Buprenorphine-naloxone therapy in pain management

Anesthesiology. 2014 May;120(5):1262-74. doi: 10.1097/ALN.0000000000000170.

Abstract

Buprenorphine-naloxone (bup/nal in 4:1 ratio; Suboxone; Reckitt Benckiser Pharmaceuticals Incorporation, Richmond, VA) is approved by the Food and Drug Administration for outpatient office-based addiction treatment. In the past few years, bup/nal has been increasingly prescribed off-label for chronic pain management. The current data suggest that bup/nal may provide pain relief in patients with chronic pain with opioid dependence or addiction. However, the unique pharmacological profile of bup/nal confers it to be a weak analgesic that is unlikely to provide adequate pain relief for patients without opioid dependence or addiction. Possible mechanisms of pain relief by bup/nal therapy in opioid-dependent patients with chronic pain may include reversal of opioid-induced hyperalgesia and improvement in opioid tolerance and addiction. Additional studies are needed to assess the implication of bup/nal therapy in clinical anesthesia and perioperative pain management.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Ambulatory Care / methods
  • Buprenorphine / administration & dosage*
  • Buprenorphine / therapeutic use*
  • Buprenorphine, Naloxone Drug Combination
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy*
  • Drug Combinations
  • Humans
  • Naloxone / administration & dosage*
  • Naloxone / therapeutic use*
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / prevention & control
  • Pain Management / methods*
  • Treatment Outcome

Substances

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