What is the role of buprenorphine implant (Probuphine) in maintenance therapy for opioid abuse?

Updated: Jun 21, 2018
  • Author: David W Dixon, DO; Chief Editor: Glen L Xiong, MD  more...
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Answer

In 2016, the FDA approved the first buprenorphine implant (Probuphine) for opioid dependence. The implant, which is comprised of four, one-inch-long rods that are implanted under the skin on the inside of the upper arm, provides a constant, low-level dose of buprenorphine for six months. Each rod contains approximately 80 mg of the drug for a total of 320 mg implanted at once. The implant is designed for use in patients who are already stable on a low dose of the drug. Because it must be inserted and removed surgically, only health care providers who have completed the training and become certified through a restricted program called the Probuphine Risk Evaluation and Mitigation Strategy (REMS) program should insert and remove the implants. [45]

Persons with opioid dependence often experience difficulty following current existing pharmacologic treatments designed to reduce or eliminate opioid use. Ling et al studied the efficacy of buprenorphine implants over a 6-month period in patients with opioid dependence. Initial induction with sublingual buprenorphine-naloxone tablets preceded implant placement. Less opioid use was observed (as assessed by urine samples) in patients using the buprenorphine implants compared with placebo implants. [46]


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