Buprenorphine plasma concentration in the management of opioid dependence.

摘要

The main pharmacological strategy currently used to treat opioid dependence relies on the agonist occupation of mu-opioid receptors, which alleviates withdrawal symptoms, decreases craving, and attenuates the effects of heroin and other opiates. Buprenorphine, a partial mu-opioid receptor agonist, is widely used as a treatment for opioid dependence. It has been shown to decrease opioid use, improve retention in treatment, and is associated with less severe side effects (eg, QTc prolongation) than methadone, while not being as time and energy consuming for patients and providers. Buprenorphine is known to have a long half-life (approximately 36 hours), and its plasma level can be relatively easily measured. Pharmacokinetic and pharmacody-namic studies have shown that dose is generally related to plasma concentration, which in turn is associated with opioid receptor blockade and clinical effects. Recommended dose range in the United States is 8-32 mg/day.