Limits to buprenorphine dosing: a comparison between quintuple and sextuple the maintenance dose every 5 days

The relative efficacy of quintuple and sextuple buprenorphine dosing in aba ting withdrawal symptoms for 120 h was compared in opioid-dependent outpati ents. Fourteen subjects received buprenorphine in a double-blind, placebo-c ontrolled, cross-over design. Daily sublingual maintenance doses were 4 mg/ 70 kg (n = 4) and 8 mg/70 kg (n = 10). After a stabilization period of dail y maintenance administration, subjects received quintuple (5 x daily mainte nance dose) and sextuple (6 x daily maintenance dose) doses every 120 h. Me asures of opioid agonist and withdrawal effects were assessed daily. Subjec tive ratings of withdrawal were significantly greater than baseline ratings beyond 96-h post dosing under both regimens. There was no evidence, howeve r, that those subjective ratings of withdrawal differed between the two reg imens. Thus, these data suggest that sextuple buprenorphine dosing, adminis tered every 5 days, does not abate opioid-withdrawal beyond 96 hours. (C) 2 001 Elsevier Science Ireland Ltd. All rights reserved.