Buprenorphine dosing every 1, 2, or 3 days in opioid-dependent patients

Abstract

These results suggest that buprenorphine may be administered safely every 72 h by tripling the maintenance dose, with only minimal withdrawal complaints. Importantly, this 72-h dosing may permit patients to attend clinic thrice weekly without the use of take-home doses.

Effects of buprenorphine sublingual tablet maintenance on opioid drug-seeking behavior by humans

“…On the other hand, because buprenorphine has high affinity for opioid receptors (Hambrook and Rance 1976;Sadee et al 1982;Lewis et al 1983), moderately high BUP doses can block subjective and physiological effects of mu-opioids for more than 1 day (Jasinski et al 1978;Rosen et al 1994;Schuh et al 1999). Consistent with this human laboratory evidence, BUP has been shown to retain its efficacy using less-than-daily dosing schedules in several clinical trials (Fudala et al 1990;Amass et al 1994Amass et al , 1998Amass et al , 2000Johnson et al 1995b;Bickel et al 1999;Petry et al 1999).…”

Effects associated with double-blind omission of buprenorphine/naloxone over a 98-h period

“…Indeed, several studies tested the efficacy of less than daily dosing, increasing the dose of buprenorphine administered on dosing days to compensate for the longer between-dose interval. Results from these studies suggest patients do not experience distressing opioid withdrawal effects for at least 48-72 h after their last active dose of buprenorphine (Amass et al 1994;Bickel et al 1999;Fudala et al 1990;Johnson et al 1995;Petry et al 1999;Schottenfeld et al 2000), and other studies provide evidence that it may be possible to increase the dosing interval beyond 72 h (Gross et al 2001;Petry et al 1999;.…”

Buprenorphine sublingual tablets: effects on IV heroin self-administration by humans

“…Furthermore, buprenorphine has high affinity for mu receptors and has been characterized as "irreversible" because it dissociates very slowly from opioid receptors. This characteristic of buprenorphine may underlie its long duration of action, which makes less-than-daily dosing with buprenorphine feasible (Amass et al 1994;Bickel et al 1999;Fudala et al 1990;Petry et al 1999). Buprenorphine's long duration of action, as well as its partial agonist effects, may contribute to its mild withdrawal effects upon discontinuation of treatment (Dum et al 1981;Heel et al 1979;Jasinski et al 1978; Kosten and Kleber 1988;Kosten et al 1990Kosten et al , 1991Mello and Mendelson 1980;Mello et al 1981;Woods and Gmerek 1985).…”