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 How Supplied:Buprenorphine (as hydrochlor.)

 Indications:Substitution treatment for opioid dependence.

 Adults:Initially 800 microgram—4mg sublingually once daily at least 6 hrs after last use of opioid. If patient is taking methadone, reduce methadone dose to max 30mg daily and allow at least 24 hrs after last dose before initiating therapy.
Increase dose of buprenorphine according to response; max 32mg daily. Once stabilised, reduce dose gradually to withdraw. Children:Under 16 years, not recommended. Buy Subutex online, for sale in Australia

 Contraindications:Severe respiratory or hepatic impairment, acute alcoholism, delirium tremens. Lactation.
Sixmo: also, history of keloid or hypertrophic scar formation, contraindication for MRI.

 Warnings:Respiratory or hepatic impairment (avoid if severe), severe renal impairment. Head injury, increased intracranial pressure, hypotension, prostatic hypertrophy, urethral stenosis, hypothyroidism, adrenocortical insufficiency, biliary tract dysfunction, sleep apnoea, history of seizures. Perform baseline LFTs and screen for hepatitis. Monitor LFTs during treatment, withdraw if hepatic necrosis or jaundice develop. History of or risk factors for QT prolongation. Risk of abuse (eg, by iv admin), particularly at start of treatment. Risk of drowsiness; warn patient. Adolescents. Elderly, debilitated. Pregnancy. Buy Subutex online, for sale in Australia
Note: Espranor is not interchangeable with other sublingual buprenorphine products. Buy Subutex online, for sale in Australia
Sixmo: also, history of connective tissue disease or recurrent MRSA skin infections. Risk of nerve damage and implant migration or expulsion.

 Interactions:MAOIs, SSRIs, SNRIs, TCADs, other serotonergic drugs, alcohol, benzodiazepines, other CNS depressants, inhibitors or inducers of CYP3A4, hepatotoxic drugs, drugs that prolong QT interval, naltrexone, nalmefene. Buy Subutex online, for sale in Australia

 Adverse Effects:Erythema, GI upset, tooth disorder, dry mouth, rash, pruritus, anorexia, dizziness, anxiety, agitation, hostility, paranoia, fatigue, headache, sweats, dyspnoea, asthma, bronchitis, drowsiness, orthostatic hypotension, insomnia, asthenia, lacrimation disorder, mydriasis, miosis, syncope, tremor, rhinorrhoea, chest pain, pyrexia, chills, mood changes, abnormal thinking, dependence, hypertonia, speech disorder, paraesthesia, amblyopia, hypertension, vasodilatation, cough, bone pain, arthralgia, myalgia, muscle spasms, infection, lymphadenopathy, palpitations, dysmenorrhoea, erectile dysfunction, withdrawal syndrome, flu-like symptoms, wt loss, abnormal LFTs.
Buvidal (mims.co.uk only): also, inj site reactions.
Sixmo: also, implant site reactions. Buy Subutex online, for sale in Australia

New Eligibility Requirements for Buprenorphine Prescribing

What’s happening – With the opioid crisis continuing unabated, HHS has released new guidelines that should help increase access to opioid use disorder (OUD) treatment. By removing a few barriers, the updated regulation makes it easier for clinicians to prescribe buprenorphine, which can help reduce opioid cravings and withdrawal symptoms.

Under the new provisions, which took effect April 28, 2021, healthcare providers who are state-licensed and are already registered with the DEA to prescribe controlled substances, can apply for a waiver to prescribe buprenorphine to up to 30 patients without first having to meet training, counseling, and ancillary service requirements. Buy Subutex online, for sale in Australia

Why it’s complicated – While prescribers who qualify can apply for the new waiver to eliminate the federal training requirements for prescribing buprenorphine, they must still meet state laws that govern supervisory requirements and prescription durations.

Reports & Perspectives – Buy Subutex online, for sale in Australia

• SAMHSA provides a quick-start guide for providers on buprenorphine and how to prescribe it for patients.
• NPR provides a Q&A with Nora Volkow, director of the National Institute on Drug Abuse, looking at why the new opioid-prescribing guidelines are significant and how they will increase access to treatment for patients in need.
• The American Dental Association unpacks the new guidelines for members and provides resources for dentists to do their part in addressing the opioid epidemic.
• Practical Pain Management provides perspective on the updated guideline for clinicians and advanced practitioners treating patients with chronic pain.
• @DrSarahWakeman (addiction medicine specialist) tweets: “Practical tips for submitting NOI for x-waiver w/o doing training under new practice guidelines…”
• @AlosaHealth (nonprofit organization supporting HCPs) tweets: “Only 1 in 10 patients with #OUD initiate buprenorphine within 1 year of diagnosis’ adherence to therapy after initiation is low, suggesting important gaps in care.” Buy Subutex online, for sale in Australia