Saturday, May 4, 2013

Buprenorphine + Naloxone in Pregnancy

Buprenorphine + Naloxone in the Treatment of Opioid Dependence during Pregnancy-Initial Patient Care and Outcome Data.
Debelak K, Morrone WR, O'Grady KE, Jones HE.
Am J Addict. 2013 May;22(3):252-4

The authors report on 10 women treated with buprenorphine/nalolxone (Suboxone) rather than buprenorphine only (Subtex) in pregnancy.

Dosing was 8/2 up to 16/4 mg SL daily.  All urine drug tests negative at delivery.  This was not an especially high functioning or low risk group: none had completed education beyond high school (six had a high school degree), all but one had never married, none were employed full‐time, and one was currently involved with the criminal justice system.

There were two maternal medical complications: one case of pre‐eclampsia and one oligohydramnios. There was one c-section.

Neonates were, generally speaking, full‐term infants with normal birth parameters. One baby was born premature after PPROM, leading to an average gestational age 37.5w and average birth weight 6lbs 3 oz.

Four neonates were treated for NAS, needing on average 3.5 mg morphine over 6.9 treatment days.

The authors conclude: Findings do not raise obvious concerns for clinicians who might be considering treatment of opioid‐dependent pregnant women with buprenorphine þ naloxone.  They did note the need for further research

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