Spotlight on buprenorphine/naloxone in the treatment of opioid dependence

CNS Drugs. 2009 Oct;23(10):899-902. doi: 10.2165/11203740-000000000-00000.

Abstract

Buprenorphine/naloxone (Suboxone) comprises the partial micro-opioid receptor agonist buprenorphine in combination with the opioid antagonist naloxone in a 4 : 1 ratio. When buprenorphine/naloxone is taken sublingually as prescribed, the naloxone exerts no clinically significant effect, leaving the opioid agonist effects of buprenorphine to predominate. However, when buprenorphine/naloxone is parenterally administered in patients physically dependent on full agonist opioids, the opioid antagonism of naloxone causes withdrawal effects, thus reducing the abuse potential of the drug combination. Buprenorphine/naloxone is an effective maintenance therapy for opioid dependence and has generally similar efficacy to methadone, although more data are needed. Less frequent dispensing of buprenorphine/naloxone (e.g. thrice weekly) does not appear to compromise efficacy and can improve patient satisfaction. Buprenorphine/naloxone is more effective than clonidine as a medically supervised withdrawal therapy. Moreover, buprenorphine/naloxone is a generally well tolerated medically supervised withdrawal and maintenance treatment. Thus, sublingual buprenorphine/naloxone is a valuable pharmacotherapy for the treatment of opioid dependence.

Publication types

  • Review

MeSH terms

  • Buprenorphine / administration & dosage*
  • Buprenorphine / pharmacokinetics
  • Buprenorphine, Naloxone Drug Combination
  • Drug Combinations*
  • Humans
  • Naloxone / administration & dosage*
  • Naloxone / pharmacokinetics
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / metabolism
  • Randomized Controlled Trials as Topic / methods
  • Treatment Outcome

Substances

  • Buprenorphine, Naloxone Drug Combination
  • Drug Combinations
  • Naloxone
  • Buprenorphine