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Buprenorphine
From WikEM
Contents
Administration
- Type: Opioid- maintenance therapy in opioid use disorder, rapid detox
- Dosage Forms:
- Routes of Administration: Buccal, sublingual, intradermal, transdermal, IV/IM
- Common Trade Names: Suboxone (buprenorphine + naloxone)
Adult Dosing
Highly variable dependent on individual
Pediatric Dosing
Variable
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk has been demonstrated
- Hepatic dosing: reduce dose or do not use in moderate - severe impairment
- Renal dosing:
Contraindications
- Allergy to class/drug
- SBO, paralytic ileus
- Acute/severe asthma (if unmonitored), respiratory depression
Adverse Reactions
Serious
- Hypotension, prolonged QT, MI
- Respiratory depression
- SBO
- Hepatotoxicity
- Stroke
- Sedation, coma
- Drug dependence or withdrawal
Common
- Pruritus
- Constipation, nausea, diarrhea, xerostomia
- Dizziness, headache, somnolence
- URI symptoms
Pharmacology
- Half-life: 24-48 hours
- Metabolism: Extensive hepatic, CYP3A4 substrate
- Excretion: Mostly fecal, some renal
Mechanism of Action
- Mixed opiate agonist-antagonist, partial mu-opioid agonist, kappa-opioid antagonist
