Spotlight on buprenorphine/naloxone in the treatment of opioid dependence.
Buprenorphine/naloxone (Suboxone) comprises the partial micro-opioid receptor agonist buprenorphine in combination with the opioid antagonist naloxone in a 4 : 1 ratio. When buprenorphine/naloxone is taken sublingually as prescribed, the naloxone exerts no clinically significant effect, leaving the opioid agonist effects of buprenorphine to predominate. However, when buprenorphine/naloxone is parenterally administered in patients physically dependent on full agonist opioids, the opioid antagonism of naloxone causes withdrawal effects, thus reducing the abuse potential of the drug combination. Buprenorphine/naloxone is an effective maintenance therapy for opioid dependence and has generally similar efficacy to methadone, although more data are needed. Less frequent dispensing of buprenorphine/naloxone (e.g. thrice weekly) does not appear to compromise efficacy and can improve patient satisfaction. Buprenorphine/naloxone is more effective than clonidine as a medically supervised withdrawal therapy. Moreover, buprenorphine/naloxone is a generally well tolerated medically supervised withdrawal and maintenance treatment. Thus, sublingual buprenorphine/naloxone is a valuable pharmacotherapy for the treatment of opioid dependence.
Orman
Jennifer S
JS
Adis, Auckland, New Zealand.
Keating
Gillian M
GM
D002047:Buprenorphine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000069479:Buprenorphine, Naloxone Drug Combination; D004338:Drug Combinations; D006801:Humans; D009270:Naloxone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
D000069479:Buprenorphine, Naloxone Drug Combination; D004338:Drug Combinations; D009270:Naloxone; D002047:Buprenorphine