On Thu, 24 Apr 1997 07:24:27 +0200, Henri Derclaye
Quote:
>I am trying to find out all about buprenorphine pharmacology,
>pharmacocinetic and galenic formulation. As pharmacist (in Belgium) I am
>very interested in {*filter*} substitution treatments. Does anyone has
>experience with buprenorphine treatments?
>HF DERCLAYE
>Belgian pharmacist.
CAUTION: Do NOT use buprenorphine in a patient dependent on opiates.
This could be extremely hazardous. Buprenorphine is a PARTIAL opiate
agonist and will therefore have both agonist and antagonist actions.
Mixing buprenorphine with opiates markedly reduces the agonist effects
of BOTH. Your patient could go into cold turkey within minutes. Not
quite as bad as naloxone, (reducing agonist activity from 100% to
close to 0%) but buprenorphine could certainly reduce activity to 60%
or less. Effects are particularly hazardous because of the sublingual
administration of buprenorphine and resultant rapid absorption
directly into the {*filter*}stream.
Buprenorphine is NOT a {*filter*} substitute. The rapid peak plasma levels
lead to physical dependence. It'd be like swapping {*filter*} for
morphine. The subsitute should have a much longer duration of action
and much slower onset of action than {*filter*}, that's why methadone was
introduced. (Yes, I know it's poor, but it's all we've got.)
The consequences of a {*filter*} {*filter*} substituting with buprenorphine
and then deciding to "have one last smack" don't bear thinking about;
respiratory depression is, after all, additive.
N Williams. UK Pharmacist.
~~~~~~~~~~~~~~~~~~~~
Neil Williams
http://www.***.com/ ~psnlprog/
Buprenorphine