Matching articles for "opioid dependence"

In Brief: Over-the-Counter Narcan Nasal Spray

   
The Medical Letter on Drugs and Therapeutics • May 1, 2023;  (Issue 1675)
The FDA has approved the over-the-counter (OTC) sale of Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone. Narcan nasal spray has been available by prescription since...
The FDA has approved the over-the-counter (OTC) sale of Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone. Narcan nasal spray has been available by prescription since 2015 for emergency treatment of opioid overdose. Generic formulations of Narcan have also been approved; the manufacturers of these products will be required to switch them to OTC status and amend their labeling accordingly. Kloxxado, an 8-mg naloxone nasal spray, remains available only by prescription.
Med Lett Drugs Ther. 2023 May 1;65(1675):72 | Show Full IntroductionHide Full Introduction

Opioids for Pain

   
The Medical Letter on Drugs and Therapeutics • December 12, 2022;  (Issue 1665)
A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous...
A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous issue.
Med Lett Drugs Ther. 2022 Dec 12;64(1665):193-200 | Show Full IntroductionHide Full Introduction

Nalmefene Returns for Reversal of Opioid Overdose

   
The Medical Letter on Drugs and Therapeutics • September 5, 2022;  (Issue 1658)
The FDA has approved a generic injectable formulation of the opioid antagonist nalmefene (Purdue) for the management of known or suspected opioid overdose. Revex, the reference product, was withdrawn from...
The FDA has approved a generic injectable formulation of the opioid antagonist nalmefene (Purdue) for the management of known or suspected opioid overdose. Revex, the reference product, was withdrawn from the market in 2008 for commercial reasons.
Med Lett Drugs Ther. 2022 Sep 5;64(1658):141-2 | Show Full IntroductionHide Full Introduction

Zimhi - A Higher-Dose Injectable Naloxone for Opioid Overdose

   
The Medical Letter on Drugs and Therapeutics • April 18, 2022;  (Issue 1648)
The FDA has approved a higher-dose injectable formulation of the opioid antagonist naloxone (Zimhi – Adamis) for emergency treatment of opioid overdose. A single IM or SC injection of the new formulation...
The FDA has approved a higher-dose injectable formulation of the opioid antagonist naloxone (Zimhi – Adamis) for emergency treatment of opioid overdose. A single IM or SC injection of the new formulation delivers 5 mg of naloxone; injectable formulations that deliver 0.4 mg or 2 mg of the drug have been available for years. Naloxone is also available in intranasal formulations for the same indication (see Table 1).
Med Lett Drugs Ther. 2022 Apr 18;64(1648):61-2 | Show Full IntroductionHide Full Introduction

In Brief: Higher-Dose Naloxone Nasal Spray (Kloxxado) for Opioid Overdose

   
The Medical Letter on Drugs and Therapeutics • September 20, 2021;  (Issue 1633)
The FDA has approved a higher-dose intranasal naloxone formulation (Kloxxado – Hikma) for emergency treatment of opioid overdose. A single spray of the new formulation delivers 8 mg of naloxone; a...
The FDA has approved a higher-dose intranasal naloxone formulation (Kloxxado – Hikma) for emergency treatment of opioid overdose. A single spray of the new formulation delivers 8 mg of naloxone; a formulation that delivers 4 mg per spray (Narcan) was approved in 2015.
Med Lett Drugs Ther. 2021 Sep 20;63(1633):151-2 | Show Full IntroductionHide Full Introduction

Clarification: Management of Opioid Withdrawal Symptoms

   
The Medical Letter on Drugs and Therapeutics • December 3, 2018;  (Issue 1561)
Some readers have questioned our characterization of opioid withdrawal as not life-threatening (Med Lett Drugs Ther 2018; 60:137). While death during opioid withdrawal is unusual, it is possible — for...
Some readers have questioned our characterization of opioid withdrawal as not life-threatening (Med Lett Drugs Ther 2018; 60:137). While death during opioid withdrawal is unusual, it is possible — for example, due to severe untreated dehydration, withdrawal-induced suicidality, or rare myocardial events. We probably should have said that opioid withdrawal is generally not life-threatening. We will make that addition to the article as it appears on our website.
Med Lett Drugs Ther. 2018 Dec 3;60(1561):200 | Show Full IntroductionHide Full Introduction

Roxybond - An Abuse-Deterrent Formulation of Short-Acting Oxycodone

   
The Medical Letter on Drugs and Therapeutics • September 10, 2018;  (Issue 1555)
The FDA has approved Roxybond (Daiichi Sankyo), an short-acting (SA) oxycodone formulation with abuse-deterrent properties, for treatment of pain requiring management with an opioid. Roxybond is the first...
The FDA has approved Roxybond (Daiichi Sankyo), an short-acting (SA) oxycodone formulation with abuse-deterrent properties, for treatment of pain requiring management with an opioid. Roxybond is the first SA opioid to be approved as an abuse-deterrent product. Oxaydo, another IR oxycodone formulation, has properties that discourage its intranasal and intravenous use, but is not considered an abuse-deterrent product by the FDA. Use of opioids for treatment of pain was reviewed in a recent issue.
Med Lett Drugs Ther. 2018 Sep 10;60(1555):145-6 | Show Full IntroductionHide Full Introduction

Management of Opioid Withdrawal Symptoms

   
The Medical Letter on Drugs and Therapeutics • August 27, 2018;  (Issue 1554)
Pharmacologic management of opioid withdrawal symptoms can reduce the intensity of drug craving and improve treatment retention in patients with opioid use disorder who will receive maintenance...
Pharmacologic management of opioid withdrawal symptoms can reduce the intensity of drug craving and improve treatment retention in patients with opioid use disorder who will receive maintenance treatment. Withdrawal management without subsequent maintenance treatment is associated with high rates of relapse, overdose death, and HIV and/or hepatitis C virus infection. Several guidelines on management of opioid withdrawal are available. Maintenance treatment of opioid use disorder was reviewed in a previous issue.
Med Lett Drugs Ther. 2018 Aug 27;60(1554):137-42 | Show Full IntroductionHide Full Introduction

Expanded Table: Some Drugs for Management of Opioid Withdrawal Symptoms (online only)

   
The Medical Letter on Drugs and Therapeutics • August 27, 2018;  (Issue 1554)
...
View Expanded Table: Some Drugs for Management of Opioid Withdrawal Symptoms
Med Lett Drugs Ther. 2018 Aug 27;60(1554):e144-6 | Show Full IntroductionHide Full Introduction

Lofexidine (Lucemyra) for Opioid Withdrawal

   
The Medical Letter on Drugs and Therapeutics • July 16, 2018;  (Issue 1551)
The FDA has approved lofexidine (Lucemyra – US WorldMeds/Salix), a centrally acting alpha2 receptor agonist, to manage withdrawal symptoms in adults abruptly stopping opioid use. Available in the UK...
The FDA has approved lofexidine (Lucemyra – US WorldMeds/Salix), a centrally acting alpha2 receptor agonist, to manage withdrawal symptoms in adults abruptly stopping opioid use. Available in the UK since 1992, lofexidine is the first nonopioid to be approved in the US for management of opioid withdrawal symptoms. Clonidine (Catapres, and generics), another central alpha2 receptor agonist, has been used off-label for this indication for many years.
Med Lett Drugs Ther. 2018 Jul 16;60(1551):115-7 | Show Full IntroductionHide Full Introduction

Opioids for Pain

   
The Medical Letter on Drugs and Therapeutics • April 9, 2018;  (Issue 1544)
Use of nonopioid drugs for pain was reviewed in a previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations...
Use of nonopioid drugs for pain was reviewed in a previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations of full opioid agonists should generally be used for acute pain that is severe enough to require treatment with an opioid. Use of extended-release or long-acting opioid formulations initially and treatment durations >1 week have been associated with an increased risk of unintended long-term use.
Med Lett Drugs Ther. 2018 Apr 9;60(1544):57-64 | Show Full IntroductionHide Full Introduction

Once-Monthly Subcutaneous Buprenorphine (Sublocade) for Opioid Use Disorder

   
The Medical Letter on Drugs and Therapeutics • February 26, 2018;  (Issue 1541)
The FDA has approved a subcutaneous (SC) extended-release formulation of the mu-opioid receptor partial agonist and kappa-opioid receptor antagonist buprenorphine (Sublocade – Indivior) for once-monthly...
The FDA has approved a subcutaneous (SC) extended-release formulation of the mu-opioid receptor partial agonist and kappa-opioid receptor antagonist buprenorphine (Sublocade – Indivior) for once-monthly treatment of moderate to severe opioid use disorder. Sublocade is the first injectable buprenorphine product to be approved in the US. Buprenorphine is also available in sublingual formulations with or without the opioid antagonist naloxone, in a buccal formulation with naloxone, and as a subdermal implant (Probuphine).
Med Lett Drugs Ther. 2018 Feb 26;60(1541):35-7 | Show Full IntroductionHide Full Introduction

Drugs for Opioid Use Disorder

   
The Medical Letter on Drugs and Therapeutics • June 5, 2017;  (Issue 1522)
Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of...
Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of blood-borne infections such as HIV and viral hepatitis, adverse pregnancy outcomes, and increased mortality. According to the CDC, there were 33,091 deaths related to opioid overdose in the US in 2015, more than in any previous year. Several guidelines on the management of opioid use disorder have recently been published.
Med Lett Drugs Ther. 2017 Jun 5;59(1522):89-96 | Show Full IntroductionHide Full Introduction

Abuse-Deterrent Opioids

   
The Medical Letter on Drugs and Therapeutics • June 5, 2017;  (Issue 1522)
Development of abuse-deterrent opioid products, including reformulation of existing products, has become a priority for drug manufacturers and public health advocates. Since our last article on this...
Development of abuse-deterrent opioid products, including reformulation of existing products, has become a priority for drug manufacturers and public health advocates. Since our last article on this subject, several new abuse-deterrent opioid formulations have been approved by the FDA, including an oxycodone tablet formulation (Roxybond – Inspirion) that is the first immediate-release opioid product FDA-approved to include claims of abuse deterrence in its labeling. No opioid formulation prevents consumption of a large number of intact dosage units, the most common method of abuse. Abuse-deterrent formulations have one or more properties that make their intentional nontherapeutic use more difficult, less attractive, or less rewarding.
Med Lett Drugs Ther. 2017 Jun 5;59(1522):95-6 | Show Full IntroductionHide Full Introduction

Buprenorphine Implants (Probuphine) for Opioid Dependence

   
The Medical Letter on Drugs and Therapeutics • July 18, 2016;  (Issue 1499)
The FDA has approved subdermal implants of the partial opioid agonist buprenorphine (Probuphine – Titan) for maintenance treatment of opioid dependence in patients stabilized on low to moderate doses of...
The FDA has approved subdermal implants of the partial opioid agonist buprenorphine (Probuphine – Titan) for maintenance treatment of opioid dependence in patients stabilized on low to moderate doses of transmucosal buprenorphine. Probuphine was designed to provide continuous low levels of buprenorphine for 6 months and to safeguard against illicit use of the drug.
Med Lett Drugs Ther. 2016 Jul 18;58(1499):94-5 | Show Full IntroductionHide Full Introduction

Buprenorphine Buccal Film (Belbuca) for Chronic Pain

   
The Medical Letter on Drugs and Therapeutics • April 11, 2016;  (Issue 1492)
Belbuca (Endo), a buccal formulation of the partial opioid agonist buprenorphine, has been approved by the FDA for management of pain severe enough to require daily, around-the-clock, long-term opioid...
Belbuca (Endo), a buccal formulation of the partial opioid agonist buprenorphine, has been approved by the FDA for management of pain severe enough to require daily, around-the-clock, long-term opioid treatment. Buprenorphine is also available as a transdermal patch (Butrans) and in a parenteral formulation (Buprenex, and generics) for treatment of pain. A sublingual formulation of buprenorphine and buccal and sublingual formulations containing buprenorphine and the opioid antagonist naloxone are approved for use as alternatives to methadone for treatment of opioid dependence.
Med Lett Drugs Ther. 2016 Apr 11;58(1492):47-8 | Show Full IntroductionHide Full Introduction

Bunavail: Another Buprenorphine/Naloxone Formulation for Opioid Dependence

   
The Medical Letter on Drugs and Therapeutics • February 2, 2015;  (Issue 1461)
The FDA has approved a buccal film formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Bunavail – BioDelivery Sciences) for maintenance treatment of...
The FDA has approved a buccal film formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Bunavail – BioDelivery Sciences) for maintenance treatment of opioid dependence. Sublingual tablet and film formulations of the same combination were approved earlier. The manufacturer of Bunavail claims that the new product is superior to sublingual formulations because of the convenience of buccal administration and better absorption into the blood, permitting use of lower doses.
Med Lett Drugs Ther. 2015 Feb 2;57(1461):19-20 | Show Full IntroductionHide Full Introduction

In Brief: Buprenorphine/Naloxone (Zubsolv) for Opioid Dependence

   
The Medical Letter on Drugs and Therapeutics • October 14, 2013;  (Issue 1427)
A new sublingual tablet formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Zubsolv – Orexo) has been approved by the FDA for maintenance treatment of opioid...
A new sublingual tablet formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Zubsolv – Orexo) has been approved by the FDA for maintenance treatment of opioid dependence. Zubsolv tablets have relatively greater bioavailability than previously approved sublingual film (Suboxone) and sublingual tablet formulations of buprenorphine/naloxone and, according to an open-label survey, they taste better. The new tablets are smaller and dissolve faster than other tablet formulations, and they are individually sealed in child-resistant packaging.1

Buprenorphine is a Schedule III controlled substance that can be prescribed in an office setting by qualified physicians who register with the Substance Abuse and Mental Health Services Administration.2

Zubsolv is available as triangular tablets containing 1.4 mg of buprenorphine and 0.36 mg of naloxone and round tablets containing 5.7 mg of buprenorphine and 1.4 mg of naloxone, which achieve plasma concentrations of buprenorphine equivalent to those with the 2/0.5-mg and 8/2-mg strengths of other buprenorphine/naloxone tablets. A package of Zubsolv 5.7/1.4-mg tablets costs the same ($211) as a box of Suboxone 8/2-mg films. A bottle of generic buprenorphine/naloxone 8/2-mg tablets costs $250.3

1. A Fischer et al. Pharmaceutical and pharmacokinetic characterization of a novel sublingual buprenorphine/naloxone tablet formulation in healthy volunteers. Drug Dev Ind Pharm 2013 Oct 7 (epub).

2. Buprenorphine: an alternative to methadone. Med Lett Drugs Ther 2003; 45:13.

3. Approximate wholesale acquisition cost (WAC) of 30 tablets or films. Source: $ource® Monthly (Selected from FDB MedKnowledge™) October 5, 2013. Reprinted with permission by FDB, Inc. All rights reserved. ©2013. www.fdbhealth.com/policies/drug-pricing-policy. Actual retail prices may be higher.

Download complete U.S. English article

Med Lett Drugs Ther. 2013 Oct 14;55(1427):83 | Show Full IntroductionHide Full Introduction

A Morphine/Naltrexone Combination (Embeda) for Pain

   
The Medical Letter on Drugs and Therapeutics • March 22, 2010;  (Issue 1334)
The FDA has approved an agonist/antagonist combination of morphine and naltrexone (Embeda – King) for treatment of chronic moderate to severe pain requiring around-the-clock analgesia for an extended period...
The FDA has approved an agonist/antagonist combination of morphine and naltrexone (Embeda – King) for treatment of chronic moderate to severe pain requiring around-the-clock analgesia for an extended period of time. The addition of naltrexone is intended to prevent abuse of morphine.
Med Lett Drugs Ther. 2010 Mar 22;52(1334):22-3 | Show Full IntroductionHide Full Introduction

Buprenorphine: An alternative to Methadone

   
The Medical Letter on Drugs and Therapeutics • February 17, 2003;  (Issue 1150)
The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only...
The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only for parenteral use in treatment of pain (Buprenex, and others), it offers an alternative to methadone (Dolophine, and others), which is now often abused (New York Times, February 9, 2003; page 1). As a schedule III narcotic, buprenorphine will be subject to fewer prescribing restrictions than a schedule II drug such as methadone (MJ Kreek and FJ Vocci, J Subst Abuse Treat 2002; 23:93).w1150a
Med Lett Drugs Ther. 2003 Feb 17;45(1150):13-5 | Show Full IntroductionHide Full Introduction