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June 15, 2021

Question of the Day – Tuesday June 15, 2021

A recent prospective, open label, randomized controlled trial found that this medication is a potential alternative to naloxone for reversal of methadone, a long acting opioid.

IV buprenorphine. This study randomized patients with methadone-induced respiratory depression to receive naloxone (titrated doses), or lower or higher doses of buprenorphine (10 ug/kg or 15 ug/kg). According to the cited reference, “55/56 patients who received buprenorphine had rapid reversal of respiratory depression, which persisted for at least 12 h. Intubation and opioid withdrawal were less common with buprenorphine. There were no serious complications or deaths in those receiving buprenorphine. The 15-μg/kg buprenorphine dose appeared to provide a longer duration of action, but precipitated withdrawal more frequently than the 10-μg/kg dose.” The authors conclude that, “buprenorphine appears to be a safe and effective substitute for naloxone in overdosed opioid-dependent patients”

Zamani N, Buckley NA, Hassanian-Moghaddam H: Buprenorphine to reverse respiratory depression from methadone overdose in opioid-dependent patients: a prospective randomized trial. Crit Care 2020;24(44):1-9. https://doi.org/10.1186/s13054-020-2740-y.

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  • Education & Groups
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        • ABAT Examination Study Guide
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      • ABAT Member Directory
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      • ABAT Board of Directors Contact Information
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