Skip Navigation LinksHome > May 2014 - Volume 120 - Issue 5 > Buprenorphine–Naloxone Therapy in Pain Management
doi: 10.1097/ALN.0000000000000170
Education: Review Article

Buprenorphine–Naloxone Therapy in Pain Management

Chen, Kelly Yan B.S.; Chen, Lucy M.D.; Mao, Jianren M.D., Ph.D.

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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.

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