title: Preliminary buprenorphine sublingual tablet pharmacokinetic data in plasma, oral fluid, and sweat during treatment of opioid-dependent pregnant women.
abstract: BACKGROUND
  Buprenorphine is currently under investigation as a pharmacotherapy to treat pregnant women for opioid dependence. This research evaluates buprenorphine (BUP), norbuprenophine (NBUP), buprenorphine-glucuronide (BUP-Gluc), and norbuprenorphine-glucuronide (NBUP-Gluc) pharmacokinetics after high-dose (14-20 mg) BUP sublingual tablet administration in three opioid-dependent pregnant women.
  
  
  METHODS
  Oral fluid and sweat specimens were collected in addition to plasma specimens for 24 hours during gestation weeks 28 or 29 and 34, and 2 months after delivery. Time to maximum concentration was not affected by pregnancy; however, BUP and NBUP maximum concentration and area under the curve at 0 to 24 hours tended to be lower during pregnancy compared with postpartum levels.
  
  
  RESULTS
  Statistically significant but weak positive correlations were found for BUP plasma and OF concentrations and BUP/NBUP ratios in plasma and oral fluid. Statistically significant negative correlations were observed for times of specimen collection and BUP and NBUP oral fluid/plasma ratios. BUP-Gluc and NBUP-Gluc were detected in only 5% of oral fluid specimens. In sweat, BUP and NBUP were detected in only four of 25 (12 or 24 hours) specimens in low concentrations (less than 2.4 ng/patch).
  
  
  CONCLUSIONS
  These preliminary data describe BUP and metabolite pharmacokinetics in pregnant women and suggest that, like methadone, upward dose adjustments may be needed with advancing gestation.
authors.affiliation: Servicio de Toxicología Forense, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Concheiro
authors.forename: Hendreé E
authors.initials: HE
authors.lastname: Jones
authors.forename: Rolley E
authors.initials: RE
authors.lastname: Johnson
authors.forename: Robin
authors.initials: R
authors.lastname: Choo
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
mesh_terms: D019540:Area Under Curve; D002047:Buprenorphine / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism / Q000493:pharmacokinetics* / Q000652:urine; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics / Q000652:urine; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D049590:Postpartum Period; D011247:Pregnancy; D012463:Saliva / Q000737:chemistry*; D013542:Sweat / Q000737:chemistry*
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine; C043585:norbuprenorphine