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Buprenorphine/naloxone - one formulation that doesn't fit all: a case report
Hannan M Braun1,2, Jessica L Taylor3,4, Sarah Axelrath5
1Division of General Internal Medicine, Denver Health and Hospital Authority, 301 W 6th Ave, Denver, 80204, CO, USA. Hannan.Braun@dhha.org.
Harm Reduction Journal
|July 31, 2024
Summary
Sublingual buprenorphine/naloxone is used for opioid use disorder, but naloxone can cause side effects in some patients. Switching to buprenorphine alone may resolve these adverse effects, improving treatment.
Area of Science:
- Pharmacology
- Addiction Medicine
Background:
- Sublingual buprenorphine/naloxone is a common treatment for opioid use disorder.
- Naloxone is included to deter misuse, but its absorption and effects may vary.
- Patient and provider understanding of naloxone's role can be limited.
Observation:
- A patient experienced adverse effects from sublingual buprenorphine/naloxone.
- These side effects resolved upon switching to sublingual buprenorphine monoproduct.
Findings:
- Naloxone is detectable in most patients on sublingual buprenorphine/naloxone.
- A subset of patients experience adverse effects attributable to naloxone.
- Misunderstanding of naloxone can impact patient-provider trust.
Implications:
- Clinicians should consider buprenorphine monoproduct for patients experiencing adverse effects.
- Individualized treatment approaches are crucial for managing opioid use disorder.
- Further research into naloxone's variable effects in sublingual formulations is warranted.
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