lofexidine

Adjunctive therapy

Brands: Lucemyra

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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Quick answers

What is lofexidine?
Lofexidine (brand Lucemyra) is an α2-adrenergic agonist indicated to mitigate opioid withdrawal symptoms during abrupt opioid discontinuation (label). It can reduce autonomic symptoms (sweating, chills, GI upset, anxiety) but does not treat opioid use disorder (OUD) itself (guideline/clinical).
What is Lucemyra?
Lucemyra is a brand name for lofexidine.
What is Lucemyra (lofexidine) used for?
Label indications include: Mitigation of opioid withdrawal symptoms during abrupt opioid discontinuation (label).
What drug class is Lucemyra (lofexidine)?
Central α2-adrenergic agonist used to mitigate opioid withdrawal symptoms (autonomic hyperactivity, anxiety, GI distress) during abrupt opioid discontinuation; does not treat opioid use disorder itself and does not reduce relapse risk without follow-on care (label/guideline).
What strengths does Lucemyra (lofexidine) come in?
Oral tablets (label): 0.18 mg lofexidine.

Snapshot

Class: Adjunctive therapy
Common US brands: Lucemyra
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

Mitigation of opioid withdrawal symptoms during abrupt opioid discontinuation (label).

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Clinical Highlights

Lofexidine (brand Lucemyra) is an α2-adrenergic agonist indicated to mitigate opioid withdrawal symptoms during abrupt opioid discontinuation (label). It can reduce autonomic symptoms (sweating, chills, GI upset, anxiety) but does not treat opioid use disorder (OUD) itself (guideline/clinical). It is often compared with clonidine (used off-label for opioid withdrawal). Lofexidine is FDA-approved for this indication and has label-driven dosing guidance, but it shares key adverse effects such as hypotension, bradycardia, and sedation (label/clinical).

A practical limitation is that withdrawal symptom control does not address relapse risk. Many care plans use lofexidine as a short-term bridge into longer-term treatment (buprenorphine, methadone, or naltrexone-based strategies) plus psychosocial support (guideline/clinical).
QT prolongation is an explicit label warning. ECG monitoring is recommended when risk factors are present (electrolyte abnormalities, heart failure, bradyarrhythmias, hepatic/renal impairment, or other QT prolonging drugs such as methadone) (label).
The compare view, lofexidine evidence feed, and lofexidine print page support counseling when withdrawal management intersects with anxiety, sleep disruption, and sedative co-use.

Dosing & Formulations

Oral tablets: 0.18 mg lofexidine (label). The usual starting dosage is three 0.18 mg tablets (0.54 mg) taken four times daily during the peak withdrawal period, with 5 to 6 hours between doses. No single dose should exceed 0.72 mg (4 tablets) (label).

The total daily dose should not exceed 2.88 mg (16 tablets) and treatment may be continued for up to 14 days guided by symptoms (label).
Labeling recommends tapering over 2 to 4 days to reduce rebound lofexidine withdrawal symptoms (label).
Dose reductions are recommended in hepatic and renal impairment (label).

Monitoring & Risks

Hypotension, bradycardia, and syncope can occur; vital signs are commonly monitored before dosing and in higher-risk patients (label/clinical). Sedation, dizziness, and fatigue can overlap with withdrawal symptoms; clinicians often review fall risk and driving safety during initiation (label/clinical).

QT prolongation risk is higher with hepatic/renal impairment and with other QT-prolonging drugs (e.g., methadone). ECG monitoring is recommended when risk factors are present (label).
Abrupt discontinuation can lead to rebound symptoms; tapering is part of typical practice (label/clinical).

Drug Interactions

Additive hypotension/bradycardia can occur with other antihypertensives, and additive sedation can occur with CNS depressants (label/clinical). Strong CYP2D6 inhibitors (or CYP2D6 poor metabolizer status) can increase lofexidine exposure; monitoring for orthostasis and bradycardia is commonly emphasized (label).

Concomitant methadone increases QT monitoring importance because both agents can prolong QTc (label).

Practice Notes

Lofexidine is usually framed as symptom relief during detoxification or transition, not as a stand-alone OUD treatment. Follow-on engagement in evidence-based OUD treatment is typically part of the plan (guideline). Clinicians often pair it with non-opioid supportive measures (hydration, GI symptom management, sleep planning) while monitoring blood pressure and QT risk (clinical).

References

LUCEMYRA (lofexidine hydrochloride) tablets prescribing information — DailyMed (2026)
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update — Journal of Addiction Medicine (2020)
TIP 63: Medications for Opioid Use Disorder — SAMHSA (2021)
The Role of Lofexidine in Management of Opioid Withdrawal — Pain Therapy (2019)