A comparison of four buprenorphine dosing regimens using open-dosing procedures: is twice-weekly dosing possible?

Addiction. 2000 Jul;95(7):1069-77. doi: 10.1046/j.1360-0443.2000.95710698.x.


Aims: To compare opioid withdrawal symptoms during 24-, 48-, 72- and 96-hour buprenorphine dosing regimens and to evaluate subjects' preferences for these different dosing schedules.

Subjects: Fourteen opioid-dependent subjects participated in this study. They received daily sublingual maintenance doses of 4 mg/70 kg (n = 4) or 8 mg/70 kg (n = 10) of buprenorphine.

Intervention: In the first study subjects received, in a random order, four dosing regimens for five repetitions of each: daily maintenance doses every 24 hours (4 or 8 mg/70 kg), double the daily maintenance dose every 48 hours (8 or 16 mg/70 kg), triple the daily maintenance dose every 72 hours (12 or 24 mg/70 kg), and quadruple the daily maintenance dose every 96 hours (16 or 32 mg/70 kg). Measures of subjective and observer opioid withdrawal symptoms were assessed prior to receipt of each dose. In a second study, subjects chose between the different dosing regimens.

Findings: Some withdrawal ratings increased during the less frequent dosing schedules in the first study. In the second study, 46% of subjects preferred the quadruple-every-fourth-day dosing regimen over every other option, and only 14% preferred to be dosed daily.

Conclusions: These results suggest that some opioid-dependent outpatients are willing and able to endure the withdrawal symptoms associated with less than daily dosing, and a twice-weekly dosing regimen may be possible.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Buprenorphine / administration & dosage*
  • Buprenorphine / adverse effects
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Narcotics / administration & dosage*
  • Narcotics / adverse effects
  • Opioid-Related Disorders / rehabilitation*
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / etiology
  • Treatment Outcome


  • Narcotics
  • Buprenorphine