High-dose tramadol conversion to buprenorphine-naloxone

Authors

DOI:

https://doi.org/10.5055/jom.2023.0774

Keywords:

tramadol, withdrawal, buprenorphine-naloxone

Abstract

Buprenorphine-naloxone is a combination medication of an opioid partial agonist and opioid antagonist that is proven to be effective in outpatient management of opioid use disorder (OUD). Tramadol is a centrally acting analgesic. This commonly used pain medication inhibits serotonin and noradrenaline reuptake by acting as a selective agonist on opioid μ receptors. Transition and tapering high-dose tramadol to buprenorphine-naloxone is not well described in the literature. We report a case of a patient who was taking 1,000-1,250 mg of tramadol daily upon presentation to the clinic. She was originally prescribed 150 mg daily with escalation in dose and frequency over a 10-year period. The patient was converted to buprenorphine-naloxone and has been successful in treatment of OUD for 1 year.

 

Author Biographies

Julienne K. Kirk, PharmD, BCPS

Professor, Department of Family & Community Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina

Charlotte T. Boyd, MA, CHES

Department of Family & Community Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina

Lisa Cassidy-Vu, MD

Department of Family & Community Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina

Linda P. McRae, PsyD

Department of Family & Community Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina

Heather E. Strickland, NP-C

Department of Family & Community Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina

Ernest Blake Fagan, MD

Family Medicine, UNC Health Sciences at Mountain Area Health Education Center, Asheville, North Carolina

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Published

03/01/2023

How to Cite

Kirk, PharmD, BCPS, J. K., C. T. Boyd, MA, CHES, L. Cassidy-Vu, MD, L. P. McRae, PsyD, H. E. Strickland, NP-C, and E. B. Fagan, MD. “High-Dose Tramadol Conversion to Buprenorphine-Naloxone”. Journal of Opioid Management, vol. 19, no. 2, Mar. 2023, pp. 187-90, doi:10.5055/jom.2023.0774.

Issue

Section

Clinical Report