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Indications

High Alert

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: QT interval prolongation, orthostatic hypotension.

Derm: sweating.

Endo: ADRENAL INSUFFICIENCY.

F and E: peripheral edema.

GI: constipation, nausea, oral hypoesthesia, oral mucosal erythema, vomiting, glossodynia, hepatitis.

Neuro: headache, insomnia.

Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA).
Misc: (INCLUDING ANAPHYLAXIS) HYPERSENSITIVITY REACTIONS , physical dependence, psychological dependence, tolerance, withdrawal phenomenon.

Interactions

Drug-Drug:

Drug-Natural Products:

Availability

(Generic available)

Route/Dosage

A Zubsolv 1.4/0.36 tablet is equivalent in terms of buprenorphine content to a Suboxone 2/0.5 tablet. A Zubsolv 5.7/1.4 tablet is equivalent in terms of buprenorphine content to a Suboxone 8/2 tablet.

Induction

Maintenance

US Brand Names

Bunavail, Suboxone, Zubsolv

Action

Therapeutic Effects:

Classifications

Therapeutic Classification:

Pharmacologic Classification: opioid agonists antagonists, opioid antagonists

Pharmacokinetics

Absorption: Buprenorphine: Well absorbed following SL administration; naloxone: Negligible absorption follows SL administration.

Distribution: Buprenorphine: Crosses the placenta; enters breast milk. CNS concentration is 15–25% of plasma.

Protein Binding: Buprenorphine: 96%.

Metabolism/Excretion: Buprenorphine: Mostly metabolized by the liver mostly via the CYP3A4 enzyme system; one metabolite is active; 70% excreted in feces; 27% excreted in urine.

Half-life: Buprenorphine: 33 hr; Naloxone: 60–90 min (up to 3 hr in neonates).

Contr. Subst. Schedule

Schedule III (C-III)

Time/Action Profile

ROUTEONSETPEAK†DURATION
SLUnknown1.5–1.7 hr24 hr

† Blood level.

Patient/Family Teaching

Pronunciation

byoo-pre-NOR-feen/na-LOX-one