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Unusual Route of Buprenorphine Administration: An Alternative Approach for Bypassing Adverse Drug Reactions Publisher



Nazari A1 ; Naderi Mazjin S1 ; Shamsipour M2, 3
Authors

Source: Current Therapeutic Research - Clinical and Experimental Published:2019


Abstract

Tramadol abuse is a critical and growing health concern in Asia. In Iran, tramadol abuse arises most commonly as a result of self-medicating that leads to tramadol dependence. Buprenorphine, a partial agonist of mu opioid receptors approved for the treatment of tramadol dependence, is administered sublingually due to its extensive first-pass metabolism and resulting low oral bioavailability. A 50-year-old man presenting with tramadol dependence after self-medicating for chronic low back pain experienced adverse reactions to a minimal dosage (0.8 mg) of sublingual buprenorphine. He was treated successfully with a modified protocol composed of swallowing sublingual tablets (0.2 mg/day initially, which increased to 0.2 mg every 12 hours during maintenance therapy). This unusual case suggests that swallowing buprenorphine sublingual tablets may prevent adverse effects and reduce the rate of treatment dropout. © 2019 The Author(s)
1. Tramadol: Clinical Applications, Psychological Effects and Toxicity, International Journal of Pharmaceutical Research (2019)
2. Tramadol, Usage, Misuse, and Addiction Processes, Neuropathology of Drug Addictions and Substance Misuse Volume 3: General Processes and Mechanisms# Prescription Medications# Caffeine and Areca# Polydrug Misuse# Emerging Addictions and Non-Drug Addictions (2016)
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