Drug Name Indication Half-life (T1/2), Notable Side Effects Initial Dosing Considerations
Neurotransmitter(s) Metabolism (CYP (link to NT or Specific lifespan
Affected 450 enzyme) affected brain circuit) considerations (age,
Target Symptoms pregnancy, breastfeeding)
Buprenorphine Indication: opioid Sublingual: 24-42 Headache, *can induce withdrawal
(Subutex) dependence hours constipation, nausea, immediately if using opioids
NT affected: partial Implant: 12 hours, oral hypoesthesia, or dissipate withdrawal if
opioid agonist w time to steady glossodynia, already experiencing it
ceiling effect (binds state is 4 weeks orthostatic Pregnancy: may be prefered
to opioid receptor, CYP3A4 hypotension, to methadone (not
prevents insertion site pain, recommended during 1st
exogenous opioid pruritis, erythema trimester
from binding) Rare: respiratory Breastfeeding: d/c or bottle
Target symptoms: depression, feed
opioid dependence hepatotoxicity *causes less sedation than
methadone
Buprenorphine/Naloxone Indication: opioid Sublingual: 24-42 Headache, *can induce withdrawal
(Suboxone, Zubsolv, Bunavail) dependence hours constipation, nausea, immediately if using opioids
NT affected: Implant: 12 hours, vomiting, sweating, or dissipate withdrawal if
buprenorphine= time to steady fatigue, dizziness, already experiencing it
opioid receptor state is 4 weeks insomnia Pregnancy: may be prefered
partial agonist Naloxone=2-12 *respiratory to methadone, not
(binds to opioid hours depression, recommended during 1st
receptor, prevents CYP3A4 withdrawal trimester
exogenous opioid symptoms, elevated Breastfeeding: d/c or bottle
from binding LFT’s feed
Naloxone= opioid
antagonist, when
combined it deters
misuse
Target symptoms:
opioid dependence
Neurotransmitter(s) Metabolism (CYP (link to NT or Specific lifespan
Affected 450 enzyme) affected brain circuit) considerations (age,
Target Symptoms pregnancy, breastfeeding)
Buprenorphine Indication: opioid Sublingual: 24-42 Headache, *can induce withdrawal
(Subutex) dependence hours constipation, nausea, immediately if using opioids
NT affected: partial Implant: 12 hours, oral hypoesthesia, or dissipate withdrawal if
opioid agonist w time to steady glossodynia, already experiencing it
ceiling effect (binds state is 4 weeks orthostatic Pregnancy: may be prefered
to opioid receptor, CYP3A4 hypotension, to methadone (not
prevents insertion site pain, recommended during 1st
exogenous opioid pruritis, erythema trimester
from binding) Rare: respiratory Breastfeeding: d/c or bottle
Target symptoms: depression, feed
opioid dependence hepatotoxicity *causes less sedation than
methadone
Buprenorphine/Naloxone Indication: opioid Sublingual: 24-42 Headache, *can induce withdrawal
(Suboxone, Zubsolv, Bunavail) dependence hours constipation, nausea, immediately if using opioids
NT affected: Implant: 12 hours, vomiting, sweating, or dissipate withdrawal if
buprenorphine= time to steady fatigue, dizziness, already experiencing it
opioid receptor state is 4 weeks insomnia Pregnancy: may be prefered
partial agonist Naloxone=2-12 *respiratory to methadone, not
(binds to opioid hours depression, recommended during 1st
receptor, prevents CYP3A4 withdrawal trimester
exogenous opioid symptoms, elevated Breastfeeding: d/c or bottle
from binding LFT’s feed
Naloxone= opioid
antagonist, when
combined it deters
misuse
Target symptoms:
opioid dependence
