Skip to main content

Table 1 Rapid micro-induction titration schedule

From: Comparing rapid micro-induction and standard induction of buprenorphine/naloxone for treatment of opioid use disorder: protocol for an open-label, parallel-group, superiority, randomized controlled trial

 

Buprenorphine/naloxonea

Hydromorphoneb

Dosing

Total daily dose

Dosing

Day 1 (0–24 h)

0.5 mg SL Q3H

4 mg SL

1–16 mg PO/SC/IV/IM

Q1-3H PRN and titrate to effect (start at the lower end of dosing range)

For 1st dose—Max 8 mg PO, or 4 mg SC/IV/IM

Day 2 (24–48 h)

1 mg SL Q3H

8 mg SL

1–16 mg PO/SC/IV/IM

Q1-3H PRN and titrate to effect (start at the lower end of dosing range)

Day 3 (48–72 h)

8–16 mg SL once daily and 1–4 mg SL Q3H PRN

8–16 mg SL; Max 32 mg SL including PRN

Discontinued

Day 4 (72–96 h)

Consolidate day 3 total dose to once daily dosing

Max 32 mg SL

Discontinued

  1. SL sublingual, Q_H every_hour, PRN as needed, PO by mouth, SC subcutaneous, IV intravenous, IM intramuscular
  2. aExpressed as milligrams of buprenorphine in a buprenorphine/naloxone SL tablet
  3. bThe opioids the patients are using are rotated to hydromorphone. Hydromorphone is administered as needed to meet the patient’s opioid requirements. Hold if sedated, RR < 10, or O2 saturation < 92%