35th AM (2024) - Poster Session-Transdermal Buprenorphine Narrative Review Poster

Transdermal Buprenorphine Narrative Review Poster

Pdf Summary

This narrative review by Koviya Sirohi et al. examines the use of transdermal (TD) patches for low-dose induction of buprenorphine in treating opioid use disorder (OUD). The focus is on addressing the lack of standardized protocols for buprenorphine induction and enhancing understanding of its application through TD patch formulations. <br /><br />Traditionally, initiating buprenorphine treatment for OUD has been challenging due to the requirement for patient withdrawal and the complex protocols aimed at avoiding precipitated withdrawal. However, new low-dose induction methods, including transdermal patches, sublingual tablets, and films, enable patients to commence treatment without withdrawal and achieve therapeutic doses within six hours.<br /><br />TD buprenorphine patches are proposed as a viable alternative during the induction phase, offering stable serum concentrations, precise dosing, and reduced risk of precipitated withdrawal. The literature reviewed indicates TD patches are effective for transitioning patients from full opioid agonists, even in complex cases involving physiological trauma, acute pain, or polysubstance use. Additionally, TD buprenorphine is potentially effective for pregnant patients.<br /><br />The reviewed studies show a buprenorphine dosing range of 5-240 mcg/h, with initiation occurring between 2-13 days. Although buprenorphine/naloxone has a high safety profile compared to methadone and other opioid agonist treatments due to its "Ceiling Effect," the main challenges remain in the induction phase. This phase can be more effective with TD patches, especially when transitioning from methadone, provided the patient is on a dose of 40mg or less.<br /><br />The review highlights the need for further research and standardized protocols to confirm the efficacy and practicality of TD buprenorphine patches in various OUD treatment scenarios. It also emphasizes buprenorphine’s position as a first-line treatment option due to its safety profile.

Keywords

transdermal patches

buprenorphine induction

opioid use disorder

precipitated withdrawal

therapeutic doses

stable serum concentrations

polysubstance use

pregnant patients

safety profile

standardized protocols

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