Day 1
Microdose Build-Up — Dose Every 2 Hours
Start at Hour 0
(at the time you and your
provider agreed on)
(at the time you and your
provider agreed on)
🔹 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
Take 8 mg all at once — in the form your provider prescribed.
=
Four 2 mg strips, or one 8 mg film — both = 8 mg
This is sometimes 4 full 2 mg strips. Your prescriber may instead give you a single 8 mg film, or another form — follow what they prescribed.
2mg
2mg
2mg
2mg
| Hour 16 | 8 mg | Four 2 mg strips taken together — or one 8 mg film, as prescribed |
Day 2
Twice-Daily Dosing — 8 mg Morning & Evening
Total daily dose: 16 mg
(unless your dose was individualized)
(unless your dose was individualized)
| 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
Common ongoing dose
(your dose and timing of dosing may differ)
(your dose and timing of dosing may differ)
| Time | Dose | How to take it |
|---|---|---|
| Once daily | 16 mg | Eight 2 mg strips taken together — or as your prescriber specified; this may vary |
🦷
Oral health while on sublingual buprenorphine
After the medication fully dissolves, take a sip of water, gently swish around your teeth and gums, and swallow. Wait at least 1 hour before brushing your teeth. The FDA has warned about dental problems (cavities, tooth loss, oral infections) with buprenorphine medicines dissolved in the mouth. Tell your clinician and dentist if you have tooth pain, cavities, gum problems, or dental concerns.
🚗
Driving and safety-sensitive work
Do not drive, operate machinery, or do safety-sensitive work during induction until you know how the medication affects you and your clinician confirms it is safe. Many patients should not drive on Day 1 of the schedule.
🩺
Your MyStreetHealth Care Team Is With You
Questions at any point in this process? Reach out before skipping or changing a dose.
💡
Why small doses first?
Some opioids — like fentanyl and methadone — stay in your tissues or bind your opioid receptors longer or more tightly than typical opioids. Kratom and concentrated 7-OH are not opioids in the regulatory sense, but they activate the same opioid receptors and behave similarly during induction. Starting buprenorphine with very small doses lets it slowly take up receptor space without abruptly displacing the existing drug, which can reduce the risk of sudden ("precipitated") withdrawal. By the time you reach the 8 mg dose on Day 1, your body is generally 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.
Some opioids — like fentanyl and methadone — stay in your tissues or bind your opioid receptors longer or more tightly than typical opioids. Kratom and concentrated 7-OH are not opioids in the regulatory sense, but they activate the same opioid receptors and behave similarly during induction. Starting buprenorphine with very small doses lets it slowly take up receptor space without abruptly displacing the existing drug, which can reduce the risk of sudden ("precipitated") withdrawal. By the time you reach the 8 mg dose on Day 1, your body is generally 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 matters. Doses are spaced every 2 hours on Day 1. Do not skip, double up, or delay unless safety requires it — see emergency line below.
✅
Some mild discomfort or mild withdrawal symptoms are normal and expected. They should improve as the day goes on. Worsening or severe symptoms should be discussed with your care team.
🔁
If you feel worse 10–15 minutes after a dose: wait 3 hours before the next dose instead of 2, and contact your MyStreetHealth provider. Spacing the dose out usually helps a brief reaction.
🚫
Do not use fentanyl, kratom, 7-OH, non-prescribed opioids, alcohol, benzodiazepines, gabapentin/pregabalin, or other sedatives once you start this schedule. Combining these with buprenorphine can cause potentially fatal respiratory depression.
📞
Contact your MyStreetHealth provider before making any changes to this schedule.
🆘
Call 911 or go to the emergency room for: trouble breathing, chest pain, confusion, fainting, inability to stay awake, severe dehydration, or suicidal thoughts.
🌐
Your MyStreetHealth care team is available via the patient portal at mystreethealth.com.