Depot Buprenorphine Injection In The Management Of Opioid Use Disorder: From Development To Implementation

Figures & data

Table 1 Comparison Of Long-Acting Formulations Of Buprenorphine FDA-Approved For Treatment Of Opioid Use Disorder

Brand name	Probuphine	Sublocade	Brixadi (US) or buvidal (Europe/Australia)
Molecular name		RBP-6000	CAM2038
Pharmaceutical	Previously Braeburn, currently Titan	Indivior	Braeburn Pharmaceuticals/Camurus
Indicated population	Stable transmucosal buprenorphine dose of 8 mg or less for three months or longer	Initiated transmucosal buprenorphine (8–24 mg) for a minimum of 7 days.	Initiation of treatment in patients not already receiving buprenorphine or switching from transmucosal buprenorphine
Route of administration	Subcutaneous implant	Subcutaneous injection	Subcutaneous injection
Duration of effect	6 months	1 month	1 week or 1 month
Dosage	320 mg (Four 80 mg implants)	100 and 300 mg	8, 16, 24 and 32 mg (weekly) or 64, 96 and 128 mg (monthly)
Long-acting technology	Ethylene vinyl acetate (EVA) polymer	18% (weight/weight) buprenorphine base in the ATRIGEL Delivery System	Prolonged release FluidCrystal injection depot technology
Location	Upper arm	Abdomen	Buttock, thigh, stomach (abdomen) or upper arm
FDA-approval	2016	2017	2018 (tentative)
Plasma concentrations (ng/mL)	Cmax 3.23 Ctrough 0.72	Cmax 4.88 (100 mg) 10.12 (300 mg) Ctrough 2.48 (100 mg) 5.01 (300 mg)	Cmax Weekly 4.35–8.23 Monthly 3.81–6.59 Ctrough Weekly 0.26–0.54 Monthly 0.45–0.93
Provider burden	+++ Live training program Procedural competency	++ Supervised injection Monthly injections	++ Supervised injection Weekly or monthly injections
Special Handling Requirements	Requires implant procedure Need for removal or replacement every 6 months	Needs Refrigeration Injection only under skin around umbilicus	No special requirements