Buprenorphine/naloxone – one formulation that doesn’t fit all: a case report

Case study
par
Braun, H. M., Taylor, J. L., & Axelrath, S.

Date de publication

2024

Géographie

USA

Langue de la ressource

English

Texte disponible en version intégrale

Oui

Open Access / OK to Reproduce

Oui

Évalué par des pairs

Yes

L’objectif

Sublingual buprenorphine is most commonly available in co-formulation with naloxone. When sublingual (SL) buprenorphine/naloxone is taken as prescribed, it is thought to reduce potential for misuse via intravenous administration since naloxone is an opioid antagonist. However, growing data and clinical experience demonstrate that previously accepted assumptions about the pharmacokinetics of these medications may not apply to all patients.

Constatations/points à retenir

In a minority of patients, naloxone can contribute to adverse and potentially treatment-limiting side effects. Furthermore, the naloxone component is commonly misunderstood by patients and providers and can foster mistrust in the therapeutic relationship if providers are perceived to be withholding a more tolerable formulation. Prescribers should have a low threshold to offer buprenorphine alone when clinically appropriate.

La conception ou méthodologie de recherche

A case study is presented of a patient whose adverse post-administration side effects on SL buprenorphine/naloxone resolved with transition to SL buprenorphine monoproduct.

Mots clés

About PWUD
Clinical guidance
Hesitancy of prescribers
Substitution/OAT
Withdrawal