BUPRENORPHINE/ NALOXONE
(Suboxone)Standard Prescription
Buprenorphine/naloxone _ / _ mg SL Q _ H
Dosages
Dose is dependent on prior opioid use and is titrated to clinical response of suppressing opioid withdrawal symptoms or cravings
Usual standard induction starting dose: 2 mg/0.5 mg SL
May repeat Q1H PRN signs of cravings or withdrawal until stable maintenance dose determined
Usual maintenance dose: 12-32 mg/day
Usual micro-induction starting dose: 0.5/0.125 mg SL Q3H
Usual standard induction starting dose: 2 mg/0.5 mg SL
May repeat Q1H PRN signs of cravings or withdrawal until stable maintenance dose determined
Usual maintenance dose: 12-32 mg/day
Usual micro-induction starting dose: 0.5/0.125 mg SL Q3H
Mechanism of Action
Buprenorphine is a long acting partial opioid agonist.
Naloxone is an opioid reversal agent.
Naloxone is an opioid reversal agent.
Naloxone is in the product to deter crushing and injecting the buprenorphine. When taken via the sublingual route, naloxone is not active (not absorbed). However, when injected, naloxone is active and will reverse the effects of buprenorphine.
Forms Supplied
Sublingual tablet: Buprenorphine:naloxone = 4:1
Buprenorphine 2 mg/naloxone 0.5 mg sublingual tablet
Buprenorphine 8mg/naloxone 2mg sublingual tablet
Buprenorphine 2 mg/naloxone 0.5 mg sublingual tablet
Buprenorphine 8mg/naloxone 2mg sublingual tablet
Comments
Tablets should only be administered via the sublingual (SL) route, as absorption of buprenorphine is significantly decreased if swallowed (taken orally (PO)).
The tablets can take up to 15 minutes to dissolve. Instruct patient to avoid swallowing, talking, eating, drinking, and smoking during this time.
COWS score should be performed to assess withdrawal symptoms.
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.
Should only be initiated by prescribers with experience in substance use management.
The tablets can take up to 15 minutes to dissolve. Instruct patient to avoid swallowing, talking, eating, drinking, and smoking during this time.
COWS score should be performed to assess withdrawal symptoms.
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.
Should only be initiated by prescribers with experience in substance use management.
References
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Last Edited
2020-10-24 02:25:22