implantable suboxone

[oreosandsake]

http://www.titanpharm.com/news/pres...tan-pharmaceuticals-announces-fda-approval-of

Probuphine

interesting.

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[lobelsteve]

Got several emails. Implant in upper arm lasts 6 mo. Can repeat x1.

1. Reimbursement
2. What if they need surgery or other painful event?
3. Just for addiction. How is pain control?
4. Requires REMS

 

[pastafan]

Got several emails. Implant in upper arm lasts 6 mo. Can repeat x1.

1. Reimbursement
2. What if they need surgery or other painful event?
3. Just for addiction. How is pain control?
4. Requires REMS

2. Regional anesthesia or potent opioid like sufentanil would most likely overcome effect. Explant.

 

[Aether2000]

It is the eqivalent of low dose suboxone. 4 implanted pellets contain 320 mg total buprenorphine = 1.8mg a day. Assuming the bioavailability is double or triple the sublingual dose then perhaps 3.6-5.4mg a day would be delivered. Fairly modest blood levels would occur. And the % failed uds is the same in both groups.

 

[gdub25]

Would potent agonist like sufentanil displace it? I've had a hard time confirming with a quick search but I thought buprenorphine had the highest affinity for mu receptor.

 

[Aether2000]

Tough question to answer: the binding capacities of different opioids at the mu receptor vary depending on the assay method chosen and tissue type. Also, the binding capacity somewhat depends on what other drugs are present in the environment. Separate from binding capacity is intrinsic activity, and while often considered the same, they are not necessarily closely linked. The partial agonist buprenorphine has a relatively moderate to high binding capacity and a modest intrinsic activity whereas sufentanil has a much higher binding capacity and intrinsic activity. The half life of buprenorphine is long (36 hours) that is much longer than many of the opioids, so ostensibly the pharmacokinetics preserve relatively high levels at the receptor and may be responsible for at least part of the effectiveness of the drug to block others. There are several opioids with higher binding capacities than buprenorphine including hydromorphone, sufentanil, and fentanyl.

 

[Guyton]

For pain control, I would probably try layering additional buprenorphine on the relatively weak baseline dose the patient is getting from the implant rather than mix opioids. My biggest concern with the implant is, what is going to keep the patient adhering to the psychosocial program or even attending to follow-up? I might consider a six month preparation for someone who has been stone cold reliable with the program for some time, but in addiction those are some pretty rare zebras.

 

[ateria radicularis magna]

is anyone doing this?