BUPRENORPHINE
(Sublocade)Standard Prescription
BUPRENORPHINE initial dose 300 mg SC once monthly for 2 months followed by maintenance dose 100 mg SC once monthly.
Dosages
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.
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.
Mechanism of Action
Long acting partial opioid agonist
Forms Supplied
Extended-Release SC Injection:
100 mg/0.5 mL, 300 mg/1.5 mL
100 mg/0.5 mL, 300 mg/1.5 mL
Comments
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)
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)
References
44, 691
Last Edited
2023-10-15 23:33:20