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Buprenorphine Pharmacology Review

Update on Transmucosal and Long-acting Formulations

Coe, Marion A., BA; Lofwall, Michelle R., MD; Walsh, Sharon L., PhD

doi: 10.1097/ADM.0000000000000457
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Buprenorphine is an effective treatment for opioid use disorder. As a high-affinity, partial agonist for the mu-opioid receptor, buprenorphine suppresses opioid withdrawal and craving, reduces illicit opioid use, and blocks exogenous opioid effects including respiratory depression. Other pharmacologic benefits of buprenorphine are its superior safety profile compared with full opioid agonists and its long half-life that allows daily or less-than-daily dosing. New and innovative buprenorphine formulations, with pharmacokinetic profiles that differ from the original tablet formulation, continue to be developed. These include higher bioavailability transmucosal tablets and films and also 6-month implantable and monthly injectable products. This growing array of available formulations allows more choices for patients and increased opportunity for clinicians to individualize treatment; thus, it is important for buprenorphine prescribers to understand these differences.

Department of Pharmacology, College of Medicine, University of Kentucky, Lexington, KY (MAC, SLW); Department of Behavioral Science, University of Kentucky, Lexington, KY (MRL, SLW); and Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY (MAC, MRL, SLW).

Send correspondence to Sharon L. Walsh, PhD, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508. E-mail: sharon.walsh@uky.edu.

Received 16 March, 2018

Accepted 1 September, 2018

Conflicts of interest: Ms Coe reports no disclosures. Over the past 3 years, Dr Lofwall has had research funding from Braeburn, has received consulting fees from Braeburn and Indivior, travel support from Braeburn and Camurus, and has received honorarium from PCM Scientific for developing and giving educational talks about opioid use disorder. Dr Walsh has received research funding and consulting fees and travel support from Braeburn and Camurus and travel support and honoraria from Indivior.

© 2019 American Society of Addiction Medicine