Buprenorphine: Difference between revisions
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== Background == |
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* Recommended as first-line treatment for [[opioid use disorder]] |
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* Typically coformulated with naloxone (trade name Suboxone) at a dose of 2 mg buprenorphine to 0.5 mg naloxone |
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* Buprenorphine is partial mu-opioid receptor agonist |
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* Theoretical ceiling effect |
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* Strong receptor affinity, displaces other opioids |
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== Dosing == |
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=== Full Start === |
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* It's use can precipitate withdrawal, so wait 12-24h after short-acting opioids, 18-36h after long-acting, or after tapering methadone, before starting buprenorphine |
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* Day 1: Ensure they are in mild withdrawal ([[COWS]] ≥12), then give 4mg, wait a few hours, give another 4mg |
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* Day 2: 12mg |
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* Day 3: 16mg; discharge and refer to Addictions clinic |
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== Further Reading == |
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* [https://www.porticonetwork.ca/documents/204049/0/Opioids+enabler+PDF/f67d20ec-3666-489a-a2dc-ebb5d63225f6 Opioid Enabler] |
* [https://www.porticonetwork.ca/documents/204049/0/Opioids+enabler+PDF/f67d20ec-3666-489a-a2dc-ebb5d63225f6 Opioid Enabler] |
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* Hämmig R ''et al.'' [https://dx.doi.org/10.2147%2FSAR.S109919 Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method]. ''Subst Abuse Rehabil''. 2016; 7: 99–105. |
* Hämmig R ''et al.'' [https://dx.doi.org/10.2147%2FSAR.S109919 Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method]. ''Subst Abuse Rehabil''. 2016; 7: 99–105. |
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[[Category:Opioid substitution therapy]] |
[[Category:Opioid substitution therapy]] |
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[[Category:Addiction medicine]] |
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Revision as of 01:26, 4 July 2020
Background
- Recommended as first-line treatment for opioid use disorder
- Typically coformulated with naloxone (trade name Suboxone) at a dose of 2 mg buprenorphine to 0.5 mg naloxone
- Buprenorphine is partial mu-opioid receptor agonist
- Theoretical ceiling effect
- Strong receptor affinity, displaces other opioids
Dosing
Full Start
- It's use can precipitate withdrawal, so wait 12-24h after short-acting opioids, 18-36h after long-acting, or after tapering methadone, before starting buprenorphine
- Day 1: Ensure they are in mild withdrawal (COWS ≥12), then give 4mg, wait a few hours, give another 4mg
- Day 2: 12mg
- Day 3: 16mg; discharge and refer to Addictions clinic
Further Reading
- Opioid Enabler
- Hämmig R et al. Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method. Subst Abuse Rehabil. 2016; 7: 99–105.
