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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(01): e88-e90
DOI: 10.1055/a-2250-6419
Case Report

Buprenorphine Induction Using Microdosing for the Management of Opioid Use Disorder in Pregnancy

Neil B. Patel 
1   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky
,
Barbara V. Parilla
1   Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky
› Institutsangaben Funding None.
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Abstract

Background Conventional buprenorphine inductions require patients to abstain from full agonist opioids until they experience mild-to-moderate opioid withdrawal. We described a successful buprenorphine induction case in a pregnant patient using microdosing, which avoided withdrawal symptoms.

Case Presentation The patient is a 29-year-old G2P1001 at 18 2/7 weeks of gestation, who desired a switch from methadone to buprenorphine to minimize neonatal opioid withdrawal syndrome (NOWS), which complicated her last pregnancy. She was given increasing microdoses of buprenorphine over a 7-day period, while continuing her daily dose of methadone. She discontinued the methadone on day 8. She did well during the week of buprenorphine microdosing, with no complaints of withdrawal or cravings. She was engaged in her prenatal care. Her dose of buprenorphine was increased to 8 mg twice daily in the third trimester for some withdrawal symptoms in the evening consisting of new onset nausea and vomiting.

The patient underwent an elective 39-week induction of labor and had a spontaneous vaginal delivery of an appropriately grown male fetus. Only nonpharmacologic interventions were used.

Conclusion Buprenorphine microdosing was well tolerated in this patient and avoided withdrawal symptoms in the mothers, and NOWS. A microdosing study in pregnancy is indicated

Keywords

opioid use disorder pregnancy - buprenorphine pregnancy - buprenorphine microdosing pregnancy - microdosing buprenorphine


Publikationsverlauf

Eingereicht: 15. Februar 2023

Angenommen: 19. Oktober 2023

Accepted Manuscript online:
22. Januar 2024

Artikel online veröffentlicht:
18. Februar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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