Zubsolv Induction Dose Question?

Buprenorphine Post
fishdoc
Posts: 111

Postby fishdoc » Wed Aug 31, 2016 6:53 am

The original studies compared Zubsolv to Suboxone TABLETS and the 2/0.5 Suboxone tab was found to be equivalent to the Zubsolv 1.4/0.36 tab, although I believe they actually compared 8/2 to 5.7/1.4. The Suboxone film, however is better absorbed than were the old Suboxone tablets, allowing higher blood levels from the "same dose." Therefore, Zubsolv may achieve slightly lower sustained levels than the film would achieve, while having a slightly higher peak level. You probably would find that most generic tablets also have this same problem, lower sustained levels, but many patients are more willing to accept the terminology, "generic Suboxone" having the same 8/2 listed on the wrapper than they are Zubsolv showing 5.7/1.4 on the package.

Bruni
Posts: 49

Postby Bruni » Wed Aug 31, 2016 6:53 am

BTW, the equivalency table between Zubsolv and Suboxonoe was established apparently by the singular 'study' which found similar 'blood levels' with Zubsolv 1.4 & Suboxone 2mg. I am not convinced in practice that they are equivalent.

Bruni
Posts: 49

Postby Bruni » Wed Aug 31, 2016 6:53 am

Zubsolv 1.4 is apparently taken to be equivalent to the Suboxone 2mg dose, and therefore is a standard induction dose.
If I trust that the patient is truthfully reporting the last dose of non-bup opioids as adequately distant and there is clearly a COWS greater than 15, I start higher than that dose.
However, the majority of my new clients (Hudson Valley, upstate NY) are already taking illicit 'suboxone', know the basic pharmacology and can be trusted with unsupervised home use.

DrBranton
Posts: 14

Postby DrBranton » Wed Aug 31, 2016 6:53 am

My practice has been to give an initial 1.4mg dose of Zubsolv followed by an additional 1.4mg in 1 to 2 hours. I have generally found that a second dose is usually required.

DrB


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