Day 1
Microdose Build-Up — Dose Every 2 Hours
Start at Hour 0
(6+ hrs after last fentanyl)
(6+ hrs after last fentanyl)
🔹 First: Prepare your medication
=
One full 2 mg strip, cut into 4 pieces
Take a 2 mg strip and cut it into 4 equal pieces.
Each piece = 0.5 mg
0.5
0.5
0.5
0.5
Phase 1 — Hours 0 – 6
0.5 mg per dose
| Hour 0 | 0.5 mg | 1 piece (¼ of a 2 mg strip) |
| Hour 2 | 0.5 mg | 1 piece (¼ of a 2 mg strip) |
| Hour 4 | 0.5 mg | 1 piece (¼ of a 2 mg strip) |
| Hour 6 | 0.5 mg | 1 piece (¼ of a 2 mg strip) |
Phase 2 — Hours 8 – 10
1 mg per dose
✂️ How to cut for this phase
=
One full 2 mg strip, cut in half
Take a 2 mg strip and cut it into 2 equal pieces.
Each piece = 1 mg
1 mg
1 mg
| Hour 8 | 1 mg | Cut a 2 mg strip in half → take ½ strip |
| Hour 10 | 1 mg | Take the other ½ strip you set aside |
Phase 3 — Hours 12 – 14
2 mg per dose
✂️ How to cut for this phase
=
One full 2 mg strip, no cutting
No cutting needed — take 1 full 2 mg strip.
Each strip = 2 mg
2 mg ✓
| Hour 12 | 2 mg | 1 full 2 mg strip |
| Hour 14 | 2 mg | 1 full 2 mg strip |
Phase 4 — Hour 16
8 mg — one large dose
No cutting needed — take 4 full 2 mg strips all at once.
=
Four full 2 mg strips = 8 mg total
4 strips × 2 mg = 8 mg total
2mg
2mg
2mg
2mg
| Hour 16 | 8 mg | Four 2 mg strips taken together at the same time |
Day 2
Twice-Daily Dosing — 8 mg Morning & Evening
Total daily dose: 16 mg
| Time | Dose | How to take it |
|---|---|---|
| Morning | 8 mg | Four 2 mg strips taken together |
| Evening | 8 mg | Four 2 mg strips taken together |
Day 3 & Beyond
Once-Daily Dosing — 16 mg Every Morning
Standard maintenance dose
| Time | Dose | How to take it |
|---|---|---|
| Once daily | 16 mg | Eight 2 mg strips taken together, same time each day |
🩺
Your MyStreetHealth Care Team Is With You
Questions at any point in this process? Reach out before skipping or changing a dose.
mystreethealth.com
VA · WV · MD · DC · OH
💡
Why small doses first?
Fentanyl stays in your opioid receptors longer than most opioids. Starting with very small doses of buprenorphine lets it slowly ease into those receptors without causing sudden withdrawal. By the time you reach the 8 mg dose on Day 1, your body is ready for it. This is why the schedule works — do not rush it. Your MyStreetHealth provider can answer any questions about how this works for you specifically.
Fentanyl stays in your opioid receptors longer than most opioids. Starting with very small doses of buprenorphine lets it slowly ease into those receptors without causing sudden withdrawal. By the time you reach the 8 mg dose on Day 1, your body is ready for it. This is why the schedule works — do not rush it. Your MyStreetHealth provider can answer any questions about how this works for you specifically.
⚠️ Important Rules — Read Carefully
🕐
Day 1 timing is exact. Doses must be taken every 2 hours on Day 1. Do not skip, double up, or delay.
✅
Some mild discomfort or mild withdrawal symptoms are normal and expected. They should improve as the day goes on.
🔁
If you feel worse 10–15 minutes after a dose: wait 3 hours before the next dose instead of 2. This is a sign the medication may be causing a brief reaction — spacing out the dose usually helps.
🚫
Do not use fentanyl or other opioids once you start this schedule. Using opioids on top of buprenorphine can be dangerous.
📞
Contact your MyStreetHealth provider before making any changes to this schedule. If you feel seriously unwell, call us or go to the nearest emergency room.
🌐
Your MyStreetHealth care team is available via the patient portal at mystreethealth.com — telehealth visits available in VA, WV, MD, DC, and OH.