Table 1 Individualized buprenorphine initiation plan
Day | Buprenorphine dose | Methadone dose | Supportive Medications |
|---|---|---|---|
4 | Buprenorphine 150 mcg buccal q6H | Methadone 175 mg PO daily | Ketamine 10 mg PO TID; monitor weekly LFTs Clonidine 0.1 mg PO TID PRN; HOLD for SBP < 100, HR < 60 Hydroxyzine 50 mg PO q6H Loperamide 4 mg PO PRN followed by 2 mg q4H PRN. MAX 16 mg/day Prochlorperazine 10 mg PO q6H PRN NO NSAID– patient with history of stomach ulcers and ESRD on iHD |
5 | Buprenorphine 300 mcg buccal q6H | Methadone 175 mg PO daily | |
6 | Buprenorphine 450 mcg buccal q6H | Methadone 175 mg PO daily | |
7 | Buprenorphine 600 mcg buccal q6H | Methadone 175 mg PO daily | |
8 | Buprenorphine 900 mcg buccal q6H | Methadone 175 mg PO daily | |
9 | Buprenorphine/Naloxone 2-0.5 mg SL TID | Methadone 80 mg PO daily | |
10 | Buprenorphine/Naloxone 4 − 1 mg SL TID | Methadone 80 mg PO daily | |
11 | Buprenorphine/Naloxone 16 − 4 mg SL x1 followed by Buprenorphine/Naloxone 8 − 2 mg SL TID | NONE | |
12 | Buprenorphine/Naloxone 8 − 2 mg SL TID | NONE |