Buprenorphine (Buprenorphine Hydrochloride) - Summary

BUPRENORPHINE SUMMARY

BUPRENORPHINE
HYDROCHLORIDE
INJECTION

Buprenorphine Hydrochloride Injection is a narcotic under the Controlled Substances Act due to its chemical derivation from thebaine.

Buprenorphine HCl injection is indicated for the relief of moderate to severe pain.

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NEWS HIGHLIGHTS

Published Studies Related to Buprenorphine

Buprenorphine medication versus voucher contingencies in promoting abstinence from opioids and cocaine. [2009.08]
During a 12-week intervention, opioid dependent participants (N = 120) maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling were randomized to receive: (a) medication contingencies (MC = thrice weekly dosing schedule vs... Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies.

Gastrointestinal symptoms under opioid therapy: a prospective comparison of oral sustained-release hydromorphone, transdermal fentanyl, and transdermal buprenorphine. [2009.08]
INTRODUCTION: The purpose of this trial was to evaluate the effect of long-term treatment with oral sustained-release hydromorphone, transdermal fentanyl, and transdermal buprenorphine on nausea, emesis and constipation... CONCLUSIONS: Gastrointestinal symptoms of cancer pain patients undergoing an opioid therapy are related to multifactorial causes. Transdermal opioids showed no benefit over oral controlled-release hydromorphone with regard to gastrointestinal symptoms. The conversion ratios for transdermal fentanyl, transdermal buprenorphine, and oral hydromorphone did not accord to the literature, because of differing occurrences of opioid tolerance after long-term therapy.

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) Prisons Project Study: protocol for a randomised controlled trial comparing methadone and buprenorphine for opiate detoxification. [2009.07.14]
BACKGROUND: In the United Kingdom (UK), there is an extensive market for the class 'A' drug heroin and many heroin users spend time in prison. People addicted to heroin often require prescribed medication when attempting to cease their drug use... Secondary outcomes will be recorded during the detoxification and then at one, three and six months post-detoxification.

[Prospective study on anesthesia for lumbar spine surgery--the effectiveness of the perioperative epidural anesthesia with buprenorphine] [2009.06]
We prospectively evaluated the efficacy of perioperative epidural buprenorphine for lumbar spinal surgery under general anesthesia. Twenty-eight patients were allocated into two groups; in one group (buprenorphine group), patients underwent the surgery under general anesthesia with perioperative epidural buprenorphine 0.2 mg, in the other group (control group), patients underwent the surgery under general anesthesia only...

Urinary excretion of buprenorphine, norbuprenorphine, buprenorphine-glucuronide, and norbuprenorphine-glucuronide in pregnant women receiving buprenorphine maintenance treatment. [2009.06]
BACKGROUND: Buprenorphine (BUP) is under investigation as a medication therapy for opioid-dependent pregnant women. We investigated BUP and metabolite disposition in urine from women maintained on BUP during the second and third trimesters of pregnancy and postpartum... CONCLUSIONS: These data are the first to evaluate urinary disposition of BUP and metabolites in a cohort of pregnant women. Variable BUP excretion during pregnancy may indicate metabolic changes requiring dose adjustment during later stages of gestation.

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Clinical Trials Related to Buprenorphine

Preference for Subutex® (Buprenorphine) Versus Suboxone® (Buprenorphin/Naloxone) in Opioid Dependent Patients on Subutex (Study P05094)(COMPLETED) [Completed]
This study is designed to determine if opioid dependent subjects who are already receiving Subutex prefer the Suboxone tablet over the Subutex tablet after switching from Subutex to Suboxone. Subjects who are selected to participate in this study will continue their prescribed dose of Subutex (buprenorphin 2 to 16 mg daily) for the first two days of the study (Day 1 and Day 2) then switch to and receive an equivalent dose of Suboxone (buprenorphine 2 to 16 mg daily) for the last 3 days of the study (Day 3, Day 4 and Day 5). The Day 5 Visit will be the subject's last study visit. Upon completing the study, subjects will continue their pre-study prescribed dosage of Subutex.

Pharmacokinetic Interactions Between Buprenorphine and Tipranavir/Ritonavir [Completed]
The main purpose of this study is to examine the effect of tipranavir combined with ritonavir, medications for the treatment of HIV-infection, on buprenorphine/naloxone (BUP) in people who have been receiving the same dose of buprenorphine/naloxone for at least 3 weeks before study entry.

Buprenorphine Maintenance vs. Detoxification in Prescription Opioid Dependence
The aim of the study is to determine whether buprenorphine maintenance versus detoxification using buprenorphine, in prescription opioid dependent patients receiving primary care management and drug counseling in an office-based setting, leads to decreased illicit opioid use.

Safety and Tolerability of Buprenorphine/Naloxone Film Strips [Active, not recruiting]
This study will evaluate the safety and tolerability on the oral mucosa of buprenorphine/naloxone film strips administered either sublingually or buccally daily for 12 weeks in opioid dependent individuals who are already on a stable regimen of buprenorphine/naloxone.

Buprenorphine Dose Escalation Trial for Treatment of Non-Dependent Opiate Users - 2 [Completed]
The purpose of this study is to evaluate the effect, pharmacokinetics and dose proportionality of buprenorphine when administered to non-dependent opiate users. 1) To evaluate whether plasma concentrations of buprenorphine increase proportionally to buprenorphine dose. 2) To evaluate the dose-response of subjective and physiological effects of buprenorphine; and 3) To determine the safety of buprenorphine.

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PATIENT REVIEWS / RATINGS / COMMENTS

Buprenorphine review by 36 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		Major Depression
Dosage & duration:		8mg sublingual tablets taken 2 sublinguals twice/day for the period of still taking it - has been 4 years
Other conditions:		Anorexia nervosa, PTSD (World Trade Center Survivor 9/11/01)
Other drugs taken:		Effexor XR, Adderall
		Reported Results
Benefits:		Subutex is mostly used to help opiate addicts withdrawal more comfortably from opiod drugs such as Vicodin, Oxycodone, and even Heroin. However, I was started on Subutex because my doctor and I were having no luck finding another med that would augment my current depression medications of Effexor XR and Adderall (which were only partially working). My doctor had found research suggesting that Subutex, because it is a partial opiate agonist itself (although much different in its properties compared to what most think of when thinking "opiate"), binds to one of the opiate receptors in the brain responsible for mood. My doctor has always been on the cutting edge of current research and was extremely open-minded in trying this med with me - and to welcomed relief as well! I have had almost ALL good results from this medication. It has definitely aided in the treatment of my very-treatment-resistent depression. The following are the benefits that I have noticed from taking Subutex: 1. Quick-acting - because Subutex is sublingual (dissolves under your tongue) it gets into your system immediately and does not have to be processed by your digestive system first. 2. Gentle effects - I have definitly not experienced any "highs". Just a subtle, but noticeable improvement in a feeling of wellbeing. 3. Also helps somewhat with anxiety by having a calming effect; in normal doses this happens without any tiredness. 4. Have not noticed ANY of the side effects that I have found with other psychiatric medications such as weight gain/loss, personality changes, sexual effects, etc. Also, in case anyone is worried that Subutex is a "partial-opiate agonist", I must emphasize that this med DOES NOT build a tolerance or make you want/need to increase dosage. I have been on this dose for four years without ever even thinking about needing more. HOWEVER!!! You must understand that - as is the case with ALL psychiatric medications - you cannot simply stop taking this medication without tapering your dose first or you will experience withdrawal effects. The one saving grace about Subutex, though, is that it has a very long half-life and will remain in your system long enough to prevent any type of withdrawal even if you miss a day or two of medication.
Side effects:		None.
Comments:		I take two 8mg tablets in the afternoon by putting them under my tongue and allowing them simply to dissolve. I do this again at night as I get into bed. That's pretty much it!