Question 1

What is Probuphine?

Accepted Answer

Probuphine is a long-acting medication delivery system containing buprenorphine, which belongs to a class of drugs called opioid partial agonists. It is designed to release a consistent and steady amount of medication into the bloodstream over an extended period of time.

The primary purpose of this therapy is to assist in the treatment of opioid dependence. It works by helping to manage the physical cravings and withdrawal symptoms associated with the condition.

Question 2

What is Probuphine used for?

Accepted Answer

Probuphine is used to treat maintenance treatment of opioid dependence.

Question 3

How does Probuphine work?

Accepted Answer

How Buprenorphine Works

Probuphine contains buprenorphine, which is a partial opioid agonist. This means it binds to the same receptors in the brain as other opioids, such as heroin or prescription painkillers, but it does not activate them as strongly. By occupying these receptors, the medication helps the body in several ways:

Reducing Cravings: It satisfies the brain's physical need for opioids, which helps decrease the urge to use other substances.

Easing Withdrawal: It provides enough stimulation to the receptors to prevent or significantly lessen the physical symptoms of withdrawal.

Blocking Effects: Because buprenorphine sticks tightly to the brain's receptors, it can block other opioids from attaching. This can prevent a person from feeling the "high" of other opioids if they are used during treatment.

The Ceiling Effect

Buprenorphine has a "ceiling effect," meaning that its effects do not continue to increase after a certain dose is reached. This makes it less likely to cause dangerous respiratory depression (slowed breathing) compared to full opioids.

Continuous Delivery System

Probuphine is unique because it is an implant that releases a constant, low level of medication into the bloodstream for six months. This steady delivery avoids the daily peaks and valleys in medication levels that can occur with oral or sublingual treatments, helping to maintain a stable state in the brain and body.

Question 4

What are the active ingredients in Probuphine?

Accepted Answer

The active ingredient in Probuphine is Buprenorphine .

Question 5

What are the side effects of Probuphine?

Accepted Answer

Common side effects of Probuphine may include:

Headache

Nausea

Injection site reactions

Always consult with a healthcare professional about potential side effects.

Question 6

What drug class is Probuphine?

Accepted Answer

Probuphine belongs to the opioid partial agonist drug class.

Question 7

What is the dosage of Probuphine and how do I take it?

Accepted Answer

Administration

Probuphine is administered as a set of implants placed under the skin of the inner upper arm. A healthcare provider performs the insertion during a minor surgical procedure in a clinical setting. Once in place, the implants release medication continuously for six months.

Treatment Schedule

Duration: The implants remain in place for six months.

Removal: At the end of the six-month period, the implants must be surgically removed by a healthcare professional.

Continued Treatment: If further treatment is required after the first six months, a new set of implants may be inserted into the other arm. A single arm should not be used for more than one treatment cycle.

Requirements for Use

This medication is intended for patients who have already achieved stability on a consistent dose of transmucosal buprenorphine. It is not used for the initial phase of treatment.

Missed Appointments

Because the medication is delivered automatically by the implant, daily dosing is not required. However, it is critical to keep the appointment for the removal of the implants at the end of the six-month cycle to ensure continuity of care and safety.

Question 8

Is Probuphine safe during pregnancy and breastfeeding?

Accepted Answer

Pregnancy

Limited data are available regarding the use of buprenorphine implants specifically during pregnancy. However, prolonged use of buprenorphine during pregnancy can cause neonatal opioid withdrawal syndrome (NOWS). This is a condition where the newborn experiences withdrawal symptoms such as irritability, tremors, and difficulty feeding. NOWS is treatable but requires medical management in a hospital setting.

Healthcare providers often consider the risks of untreated opioid use disorder, which can also harm the fetus, when deciding whether to continue buprenorphine treatment during pregnancy. It is important to discuss the risks and benefits of treatment with a healthcare professional.

Breastfeeding

Buprenorphine passes into breast milk in small amounts. While many individuals continue treatment while breastfeeding, it is important to monitor the infant for signs of excessive sleepiness or breathing difficulties. If these symptoms occur, seek medical help immediately.

The decision to breastfeed while using Probuphine should be made in consultation with a doctor to ensure the safety of the baby and the health of the parent.

Question 9

What forms and strengths does Probuphine come in?

Accepted Answer

Probuphine is supplied as a small, rod-shaped implant. It is designed for subdermal insertion, where it is placed under the skin of the upper arm by a healthcare provider.

Subdermal implant

Question 10

What is the FDA approval status of Probuphine?

Accepted Answer

FDA Approval and Indication

The FDA approved Probuphine in 2016 as the first subdermal implant for the maintenance treatment of opioid dependence. It is specifically indicated for patients who have achieved clinical stability on a daily dose of 8 mg or less of oral or sublingual buprenorphine.

Boxed Warning

Probuphine carries a boxed warning due to risks associated with the surgical procedures required for its insertion and removal. Potential complications include:

Nerve damage or injury to the arm where the implant is placed.

Migration of the implant, which could lead to embolism if it enters the bloodstream.

Protrusion or accidental expulsion of the implant.

REMS Program

Because of the risks associated with the insertion and removal process, Probuphine is only available through a restricted distribution program called the Probuphine REMS (Risk Evaluation and Mitigation Strategy) Program. Healthcare providers who prescribe, insert, or remove the implants must complete specific training and certification.

Controlled Substance Status

Buprenorphine, the active ingredient in Probuphine, is classified as a Schedule III controlled substance. This classification is due to its potential for abuse and the risk of physical or psychological dependence.

Safety Communications

The FDA has issued communications urging healthcare providers to use caution when considering withholding opioid addiction medications from patients who are also taking benzodiazepines or other central nervous system depressants. While combined use increases the risk of serious side effects, the FDA notes that the benefits of continuing addiction treatment often outweigh these risks.

Question 11

What should I know about Probuphine and withdrawal?

Accepted Answer

Withdrawal Symptoms

Stopping Probuphine or removing the implants can cause opioid withdrawal. Because the medication stays in your system for some time, withdrawal symptoms may not start right away. Symptoms often include:

Nausea, vomiting, or diarrhea

Muscle aches and joint pain

Anxiety, irritability, or sleep problems

Sweating, chills, or goosebumps

Runny nose or watery eyes

Discontinuing Treatment

The implants provide a steady dose of buprenorphine for six months. If they are removed and not replaced with another form of treatment, withdrawal is likely. Healthcare providers usually monitor patients closely after removal to manage any physical or psychological symptoms that arise.

Neonatal Withdrawal

Long-term use of buprenorphine during pregnancy can lead to neonatal opioid withdrawal syndrome in the newborn. This requires medical management shortly after birth to address symptoms such as irritability, abnormal sleep patterns, and tremors.

Probuphine

📋Overview

What It's Used For

How It Works

Side Effects

Warnings & Precautions

Dosage & How to Take

Pregnancy & Breastfeeding

Forms & Strengths

FDA / Regulatory Status

Withdrawal Information

FAQ

Additional Resources

Support & Help Resources

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