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Language of Resource
Full Text Available
Open Access / OK to Reproduce
Peer Reviewed
Objective
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.
Findings/Key points
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.
Design/methods
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.
