(buprenorphine) articles in PubMed
- Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness and Guidelines [BOOK]
- Canadian Agency for Drugs and Technologies in Health: Ottawa (ON)BOOK
- In 2013, Suboxone (buprenorphine/naloxone) became available as a generic and its direct cost, and cost differential with methadone, decreased. Buprenorphine/naloxone has several advantages compared w...
In 2013, Suboxone (buprenorphine/naloxone) became available as a generic and its direct cost, and cost differential with methadone, decreased. Buprenorphine/naloxone has several advantages compared with methadone. Methadone is a full agonist; there is no ceiling to respiratory depression or sedation effects and an overdose can be fatal. Buprenorphine also has a long half-life but because it is a partial agonist, it has a ceiling effect (effect plateaus at higher doses) and thus the risk of overdose is decreased. Other advantages of buprenorphine/naloxone include its long duration of action which allows for every second day dosing if needed; its administration as a sublingual tablet; its lack of requirements of an exemption to be prescribed; and its formulation with less potential for abuse. Given the foregoing, an assessment is required to assist decision-makers and prescribers in selecting between the two treatments. Hence, the purpose of this review is to provide evidence on the comparative clinical effectiveness and cost-effectiveness of buprenorphine/naloxone compared with methadone, for the treatment of patients with opioid use disorder. Clinical practice guidelines will also be examined.
- Evaluation of buprenorphine hydrochloride Pluronic(®) gel formulation in male C57BL/6NCrl mice. [Journal Article]
- Lab Anim (NY) 2016 Sep 21; 45(10):370-9LA
- Providing adequate analgesia while minimizing handling and stress post-surgery can be challenging. Recently, there have been commercial products made available for providing long acting analgesia in ...
Providing adequate analgesia while minimizing handling and stress post-surgery can be challenging. Recently, there have been commercial products made available for providing long acting analgesia in rodents. However, we find there are limitations for use in mice due to the viscosity of the product and the small dosing volumes needed. This project evaluated an in-house compounded formulation of buprenorphine easily made in the laboratory using pharmaceutical grade products. The release of buprenorphine was evaluated when compounded with two types of hydrogels (Pluronic(®) F-127 and F-68). Mice given buprenorphine in hydrogel (BP) demonstrated higher serum levels of buprenorphine for a longer period of time compared to mice given standard buprenorphine (Bup). However, the rate of decline in serum levels between the groups was similar; thus, it is more likely that the higher buprenorphine concentration seen in the BP group is due to the higher dose of buprenorphine given, rather than a slower release of product. Feed consumption was decreased in both groups one day after dosing; however, there was no difference in body weights. Increased activity in the open field was observed with both buprenorphine formulations, and lipemia was observed in mice given BP which persisted to at least 96 h. Based on our results, we conclude that this formulation did not sustain the release of buprenorphine or eliminate the increased activity commonly seen in mice given buprenorphine. In addition, the lipemia may confound research parameters, especially in cardiac studies and lipid metabolism studies. Therefore, we cannot recommend this formulation for use.
- Physician Capacity to Treat Opioid Use Disorder With Buprenorphine-Assisted Treatment. [Journal Article]
- JAMA 2016 Sep 20; 316(11):1211-1212JAMA
- No evidence of potentiation of buprenorphine by milnacipran in healthy subjects using a nociceptive test battery. [Journal Article]
- Eur J Pain 2016 Sep 21EJ
- CONCLUSIONS: Buprenorphine showed dose-dependent effects consistent with its pharmacological profile. Milnacipran alone did not affect any of the pain variables. The combination of both buprenorphine and milnacipran did not potentiate or show a synergistic effect on the pain models used in this study.Buprenorphine is known to be a potent opioid agonist. Animal studies suggest that milnacipran co-administered with opioids may potentiate the analgesic effect of μ-opioid receptor agonists. Here, we found that buprenorphine showed a dose-dependent analgesic effect, but that no potentiation or synergy on a battery of evoked pain tasks could be observed after co-administration of both milnacipran and buprenorphine.
- Pharmacokinetics of liposomal encapsulated buprenorphine suspension following subcutaneous administration to cats. [Journal Article]
- J Vet Pharmacol Ther 2016 Sep 20JV
- We investigated the effects of liposome encapsulation at prolonging the systemic exposure of buprenorphine following subcutaneous administration in cats. Seven healthy male cats were dosed intravenou...
We investigated the effects of liposome encapsulation at prolonging the systemic exposure of buprenorphine following subcutaneous administration in cats. Seven healthy male cats were dosed intravenously with 0.02 mg/kg buprenorphine solution (STD-BUP), followed 14 days later by a subcutaneous injection of 0.2 mg/kg buprenorphine as a liposomal suspension (SUS-BUP) containing drug molecules both in liposomes and the suspending vehicle. Buprenorphine time plasma concentration data for both dosing routes were analyzed simultaneously with four compartmental models. Goodness of fit was assessed both graphically and with the Akaike information criterion. The time-course of intravenous STD-BUP was biphasic, with a 4.39 h average terminal half-life. The subcutaneous SUS-BUP produced plasma buprenorphine concentrations above 0.5 μg/L for more than 96 h, with three distinct peaks in the first 15 h. The model with best fit comprised a central and a peripheral compartment, plus three subcutaneous absorption compartments: one of dissolved drug molecules that were absorbed through a first-order process, and two of liposome-encapsulated drug molecules that were transferred to the solution compartment through separate zero-order processes. Liposomes effectively prolonged the systemic exposure of buprenorphine in cats.
- Too much or never enough: a response to Treatment of opioid disorders in Canada: looking at the 'other epidemic'. [Editorial]
- Subst Abuse Treat Prev Policy 2016; 11(1):33SA
- Prescription opioid (PO) misuse is a major health concern across North America, and it is the primary cause of preventable death for the 18-35 year old demographic. Medication assisted therapy includ...
Prescription opioid (PO) misuse is a major health concern across North America, and it is the primary cause of preventable death for the 18-35 year old demographic. Medication assisted therapy including methadone and buprenorphine, is the standard of care for patients with opioid-dependence. Moreover, both of these medications are recognized as essential medicines by World Health Organization. In Ontario Canada, the availability of medication assisted therapy has expanded substantially, with almost a ten-fold increase number of patients accessing methadone in Ontario in the past decade. In their manuscript, Fischer et. al. (2016), present a view that expansion of opioid maintenance therapy (OMT) has outpaced true patient need and alternate strategies should be considered as first-line treatments. Here, we present a countering perspective-that medication assisted therapy, along with other harm reduction strategies, should be widely available to all opioid-dependent people as first-line treatments.
- Pharmacotherapy for Neonatal Abstinence Syndrome: Choosing the Right Opioid or No Opioid at All. [Journal Article]
- Neonatal Netw 2016; 35(5):314-20NN
- Neonatal abstinence syndrome (NAS) from in utero opioid exposure has reached epidemic levels in the United States. Although nonpharmacologic therapies form the foundation of care, many neonates requi...
Neonatal abstinence syndrome (NAS) from in utero opioid exposure has reached epidemic levels in the United States. Although nonpharmacologic therapies form the foundation of care, many neonates require pharmacotherapy. Morphine represents the most widely used first-line agent and effectively treats the symptoms of withdrawal. However, methadone or buprenorphine may facilitate earlier discharge. Although phenobarbital is traditionally used when opioids fail, clonidine may be a more appropriate adjunctive agent to minimize negative neurodevelopmental impact. Consideration of the available data allows hospitals to generate effective pharmacologic strategies to manage NAS while further research continues.
- Impact of early childhood trauma on retention and phase advancement in an outpatient buprenorphine treatment program. [Journal Article]
- Am J Addict 2016; 25(7):542-548AJ
- CONCLUSIONS: The results from a convenience sample participating in a university-based buprenorphine treatment program demonstrated significant association between self-reported early childhood trauma and retention during the first 90 days. These findings suggest that addressing early trauma could potentially improve adherence rates leading to reduced disease burden. This study extends the knowledge base on potential predictive factors associated with successful participation in outpatient buprenorphine treatment. (Am J Addict 2016;25:542-548).
- Intranasal opioid administration in rhesus monkeys: PET imaging and antinociception. [Journal Article]
- J Pharmacol Exp Ther 2016 Sep 13JP
- The goal of this study was to evaluate the effects of intransally administered opioids in rhesus monkeys using the tail-withdrawal assay, and to correlate these effects with measures of receptor occu...
The goal of this study was to evaluate the effects of intransally administered opioids in rhesus monkeys using the tail-withdrawal assay, and to correlate these effects with measures of receptor occupancy using positron emission tomography (PET) imaging. Initial experiments characterized the antinociceptive effects of intranasal (IN) fentanyl and buprenorphine relative to intramuscular (IM) injection. Fentanyl (0.010- 0.032 mg/kg) and buprenorphine (0.1-1.0 mg/kg) produced dose-dependent increases in tail-withdrawal latency that did not differ between routes of delivery. The second experiment compared the ability of IN and intravenous (IV) naloxone (NLX) to block the antinociceptive effects IV fentanyl, and to measure receptor occupancy at equipotent doses of NLX using PET imaging. IN and IV NLX (0.0032- 0.032 mg/kg) produced dose-dependent decreases in fentanyl-induced antinociception. Again, there was no difference observed in overall potency between routes. PET imaging showed that IV and IN NLX produced similar decreases in receptor occupancy as measured by [11C]carfentanil blocking, although there was a trend for IV NLX produce marginally greater occupancy changes. This study validated the first procedures to evaluate the IN effects of opioids in rhesus monkeys.
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- Curious crosses: injection-induced lesions. [Journal Article]
- Am J Med 2016 Sep 9AJ