficulties: Trouble feeding or maintaining a regular feeding pattern.
• Tremors: Shaking or jitteriness.
• Sleep disturbances: Difficulty sleeping or remaining settled.
• Digestive symptoms: Vomiting or loose stools.

Symptoms vary in severity, and not every exposed newborn requires medication. Some babies respond to supportive care, including rooming-in, skin-to-skin contact, and feeding support, while others need additional treatment.

The CDC guidance on neonatal opioid withdrawal syndrome explains how healthcare teams monitor and care for infants affected by prenatal opioid exposure.

The possibility of NOWS does not automatically mean Suboxone treatment should be discontinued. Maintaining effective treatment for opioid use disorder can provide important benefits for both the pregnant patient and the baby.

Risks of Suboxone Withdrawal During Pregnancy

Stopping Suboxone suddenly can cause opioid withdrawal symptoms, including nausea, vomiting, diarrhea, sweating, anxiety, restlessness, and muscle aches. Withdrawal can also lead to intense cravings and an increased risk of returning to opioid use.

During pregnancy, these concerns deserve additional attention because dehydration, poor nutrition, and unstable opioid use may affect maternal health. Returning to illicit opioids can also increase the risk of overdose, especially if opioid tolerance has changed.

The SAMHSA clinical guidance for pregnant and parenting women with opioid use disorder emphasizes comprehensive treatment planning and the importance of ongoing medication management during pregnancy.

Should You Stop Suboxone If You Find Out You’re Pregnant?

No one should automatically stop Suboxone simply because they discover they are pregnant. The appropriate next step is to contact the healthcare provider managing their opioid use disorder treatment and arrange prenatal care if they have not already done so.

Your providers can review whether to continue the current medication, adjust the dose, or consider a different formulation. These decisions should account for your treatment stability, pregnancy-related changes, and risk of withdrawal or returning to opioid use.

Can You Experience Withdrawal When Switching Medications?

Changing opioid treatment medications requires careful planning. Starting buprenorphine at the wrong time after certain full opioid agonists can trigger precipitated withdrawal, a rapid onset of uncomfortable withdrawal symptoms.

However, switching between buprenorphine-naloxone and buprenorphine-only formulations is a different situation and does not automatically cause precipitated withdrawal when appropriately managed. Dose changes and other treatment adjustments should still be supervised.

Our article on precipitated withdrawal explains how this complication occurs and why medication transitions require professional guidance.

Managing Opioid Use Disorder While Pregnant

Treatment for opioid use disorder in pregnancy involves more than choosing a medication. The goal is to maintain stability, reduce the risk of returning to opioid use, and support maternal and infant health throughout pregnancy and after delivery.

A coordinated treatment plan may involve an obstetric healthcare provider, an addiction treatment clinician, and other professionals familiar with pregnancy-related care.

Important parts of treatment include:

• Continuing prescribed medication: Take buprenorphine or another recommended treatment according to your healthcare provider’s instructions.
• Attending prenatal appointments: Regular monitoring helps identify pregnancy-related concerns and supports fetal development.
• Reviewing all medications: Tell your healthcare providers about prescriptions, supplements, alcohol, and other substance use.
• Monitoring withdrawal symptoms: Report new cravings, withdrawal symptoms, or medication-related side effects.
• Planning for delivery: Discuss newborn monitoring, pain management, and postpartum treatment before your due date.
• Maintaining recovery support: Counseling, peer support, and behavioral health services can complement medication treatment.

Pregnancy can also change how the body processes medications. Some patients may need buprenorphine dose adjustments or changes in dosing frequency as pregnancy progresses. These adjustments should be based on symptoms and clinical assessment rather than a fixed schedule.

Planning for Labor and Delivery

Tell your obstetric care team that you take Suboxone or another buprenorphine medication before delivery. This allows the team to plan pain management and prepare for appropriate newborn monitoring.

Buprenorphine treatment is generally continued during labor and delivery, while additional pain relief may be needed because maintenance medication does not provide sufficient pain control for childbirth.

Your healthcare providers can also discuss what to expect if your baby requires observation for withdrawal symptoms after birth.

Continuing Treatment After Pregnancy

The postpartum period can bring sleep disruption, stress, and changes in daily responsibilities. These challenges may increase vulnerability to returning to opioid use, making continued treatment and follow-up especially important.

Do not assume Suboxone should be stopped after delivery. Your healthcare provider can reassess your medication needs and help you maintain a treatment plan that supports recovery while caring for your newborn.

Suboxone and Breastfeeding: Is It Safe?

Breastfeeding is generally encouraged for patients receiving stable buprenorphine treatment when there are no other contraindications, such as ongoing illicit substance use or certain medical conditions. However, individual circumstances must be reviewed with the maternal and infant healthcare teams.

Buprenorphine passes into breast milk in small amounts, and infant exposure is generally low. The NIH LactMed guidance on buprenorphine and breastfeeding indicates that breastfeeding is acceptable for many patients taking buprenorphine, with appropriate monitoring of the infant.

What About Naloxone in Suboxone?

Suboxone also contains naloxone, which has very low oral bioavailability. Available information suggests that naloxone exposure through breast milk is unlikely to produce significant effects in a breastfed infant, although the evidence is more limited than for buprenorphine alone.

Patients should still discuss breastfeeding while taking the combination product with their healthcare providers rather than assuming that all circumstances are the same.

What Should You Watch for While Breastfeeding?

Babies exposed to buprenorphine through breast milk should be monitored for unusual sleepiness, difficulty feeding, poor weight gain, or breathing problems.

If your baby is difficult to wake, has trouble breathing, or becomes unusually unresponsive, seek emergency medical care. Breastfeeding decisions should also consider your recovery stability, other medications, and your baby’s overall health.

Frequently Asked Questions About Suboxone and Pregnancy

Can you take Suboxone while pregnant?

Some pregnant patients can continue Suboxone under medical supervision. The decision depends on treatment stability, medical history, and the recommendations of their prenatal and addiction treatment providers.

Is buprenorphine safe during pregnancy?

Buprenorphine is a recommended medication for opioid use disorder during pregnancy. Although treatment requires monitoring, it can provide important benefits compared with untreated opioid use disorder.

Is Subutex safer than Suboxone during pregnancy?

Buprenorphine-only formulations have traditionally been preferred, but available evidence on buprenorphine-naloxone is reassuring. The appropriate choice depends on individual clinical circumstances.

Can Suboxone cause withdrawal symptoms in a newborn?

Yes. Prenatal exposure to buprenorphine can lead to neonatal opioid withdrawal syndrome, although symptoms vary and not every baby requires medication.

Should you stop Suboxone when you find out you’re pregnant?

No. Do not stop or change your medication independently. Contact your healthcare provider promptly to discuss the safest treatment plan.

Can Suboxone cause miscarriage?

Research has not established that prescribed Suboxone directly causes miscarriage. Pregnancy outcomes are influenced by many factors, including underlying health conditions and substance use, so individual risks should be discussed with a prenatal healthcare provider.

Can you breastfeed while taking Suboxone?

Breastfeeding may be appropriate for patients receiving stable treatment who meet other safety criteria. Your healthcare providers should review your medications and monitor your baby for unusual sleepiness or feeding difficulties.

Will you need a different Suboxone dose during pregnancy?

Some patients need dose adjustments because pregnancy can change how buprenorphine is processed. Your healthcare provider will determine whether changes are necessary based on your symptoms and treatment response.

Discuss Suboxone Treatment During Pregnancy With DevotedDOc

Finding out you’re pregnant while taking Suboxone can raise questions about medication safety, your baby’s health, and whether your treatment needs to change. Buprenorphine remains an important option for managing opioid use disorder during pregnancy, and continuing effective treatment may help reduce the risks associated with withdrawal and returning to opioid use.

DevotedDOc offers physician-led telehealth services for opioid use disorder treatment. If you’re pregnant or planning a pregnancy, discussing your medication history with a healthcare provider is an important first step. Your Suboxone prescriber and prenatal care team can work together to determine the safest approach, including whether specialized pregnancy-related treatment is needed.

Have questions about your Suboxone treatment? Book your appointment with DevotedDOc to discuss your next steps and coordinate appropriate care.