Using buprenorphine in patient with Intrathecal fentanyl pump

[ghm]

Does anyone know if any studies have shown if a patient on low dose Intrathecal fentanyl (<2mg\day) is given buprenorphine to help with withdraw symptoms as dose is lowered and/or help with chronic pain will the suboxone induce full blown withdraw or just attach to unused receptors. It is my understanding that fentanyl has a very strong affinity for mu receptors and we know buprenorphine does as well. I have been told by some colleagues they have used suboxone with patients on low Intrathecal fentanyl and withdraw was NOT induced. Has anyone seen any articles, studies, etc that speaks to this issue.

 

[Just A Guy]

Moved to Other Drugs.

 

[DonStatus]

I would er on the side of caution with this patient and not use bupe. Other short acting opiates should be given to ease withdrawal symptoms. Because although you are right fent has a high binding affinity the bupe can still rip the fent off the receptors and throw the patient into terrible withdrawal.

And I'm going to assume that isn't good for a patient with a pump because let's face it if you have a pump your not the healthiest person in the world.

Best of luck