Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 May;120(5):1262-74.
doi: 10.1097/ALN.0000000000000170.

Buprenorphine-naloxone therapy in pain management

Kelly Yan Chen  1 , Lucy Chen, Jianren Mao
Affiliations
Review

Buprenorphine-naloxone therapy in pain management

Kelly Yan Chen et al. Anesthesiology. 2014 May.

Abstract

Buprenorphine-naloxone (bup/nal in 4:1 ratio; Suboxone; Reckitt Benckiser Pharmaceuticals Incorporation, Richmond, VA) is approved by the Food and Drug Administration for outpatient office-based addiction treatment. In the past few years, bup/nal has been increasingly prescribed off-label for chronic pain management. The current data suggest that bup/nal may provide pain relief in patients with chronic pain with opioid dependence or addiction. However, the unique pharmacological profile of bup/nal confers it to be a weak analgesic that is unlikely to provide adequate pain relief for patients without opioid dependence or addiction. Possible mechanisms of pain relief by bup/nal therapy in opioid-dependent patients with chronic pain may include reversal of opioid-induced hyperalgesia and improvement in opioid tolerance and addiction. Additional studies are needed to assess the implication of bup/nal therapy in clinical anesthesia and perioperative pain management.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors declare no competing interests.

Figures

Figure 1
Figure 1
Schematic illustration of the effect of buprenorphine as a partial mu-opioid receptor agonist.
Figure 2
Figure 2
Schematic illustration of the antagonizing effect of naloxone, an element in buprenorphine-naloxone, on mu-opioid receptors.
Figure 3
Figure 3
A flowchart illustrating the clinical effect of buprenorphine-naloxone (bup/nal) on various categories of chronic pain patients with or without opioid dependence or addiction. OIH: opioid-induced hyperalgesia
See this image and copyright information in PMC

References

    1. Toblin RL, Mack KA, Perveen G, Paulozzi LJ. A population-based survey of chronic pain and its treatment with prescription drugs. Pain. 2011;152:1249–55. - PubMed
    1. Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: Results of an Internet-based survey. J Pain. 2010;11:1230–9. - PubMed
    1. Compton WM, Volkow ND. Major increases in opioid analgesic abuse in the United States: Concerns and strategies. Drug Alcohol Depend. 2006;81:103–7. - PubMed
    1. Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf. 2006;15:618–27. - PubMed
    1. Kroutil LA, Van Brunt DL, Herman-Stahl MA, Heller DC, Bray RM, Penne MA. Nonmedical use of prescription stimulants in the United States. Drug Alcohol Depend. 2006;84:135–43. - PubMed

Publication types

MeSH terms