Sublocade Loading Dose for Opioid Use Disorder

Clinical Considerations

• The American College of Physicians, as reported in the Annals of Internal Medicine, advises against administering Sublocade to patients not already receiving sublingual buprenorphine, as this can precipitate severe withdrawal due to buprenorphine's high mu-receptor affinity displacing other opioids 1
• Patients on Sublocade may require higher doses of full agonist opioids for acute pain management due to competitive receptor binding, with careful monitoring for respiratory depression, as recommended by the Annals of Internal Medicine and Praxis Medical Insights 1, 2

Medication Interactions

• The Annals of Internal Medicine recommends avoiding mixed agonist-antagonist opioids, such as pentazocine, nalbuphine, and butorphanol, during Sublocade treatment, as they will precipitate withdrawal by displacing buprenorphine from mu-receptors 1