Buprenorphine-Naloxone (Suboxone) initial and max dosing for opioid withdrawal.

• A. 8 mg/2 mg initial; max 16/4
• B. 24 mg/6 mg initial; max 48/12
• C. 12 mg/3 mg initial; max 18/6
• D. 16 mg/4 mg initial; max 24/6

Answer: (D)

Treating opioid withdrawal with Suboxone aims to quickly suppress withdrawal symptoms while preventing misuse. Buprenorphine is a partial opioid agonist, and naloxone is added mainly to deter injection; when taken sublingually, naloxone has little effect, so the buprenorphine provides relief without causing withdrawal.

The best dosing uses two 8 mg/2 mg films together for an initial amount of 16 mg buprenorphine and 4 mg naloxone. This higher initial dose more rapidly controls withdrawal, then the daily maximum is typically 24 mg buprenorphine with 6 mg naloxone. This pairing aligns with common induction practice and safe daily limits.

Other options either start with too little to adequately suppress withdrawal or propose daily maximums that are not consistent with standard safety guidelines or the sublingual naloxone component.