| Opioid use disorder treatment (induction and maintenance) (label). View labelExact | Treatment is often structured in phases (induction, stabilization, maintenance) with dose changes guided by withdrawal symptoms, cravings, and safety (guideline/clinical).
Induction timing is individualized by opioid type and timing of last use; objective withdrawal assessment is commonly used to reduce precipitated withdrawal risk (label/guideline). | Combination of buprenorphine (partial μ-opioid receptor agonist) and naloxone (opioid antagonist) used for treatment of opioid use disorder. Naloxone has low bioavailability sublingually but deters injection misuse (label/guideline). | CYP3A4 (buprenorphine), UGT1A1/UGT2B7 (buprenorphine glucuronidation) | Single-dose range 24–42 h | No | | - Early follow-up to assess withdrawal control, cravings, sedation, and adherence (guideline/clinical).
- Review concurrent CNS depressants at each visit and reassess risk when new sedating medications are started (label/clinical).
- Monitor for diversion/misuse as clinically indicated (structured follow-up, PDMP review, urine drug testing depending on setting) (guideline/clinical).
- Consider hepatic monitoring when baseline liver disease is present or when symptoms emerge (label/clinical).
| No | 2026-02-12 |
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methadoneAdjunctive therapyBrands: Methadose, Dolophine | Opioid use disorder maintenance in certified opioid treatment programs and analgesia (label varies by product). View labelExact | Opioid use disorder (OUD) dosing is typically managed within an opioid treatment program, with dose changes guided by withdrawal control, cravings, and safety (guideline/clinical).
Because accumulation risk is highest early in treatment, many programs avoid rapid escalation and reassess frequently after dose changes (label/clinical). | Long-acting full μ-opioid receptor agonist used for opioid use disorder maintenance (in regulated opioid treatment programs) and for analgesia. Long and variable half-life can lead to accumulation and overdose risk if titration is too rapid (label/guideline). | CYP2B6, CYP3A4, Other CYP enzymes (variable; label) | Single-dose range 8–59 h | No | | - Monitor sedation and respiratory status during initiation and after dose increases; reassess concurrent sedatives and polysubstance use risk (label/clinical).
- QTc planning: consider ECG monitoring when cardiac risk factors, high doses, or QT-active co-medications are present (label/clinical).
- Monitor for constipation and other opioid adverse effects that can affect adherence and quality of life (clinical).
- Reassess withdrawal control and cravings and adjust treatment supports (housing, therapy, peer support) when available (guideline/clinical).
| No | 2026-02-22 |
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| Treatment of alcohol dependence; blockade of the effects of exogenously administered opioids in the management of opioid dependence (label). View labelExact | Alcohol dependence: 50 mg once daily was used in placebo-controlled outpatient trials for up to 12 weeks as an adjunct to psychosocial methods (label). | Opioid receptor antagonist used for alcohol dependence and for opioid dependence relapse prevention via opioid blockade; requires an opioid-free period to avoid precipitated withdrawal and has hepatotoxicity cautions at higher doses. | Extensive hepatic metabolism (first pass) | Single-dose mean 4 h | No | — | - Liver function testing (baseline and follow-up), especially with alcohol-related liver disease (label/clinical).
- Opioid exposure screening and documentation of opioid-free verification strategy (label/clinical).
- Monitoring for nausea, dizziness, and fatigue that can affect adherence and function (clinical).
- Perioperative/acute pain planning because opioid analgesia may be ineffective while naltrexone is active (clinical).
| No | 2026-02-12 |
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| Hypertension (label). Psychiatric uses are typically off-label (formulation- and population-dependent). View labelExact | Hypertension labeling commonly starts at 0.1 mg twice daily (morning and bedtime) (label). | Alpha-2 adrenergic agonist; reduces central sympathetic outflow (antihypertensive; also used off-label in psychiatry). | Hepatic metabolism (multiple pathways) | Single-dose range 12–16 h | No | | - Baseline and periodic blood pressure and heart rate, especially during titration or dose changes.
- Orthostasis, dizziness, and sedation; adjust dosing timing and review interacting medications if symptoms emerge.
- Renal impairment and medication adherence; missed doses can trigger rebound hypertension in some patients.
- Discontinuation plan documented in advance to reduce rebound hypertension and agitation risk.
| No | 2025-12-30 |
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