Patient Prefers Subutex

Buprenorphine Post
Posts: 137

Postby deegee » Tue Jun 02, 2015 1:04 pm

I would not put naloxone on the allergy list. This has potential issues when another provider gets your records. Soon it will be written in stone and the patient has a free ride for buprenorphine mono product.
Offering bunavail is a good option to lessen the swallowed naloxone.

Posts: 1404

Postby drpasser » Tue Jun 02, 2015 1:04 pm

Too bad, I have this happen all the time. Every new pt gets Rxed the combo product. I agree, there should have been attempts toward tapering before now, although I know, some drs aren't really doing this. Pts I get from elsewhere, have often been on the same dosages for years.

I let the pt know, he or she only will be Rx Suboxone, not Subutex, and tapering over time will be strongly encouraged and attempted.


Posts: 198

Postby NoDrugs4u » Tue Jun 02, 2015 1:04 pm

I'm a newbie at this, so my 2 cents are worth just that. But what stood out to me was "maintained on Subutex for YEARS", what about weaning? And, do you have their old records to document their "allergy" to naloxone? My policy is like yours - no Subutex unless pregnant. Maybe you could suggest they try Bunavail and tell them it is "less allergic" or "better tolerated" or some other nonspecific endorsement.

How exactly did you "inherit" these patients? You could just tell them that you only prescribe Suboxone. Take it or leave it. (I choose this option)

Posts: 101

Postby edibill » Tue Jun 02, 2015 1:04 pm

Unless your state has a specific law it isn't illegal. Do what your gut tells you. If you do prescribe generic bup then maybe do a few random mid-month drug counts and see how that goes. Document their adverse reactions as specifically as you can. List naloxone in their allergy list.

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