TY - JOUR
AU - M. R. Lofwall
AU - J. L. Young
AU - Z. Hansen
AU - E. M. Wachman
AU - C. Wilder
AU - C. Guille
AU - J. E. Charles
AU - L. Leeman
AU - J. R. Gray
AU - T. J. Winhusen
A1 - 
AB - Weekly and monthly CAM2038 (Brixadi(®)) extended-release subcutaneous buprenorphine (XR bup) has been available in Europe and Australia for several years and was approved by the Food and Drug Administration in May 2023. Little is known about the clinical experience of patients and providers using this new medication during prenatal care. Two cases of pregnant persons with opioid use disorder receiving weekly XR bup in an ongoing randomized multi-site outpatient clinical trial are presented along with a brief review of the pharmacology and literature on XR bup formulations. The cases in pregnancy illustrate how treatment with the weekly formulation is initiated including how to make dose adjustments, which may be necessary given the longer half-life; it takes 1 month to achieve steady state. Injection site pain with medication administration was time limited and managed readily. Other injection site reactions experienced included subcutaneous erythema and induration that was delayed in onset and typically mild, resolving with minimal intervention. Delivery management and breastfeeding recommendations while on weekly XR bup were not different compared to sublingual buprenorphine (SL bup). Weekly XR bup is a new treatment for opioid use disorder that may be used in the obstetric population. Obstetric and addiction medicine clinicians should be aware of this new formulation as its use is expected to increase.
AD - Departments of Behavioral Science and Psychiatry, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY, USA.; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Family Medicine, Division of Addiction Science, Marshall University, Huntington, WV, USA.; Department of Pediatrics, Boston Medical Center, Boston, MA, USA.; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.; Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.; Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, SC 29425, USA.; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, UT, USA.; Department of Internal Medicine, Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, UT, USA.; Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.; Substance Use Disorder Initiative, Department of Psychiatry, and Departments of Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
AN - 38435674
BT - J Clin Gynecol Obstet
C5 - Opioids & Substance Use; Healthcare Disparities; Education & Workforce
CP - 3
DA - Dec
DO - 10.14740/jcgo919
DP - NLM
ET - 20231228
IS - 3
JF - J Clin Gynecol Obstet
LA - eng
N2 - Weekly and monthly CAM2038 (Brixadi(®)) extended-release subcutaneous buprenorphine (XR bup) has been available in Europe and Australia for several years and was approved by the Food and Drug Administration in May 2023. Little is known about the clinical experience of patients and providers using this new medication during prenatal care. Two cases of pregnant persons with opioid use disorder receiving weekly XR bup in an ongoing randomized multi-site outpatient clinical trial are presented along with a brief review of the pharmacology and literature on XR bup formulations. The cases in pregnancy illustrate how treatment with the weekly formulation is initiated including how to make dose adjustments, which may be necessary given the longer half-life; it takes 1 month to achieve steady state. Injection site pain with medication administration was time limited and managed readily. Other injection site reactions experienced included subcutaneous erythema and induration that was delayed in onset and typically mild, resolving with minimal intervention. Delivery management and breastfeeding recommendations while on weekly XR bup were not different compared to sublingual buprenorphine (SL bup). Weekly XR bup is a new treatment for opioid use disorder that may be used in the obstetric population. Obstetric and addiction medicine clinicians should be aware of this new formulation as its use is expected to increase.
PY - 2023
SN - 1927-1271 (Print); 1927-1271
SP - 110
EP - 116+
ST - What to Expect With Pregnant or Postpartum Prescribing of Extended-Release Buprenorphine (CAM2038)
T1 - What to Expect With Pregnant or Postpartum Prescribing of Extended-Release Buprenorphine (CAM2038)
T2 - J Clin Gynecol Obstet
TI - What to Expect With Pregnant or Postpartum Prescribing of Extended-Release Buprenorphine (CAM2038)
U1 - Opioids & Substance Use; Healthcare Disparities; Education & Workforce
U3 - 10.14740/jcgo919
VL - 12
VO - 1927-1271 (Print); 1927-1271
Y1 - 2023
ER -