Sunday, August 16, 2009
enSarfe Dosage & Administration
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Treatment with buprenorphine is intended for use in adults and children above 15 years who have agreed to be treated for addiction.
When initiating buprenorphine treatment, the physician should be aware of the partial agonist profile of the buprenorphine molecule. Buprenorphine binds to the micro and k opiate receptors and may precipitate withdrawal symptoms in opioid-dependent patients.
Administration is sublingual. Physicians must advise patients that the sublingual route is the only effective and safe route of administration for this drug. The tablet should be kept under the tongue until dissolved, which usually accurs within 5-10 min.
Induction Therapy: The initial dose is from 0.8-4mg, administered as a single daily dose.
For opioid-dependent drug addicts who have not undergone withdrawal: 1 dose administered sublingually at least 4 hours after the last use of the opioid, or when the first signs of craving appear.
For patients receiving methadone: Before beginning buprenorphine therapy, the dose of methadone should be reduced to maximum of 30mg/day. Buprenorphine may precipitate symptoms of withdrawal in patients dependent upon methadone.
Dosage Adjustment and Maintenance: The dose of buprenorphine should be increased progressively according to the clinical effect of the individual patient and should not exceed a maximum single daily dose of 16mg. The dosage is titrated according to reassessment of the clinical and psychological status of the patient.
Dosage Reduction & Termination of Treatment: After a saticfactory period of stabilisation has been achieved, the dosage may be reduced gradually to a lower maintenance dose; when deemed appropriate, treatment may be discontinued in some patients. The availability of the sublingual tablet in doses of 2 and 8 mg, respectively, allows for a downward titration of dosage. Patients should be monitored following termination of buprenorphine treatment because of the potential for relapse.
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