A comparison of four buprenorphine dosing regimens in the treatment of opioid dependence.
OBJECTIVE
This study compared 24-, 48-, 72-, and 96-hour buprenorphine dosing regimens in opioid-dependent outpatients.


METHODS
Fourteen subjects received buprenorphine in a double-blind, placebo-controlled crossover trial. Daily sublingual maintenance doses were 4 mg/70 kg (n = 5) and 8 mg/70 kg (n = 9). After a stabilization period of maintenance administration, subjects received, in a random order, four dosing regimens for five repetitions of each regimen: a maintenance dose every 24 hours, a doubled maintenance dose every 48 hours, a tripled maintenance dose every 72 hours, and a quadrupled maintenance dose every 96 hours. In the latter three dosing regimens, subjects received placebo on the interposed day(s). Study participation was contingent on opioid abstinence and daily clinic attendance. Measures of subjective opioid agonist and withdrawal effects were assessed daily.


RESULTS
Relative to standard maintenance dosing, none of the higher doses induced agonist effects. Changes in indices of subjective withdrawal effects were noted as the time since the last active dose increased during intermittent dosing regimens, but the magnitude of these effects was relatively low and was comparable to those found in other alternate-day dosing studies.


CONCLUSIONS
These results support the feasibility and safety of twice weekly buprenorphine dosing regimens.
Petry
N M
NM
University of Vermont, Department of Psychiatry, Substance Abuse Treatment Center, Burlington, USA.
Bickel
W K
WK
Badger
G J
GJ
D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
D009294:Narcotics; D002047:Buprenorphine