Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review

Methadone, a full opioid agonist at the mu-, kappa-, and delta-receptor, and buprenorphine, a partial agonist at the mu receptor, are first-line medications in opioid maintenance treatment. Transition from methadone to buprenorphine may precipitate withdrawal, and no accepted algorithm for this proc...

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Autor principal:	Michael Soyka
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	opioids opioid dependence methadone buprenorphine induction transition Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/9a223c56bc1442dfa904366310df96ed
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spelling	oai:doaj.org-article:9a223c56bc1442dfa904366310df96ed2021-11-30T12:49:57ZTransition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review1663-981210.3389/fphar.2021.718811https://doaj.org/article/9a223c56bc1442dfa904366310df96ed2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.718811/fullhttps://doaj.org/toc/1663-9812Methadone, a full opioid agonist at the mu-, kappa-, and delta-receptor, and buprenorphine, a partial agonist at the mu receptor, are first-line medications in opioid maintenance treatment. Transition from methadone to buprenorphine may precipitate withdrawal, and no accepted algorithm for this procedure has been developed. Current treatment strategies recommend transfer from methadone to buprenorphine predominantly in patients at low doses of methadone (30–40 mg/day). There are some reports indicating that transition from higher doses of methadone may be possible. A number of dosing strategies have been proposed to soften withdrawal symptoms and facilitate transfer including use of other opioids or medications and especially microdosing techniques for buprenorphine. The case series and studies available thus far are reviewed.Michael SoykaFrontiers Media S.A.articleopioidsopioid dependencemethadonebuprenorphineinductiontransitionTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	opioids opioid dependence methadone buprenorphine induction transition Therapeutics. Pharmacology RM1-950
spellingShingle	opioids opioid dependence methadone buprenorphine induction transition Therapeutics. Pharmacology RM1-950 Michael Soyka Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
description	Methadone, a full opioid agonist at the mu-, kappa-, and delta-receptor, and buprenorphine, a partial agonist at the mu receptor, are first-line medications in opioid maintenance treatment. Transition from methadone to buprenorphine may precipitate withdrawal, and no accepted algorithm for this procedure has been developed. Current treatment strategies recommend transfer from methadone to buprenorphine predominantly in patients at low doses of methadone (30–40 mg/day). There are some reports indicating that transition from higher doses of methadone may be possible. A number of dosing strategies have been proposed to soften withdrawal symptoms and facilitate transfer including use of other opioids or medications and especially microdosing techniques for buprenorphine. The case series and studies available thus far are reviewed.
format	article
author	Michael Soyka
author_facet	Michael Soyka
author_sort	Michael Soyka
title	Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
title_short	Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
title_full	Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
title_fullStr	Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
title_full_unstemmed	Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review
title_sort	transition from full mu opioid agonists to buprenorphine in opioid dependent patients—a critical review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9a223c56bc1442dfa904366310df96ed
work_keys_str_mv	AT michaelsoyka transitionfromfullmuopioidagoniststobuprenorphineinopioiddependentpatientsacriticalreview
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Transition From Full Mu Opioid Agonists to Buprenorphine in Opioid Dependent Patients—A Critical Review

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