Buprenorphine Extended-Release Treatment for Opioid Use Disorder in the Postpartum Period

Abstract

Buprenorphine extended-release (XR) is an extended-release monthly injection to treat opioid use disorder (OUD). This retrospective case series includes 15 postpartum patients who were treated with buprenorphine-XR at a single center and reports on their outcomes. The average total daily sublingual buprenorphine dose before initiation of buprenorphine-XR was 16.25 mg (SD±7.76, range 2–32 mg). Overall, 137 total doses of buprenorphine-XR were administered between May 17, 2021, and April 11, 2023. Urine toxicology test results were negative for opioids other than buprenorphine in the majority (80.0%) of patients once appropriate maintenance doses were achieved. Euphoria and intoxication were not reported. A minority of patients (20.0%) discontinued buprenorphine-XR. Although more extensive research is needed before widespread use, buprenorphine-XR may be a favorable treatment for OUD in this high-risk population.

Postpartum Extended-Release Buprenorphine Tissue Necrosis

“…There are limited but reassuring data about the use of XRB in the postpartum population. [8][9][10][11] However, studies show that XRB may be preferred by patients compared with sublingual buprenorphine 12 and that it has favorable patient-centered outcomes. 13 Both peripartum individuals and obstetric care clinicians are often unaware about the option of XRB, though many would consider this form of MOUD if it were offered.…”

“…26 Extended-release buprenorphine is a safe, acceptable, and potentially preferred MOUD option for patients, particularly in the postpartum period. [8][9][10][11] In our clinic, patients are offered a variety of MOUD in pregnancy and the postpartum period, including XRB. We have transitioned more than 20 individuals to XRB from sublingual buprenorphine in the postpartum period.…”