title: Probuphine® (buprenorphine implant): a promising candidate in opioid dependence.
abstract: Opioid dependence leads to physical dependence and addiction which finally results in profound medical, psychological and social dysfunction. One of the useful medications for opioid dependence is buprenorphine, the partial opioid agonist, which is used alone or in combination with naloxone. However, buprenorphine is the victim of its own success due to its illicit use and accidental poisoning in children. Also, buprenorphine typically requires daily self-administration and its effectiveness heavily depends on patient adherence. So, poor treatment adherence results in ineffective treatment manifesting as craving and withdrawal symptoms. Short-term use of buprenorphine in opioid dependence is also often followed by relapse. Buprenorphine when used sublingually often results in inadequate or fluctuating blood concentrations and poorer treatment retention compared with methadone. All of these led to the development of Probuphine®, a polymeric matrix composed of ethylene vinyl acetate and buprenorphine in the form of implants, that are implanted subdermally in office practice and deliver the active drug over 6 months. Buprenorphine release from such implant is fairly consistent, avoiding plasma peaks and troughs, and the implant is also reported to be safe. In this review article, we have highlighted these aspects of treatment of opioid addiction, stressing on the pharmacology of buprenorphine and Probuphine®, and relevant clinical trials addressing the efficacy and safety of Probuphine®. This sustained-release implantable formulation of buprenorphine has the potential to be a suitable alternative to daily or alternate day sublingual buprenorphine which can thereby eliminate the need for daily supervision, minimizing fluctuations in plasma concentrations, and allowing these patients to reduce clinic or pharmacy visits.
authors.affiliation: Jamia Hamdard (Hamdard University) - Department of Medical Elementology and Toxicology, Faculty of Science, New Delhi, India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Barnwal
authors.affiliation: Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, India.
authors.forename: Saibal
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Clinical and Experimental Pharmacology - Calcutta School of Tropical Medicine, Kolkata, India.
authors.forename: Somnath
authors.initials: S
authors.lastname: Mondal
authors.affiliation: Swamy Vivekanandha College of Pharmacy - Department of Pharmacology, Namakkal, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Ramasamy
authors.affiliation: Christian Medical College - Department of Psychiatry, Vellore, India.
authors.forename: Tanay
authors.initials: T
authors.lastname: Maiti
authors.affiliation: Christian Medical College - Student (MBBS), Vellore, India.
authors.forename: Arunava
authors.initials: A
authors.lastname: Saha
keywords: Probuphine®; addiction; buprenorphine; implant; opioid dependence