Examining the limits of the buprenorphine interdosing interval: daily, every-third-day and every-fifth-day dosing regimens

Opioid-dependent outpatients may be more likely to present for pharmacologi cal treatment if less than daily dosing can be arranged. These studies comp ared opioid withdrawal symptoms during 24-, 72-, and 120-hour buprenorphine dosing regimens and evaluated participants' preferences for these differen t dosing regimens. Participants. Thirty-three opioid-dependent participants received daily sublingual maintenance doses of 4 mg/70 kg (n = 14) or 8 mg /70 kg (n = 19) of liquid buprenorphine. Methods. In Study I participants r eceived, in a random order, three dosing regimens for Zve repetitions of ea ch: daily maintenance doses every 24 hours (4 or 8 mg/70 kg), triple the da ily maintenance dose every 72 hours (12 or 24 mg/70 kg) and quintuple the d aily maintenance dose every 120 hours (20 or 40 mg/70 kg). Doses were admin istered under double-blind procedures, and placebos were administered on th e interposed days during the latter two regimens. Subjective and observer r atings of opioid withdrawal symptoms were assessed daily prior to receipt o f each dose. In Study II, a new group of participants received each of the three dosing regimens under open-dosing procedures and then chose between t he different dosing regimens. Findings. Opioid withdrawal symptoms increase d significantly during the every-fifth-day dosing regimen in both the blind - and open-dosing studies. In the choice phase of Study II, only one partic ipant (7%) chose quintuple-every-fifth-day dosing over all other dosing opt ions. Conclusions. These results suggest that the maximum duration of actio n of buprenorphine is less than 5 days when five times the daily maintenanc e dose is provided.