TY - JOUR
AU - N. B. Patel
AU - B. V. Parilla
A1 - 
AB - Background  Conventional buprenorphine inductions require patients to abstain from full agonist opioids until they experience mild-to-moderate opioid withdrawal. We described a successful buprenorphine induction case in a pregnant patient using microdosing, which avoided withdrawal symptoms. Case Presentation  The patient is a 29-year-old G2P1001 at 18 2/7 weeks of gestation, who desired a switch from methadone to buprenorphine to minimize neonatal opioid withdrawal syndrome (NOWS), which complicated her last pregnancy. She was given increasing microdoses of buprenorphine over a 7-day period, while continuing her daily dose of methadone. She discontinued the methadone on day 8. She did well during the week of buprenorphine microdosing, with no complaints of withdrawal or cravings. She was engaged in her prenatal care. Her dose of buprenorphine was increased to 8 mg twice daily in the third trimester for some withdrawal symptoms in the evening consisting of new onset nausea and vomiting. The patient underwent an elective 39-week induction of labor and had a spontaneous vaginal delivery of an appropriately grown male fetus. Only nonpharmacologic interventions were used. Conclusion  Buprenorphine microdosing was well tolerated in this patient and avoided withdrawal symptoms in the mothers, and NOWS. A microdosing study in pregnancy is indicated.
AD - Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky.
AN - 38370328
BT - AJP Rep
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 1
DA - Jan
DO - 10.1055/a-2250-6419
DP - NLM
ET - 20240218
IS - 1
JF - AJP Rep
LA - eng
N2 - Background  Conventional buprenorphine inductions require patients to abstain from full agonist opioids until they experience mild-to-moderate opioid withdrawal. We described a successful buprenorphine induction case in a pregnant patient using microdosing, which avoided withdrawal symptoms. Case Presentation  The patient is a 29-year-old G2P1001 at 18 2/7 weeks of gestation, who desired a switch from methadone to buprenorphine to minimize neonatal opioid withdrawal syndrome (NOWS), which complicated her last pregnancy. She was given increasing microdoses of buprenorphine over a 7-day period, while continuing her daily dose of methadone. She discontinued the methadone on day 8. She did well during the week of buprenorphine microdosing, with no complaints of withdrawal or cravings. She was engaged in her prenatal care. Her dose of buprenorphine was increased to 8 mg twice daily in the third trimester for some withdrawal symptoms in the evening consisting of new onset nausea and vomiting. The patient underwent an elective 39-week induction of labor and had a spontaneous vaginal delivery of an appropriately grown male fetus. Only nonpharmacologic interventions were used. Conclusion  Buprenorphine microdosing was well tolerated in this patient and avoided withdrawal symptoms in the mothers, and NOWS. A microdosing study in pregnancy is indicated.
PY - 2024
SN - 2157-6998 (Print); 2157-7005
SP - e88
EP - e90+
ST - Buprenorphine Induction Using Microdosing for the Management of Opioid Use Disorder in Pregnancy
T1 - Buprenorphine Induction Using Microdosing for the Management of Opioid Use Disorder in Pregnancy
T2 - AJP Rep
TI - Buprenorphine Induction Using Microdosing for the Management of Opioid Use Disorder in Pregnancy
U1 - Opioids & Substance Use; Healthcare Disparities
U3 - 10.1055/a-2250-6419
VL - 14
VO - 2157-6998 (Print); 2157-7005
Y1 - 2024
ER -