Buprenorphine+Naloxone

Uses	Opioid dependence, Opioid withdrawal symptoms, Pre- and post-operative pain management
Therapy	Deaddiction
Side Effects	Headache, Drowsiness, Sedation, Dizziness, Fainting, Nausea, Sweating, Dry mouth, Constipation, Blurring of vision, Abdominal pain, Respiratory depression, Irregular heartbeat

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Molecule Description

Buprenorphine+Naloxone is a combination drug used to treat opioid dependency. Uses of Buprenorphine+Naloxone include treatment of symptoms due to withdrawal from opioids such as morphine, codeine, fentanyl, methadone, hydrocodone, etc.

Uses

Buprenorphine+Naloxone is used for the treatment of:
Opioid dependency
Opioid withdrawal symptoms
Pre- and post-operative pain management

Contraindications

When should one not use Buprenorphine+Naloxone

Do not take Buprenorphine+Naloxone:
If you have an apparent allergic reaction to either of the components of Buprenorphine+Naloxone (buprenorphine or naloxone).
If you have severe liver disease.
If you have respiratory depression.

Side effects

Common side effects of this drug are:

Common side effects of Buprenorphine+Naloxone include:
Headache
Drowsiness
Sedation
Dizziness
Fainting
Nausea
Sweating
Dry mouth
Constipation
Blurring of vision
Abdominal pain
Respiratory depression
Irregular heartbeat

Precautions and Warnings

Pregnancy

Buprenorphine+Naloxone may require dose readjustments in case of pregnancy. Your doctor or gynaecologist may prescribe Buprenorphine+Naloxone after calculating the benefit/risk ratio and examining for signs and symptoms of opioid dependence and withdrawal. The FDA has issued a black box warning for Buprenorphine+Naloxone. Always consult a doctor or gynaecologist before starting Buprenorphine+Naloxone. Never self prescribe or self-medicate.

Breast Feeding

Buprenorphine in Buprenorphine+Naloxone is known to be secreted in milk. Since it is an opioid, it may cause opioid withdrawal syndrome in infants. Some quantities of naloxone are also secreted in the milk. Consult a doctor or a gynaecologist before starting Buprenorphine+Naloxone during nursing. Never self prescribe or self-medicate.

Driving

Buprenorphine+Naloxone contains buprenorphine, an opioid that may cause changes in mental alertness, sedation, dizziness, drowsiness, fainting, confusion, and blurring of vision. Driving is not advised while taking Buprenorphine+Naloxone.

Alcohol

Buprenorphine and naloxone interact with alcohol and may cause agitation, respiratory depression, sedation, dizziness, drowsiness, seizures, depression, motor incoordination, fainting, and blurring of vision. Therefore, it is advised to stay away from alcohol entirely while taking Buprenorphine+Naloxone.

Other General Warnings

Talk to your doctor if

You are allergic to buprenorphine.
You are allergic to naloxone.
You have liver disease.
You have kidney disease.
You have a history of drug abuse or dependence.
You are a chronic alcoholic.
You have sleep apnea.
You have lung or breathing problems like Chronic Obstructive Pulmonary Disease (COPD).
You have depression.
You are on diuretic pills.
You have brain disorders like head injury, tumours, and seizures.
You have mental disorders or mood disorders.
You have constipation or diarrhoea.
You have stomach problems like a blockage.
You have paralytic ileus.
You have asthma.
You have an enlarged prostate.

Mode of Action

How Does It Work?

Buprenorphine contains partial agonist activity at certain mu-opioid receptors and acts as an analgesic. Naloxone acts as an opioid antagonist. Both of these work in synergy to prevent opioid dependence and withdrawal.

Interactions

Interactions with other medicines

Buprenorphine+Naloxone may interact with other medicines. Do not take Buprenorphine+Naloxone or take with caution if you take any of the medicines listed here. Consult with a doctor before starting treatment with Buprenorphine+Naloxone.
Alvimopan
Lefamulin
Opioid antagonists like naltrexone, methylnaltrexone and nalmefene
Antipsychotics like clozapine and risperidone
CNS depressants like lorazepam and alprazolam
CNS stimulants like amphetamine
Selective serotonin reuptake inhibitors (SSRIs) like sertraline and fluoxetine
Tricyclic antidepressants like imipramine and clomipramine
CYP3A4 inhibitors like ketoconazole and itraconazole

Interactions with food items

Take Buprenorphine+Naloxone with or without food.
Avoid drinking grapefruit juice with this medicine.

Dosage

Overdose

Overdose of Buprenorphine+Naloxone can result in meiosis, sedation, drowsiness, respiratory depression, slowed breathing, anxiety, depression, panic attacks, insomnia, headache, sweating, delirium, constipation, difficulty urinating, bladder pain, low blood pressure, and low heart rate. Consult your doctor or rush to a hospital if you have overdosed or suspect an overdose.

Missed a Dose

If you miss taking a dose of Buprenorphine+Naloxone, take the missed dose as soon as you remember. If it's time for the next dose, continue with the regular dosage. Do not take a double dose to compensate for the missed dose.

Frequently Asked Questions (FAQs)

The liver primarily metabolises buprenorphine. The liver also metabolises naloxone, but the kidney excretes the metabolites. Naloxone levels are generally not alarming in the case of mild to moderate kidney disease. The dose can be readjusted in case of severe renal disease. Consult your doctor before you start taking this medicine.

Buprenorphine and naloxone are both metabolised by the liver. So, any liver damage may alter the levels of these two drugs inside the body. Therefore, the dose may need to be adjusted in mild to moderate liver disease. However, in severe liver damage and liver failure, Buprenorphine+Naloxone is contraindicated. Always consult a doctor in case of a liver disorder before taking this medicine.

Buprenorphine+Naloxone is mainly used to control withdrawal symptoms due to chronic opioid dependence and overdose. Buprenorphine is a mild analgesic, but its clinical effectiveness is more in managing withdrawal symptoms. Use this medicine for managing your withdrawal symptoms. Consult your physician if you want medicine for relieving your pain.

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