Titrate individually in increments of up to 150 mcg every 12 hours no more frequently than every 4 days to a dose that provides adequate analgesia and minimizes adverse reactions. Usual Adult Dose for Chronic PainĪs Initial Opioid Analgesic: 75 mcg buccally once a day, or if tolerated every 12 hours for at least 4 days then increase to 150 mcg every 12 hours Use: For the management of pain severe enough to require an opioid analgesic and for which alternate treatments are inadequate. Use the lowest effective dose for the shortest duration consistent with the individual patient's treatment goals. Monitor closely for respiratory depression, especially within the first 24 to 72 hours. Use extra caution with IV administration, especially the first dose. Maximum single dose: 0.3 mg (IV) or 0.6 mg (IM) A single 0.6 mg IM dose may be given to patients who are not in a high risk category (see Warnings). Initial dose: 0.3 mg deep IM or slow IV (over at least 2 minutes) may repeat this dose once after 30 to 60 minutes if needed then, 0.3 mg IV/IM every 6 hours as needed There is no maximum recommended duration for maintenance therapy as indefinite treatment may be required when the decision is made to discontinue, doses should be tapered. Uses: For the treatment of opioid dependence as part of a complete treatment plan to include counseling and psychosocial support. After 1 insertion in each arm, most patients should be transitioned back to transmucosal products for continued treatment as there is no experience with inserting additional implants into other sites in the arm or into a previously-used site. Each dose consists of 4 implants each implant contains 74.2 mg of buprenorphine. Implant insertions and removals should be performed by certified healthcare providers. Insert 1 dose subdermally in the inner side of the upper arm Patients should not be tapered to a lower dose for the sole purpose of transitioning to the implant. Bunavail buprenorphine 4.2 mg/naloxone 0.7 mg per day or less or Zubsolv buprenorphine 5.7 mg/naloxone 1.4 mg per day or less) Currently receiving buprenorphine maintenance (with or without naloxone) at doses of 8 mg/day or less, or equivalent transmucosal product (e.g. Achieved and sustained prolonged clinical stability on transmucosal buprenorphine as evidenced by a stable dose for 3 months or longer without any need for supplemental dosing or dose adjustments. SUBDERMAL IMPLANT (Probuphine): For use in opioid-tolerant patients who meet ALL of the following criteria: Monthly doses should allow for a minimum of 26 days between doses occasional delays in dosing of up to 2 weeks are not expected to have a clinically significant impact on treatment effect. 
Initiating therapy with subcutaneous injections has not been studied subcutaneous injections should only be initiated following induction and dose-adjustment with a transmucosal buprenorphine-containing product.self-reported illicit opioid use or positive urine drug screens Maintenance dose may be increased to 300 mg monthly for those tolerating lower dose and demonstrating a less than satisfactory clinical response, e.g.Maintenance dose: 100 mg subcutaneously once a month.Initial dose: 300 mg subcutaneously once a month for 2 months.
When determining prescription quantity for unsupervised administration, consider the patient's level of stability, the security of his or her home situation, and other factors likely to affect the ability to manage supplies of take-home medications.ĮXTENDED-RELEASE SUBCUTANEOUS Injection (Sublocade): Following a minimum of 7-days of treatment with a transmucosal product delivering the equivalent of 8 to 24 mg buprenorphine per day:.Buprenorphine with naloxone is the preferred drug for maintenance treatment unsupervised maintenance treatment with buprenorphine should be limited to those who cannot tolerate buprenorphine-naloxone.Maximum dose: 24 mg/day higher doses have not shown a clinical advantage.Target dose: 16 mg sublingually once a day range 4 to 24 mg/day.Adjust dose in 2 to 4 mg increments/decrements to a level that holds patient in treatment and suppresses opioid withdrawal signs and symptoms.SUBLINGUAL Tablets: Following a 2-day induction: Usual Adult Dose for Opiate Dependence - Maintenance
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