Opioid use disorder: Buprenorphine/Naloxone, Methadone & Naltrexone.
This chapter will compare following three FDA approved medications for opioid use disorder:
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Methadone (MET).
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Buprenorphine/Nalaxone (BUP).
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Naltrexone injectable- Vivitrol (NTX).
MET |
BUP |
NTX |
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BASELINE LABS |
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MONITORING |
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DOSAGE |
INITIAL DOSE: 20-30 mg daily dose.
MAINTENANCE DOSE: 60- 120 mg daily dose.
Titrate carefully, consider methadone’s delayed cumulative effects. |
Patients dependent on short acting opioids:
Patients dependent on methadone or long acting opioids:
MAINTENANCE DOSE:
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380 mg delivered intramuscularly every 4 weeks or once a month. |
HEPATICIMPAIRMENT |
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RENALIMPAIRMENT |
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CONTRA-INDICATION |
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SOURCE:
- Addiction. 2014 Jan; 109(1): 79–87.
- VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF SUBSTANCE USE DISORDERS.
- Methadone package insert.
- SUBOXONE® (buprenorphine and naloxone) package insert.
- VIVITROL® (naltrexone for extended-release injectable suspension) package insert.
Please do post your questions or comments below.

Dr. Harvinder Singh, M.D. (Admin)

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