DRUG | SUPPLIED | DOSE | COMMENTS |
---|---|---|---|
BUPRENORPHINE (Paeds) (Sublocade) Mechanism of action: Long acting partial opioid agonist Ref: 44, 691 Last update: 2023-10-15 |
Extended-Release SC Injection: 100 mg/0.5 mL, 300 mg/1.5 mL |
Opioid Use Disorder Initial: 300 mg SC once monthly for 2 months Maintenance: 100 mg SC once monthly, increase to 300 mg SC once monthly if clinical response unsatisfactory If established on long-term transmucosal buprenorphine at doses between 8-18 mg, dose can be reduced to 100 mg SC at the second injection if opioid withdrawal and cravings are controlled. |
There should be a minimum of 26 days between doses. If a dose is missed it should be received as soon as possible. Occasional delays in dosing up to 2 weeks are not expected to have a clinically significant impact on treatment effect COWS scale can be performed to assess for withdrawal. Withdrawal may occur months after discontinuation Adverse effects are similar to other opioids: e.g., sedation, dizziness, nausea, vomiting, and constipation. Risk of respiratory depression is lower than with other opioids but still possible. Other adverse effects include: injection site reactions, opioid withdrawal, hepatitis, and adrenal insufficiency Pain with injection and at the injection site is common. Consider premedication for pain and/or anxiety After administration, the medication forms a solid mass underneath the skin that can be seen or felt for several weeks. Over time the mass will decrease in size. Do not rub or massage the injection site Should only be initiated by prescribers with experience in substance use management and who have completed the manufacturer’s training course Must be administered by a certified health care professional (a prescriber [MD, NP] or nurse who has completed the manufacturer’s training course) Standard Prescription: BUPRENORPHINE initial dose 300 mg SC once monthly for 2 months followed by maintenance dose 100 mg SC once monthly. |