CONCLUSION: In a chronic pain patient continued on Suboxone perioperatively, significant improvement in control of postoperative pain was observed following tapered doses, and eventually her use of Suboxone was discontinued. This case highlights the potential for opioid receptor blockade by Suboxone, which can interfere with acute pain management.
PMID: 24985936 [PubMed – as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

Although substitution therapy with opiate agonist treatments such as methadone and buprenorphine has resulted in a reduction of illicit drug use related harm, such treatment has also resulted in severe problems in some countries where opioid-dependent individuals now inject illicitly sold buprenorphine or buprenorphine-naloxone instead of heroin. There is no approved treatment for buprenorphine dependence. Naltrexone is an opioid antagonist which has been used for the treatment of both alcohol and opioid dependencies. Although both buprenorphine and heroin resemble each other concerning their effects, buprenorphine has a higher affinity to opioid receptors than heroin. Therefore, it is not known if naltrexone can block the psychoactive effects of buprenorphine as it does for heroin. This p…

Authors: Poon S, Pupco A, Koren G, Bozzo P
Abstract
QUESTION: I have a patient recently confirmed to be 6 weeks pregnant. For the past 6 months she has been treated for an opioid addiction with buprenorphine-naloxone combination. Should I be concerned about her exposure to this drug combination up to this point of the pregnancy? Should I switch her medication to methadone now that she is pregnant?
ANSWER: The limited data on buprenorphine exposure during pregnancy show no increased risk of adverse outcomes in the newborn. There are limited data on naloxone exposure during pregnancy; however, oral use is not expected to be associated with an increased risk of adverse pregnancy outcomes. Physicians treating pregnant women or women who become pregnant while they are stable taking …

Updated Date: Jun 30, 2014 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Updated Date: Jun 30, 2014 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Orexo AB announced new topline results of 2 clinical trials with a combination of buprenorphine and naloxone for buprenorphine induction and plans to pursue approval of an expanded label in the US. Medscape Medical News (Source: Medscape Medical News Headlines)

Orexo AB announced new topline results of 2 clinical trials with a combination of buprenorphine and naloxone for buprenorphine induction and plans to pursue approval of an expanded label in the US. Medscape Medical News (Source: Medscape Medical News Headlines)

CONCLUSIONS: It is difficult to draft conclusions on the basis of only two trials. One of the possible reasons for the lack of evidence could be the difficulty of conducting trials with young people for practical and ethical reasons.There is an urgent need for further randomised controlled trials comparing maintenance treatment with detoxification treatment or psychosocial treatment alone before carrying out studies that compare different pharmacological maintenance treatments. These studies should have long follow-up and measure relapse rates after the end of treatment and social functioning (integration at school or at work, family relationships).
PMID: 24957634 [PubMed – as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)

(Source: RxList – New and Updated Drug Monographs)

(Source: RxList – New and Updated Drug Monographs)