First experience with an injectable depot formulation of buprenorphine (Buvidal®) in pregnancy

Ever since the first approval of buprenorphine (BUP) for opiate substitution therapie (OST) a focus lay on the use of BUP in pregnancy. Following the work of G. Fischer et al., various authors have described benefits for the pregnant women and newborn resulting from the use of BUP as compared to methadone (MDN).

Only recently an injectable depot formulation of BUP has been approved for BUP-based OST. The proprietary „FluidCrystal®“ technology developed by Camurus (Sweden, www.camurus.com) allows for weekly and even monthly injections of BUP resulting in plasma concentrations that remain within the therapeutic range for a long time. Since frequent fluctuations of opiate levels, as observed in heroin using pregnant opiate addicts, are considered one of the reasons for intrauterien growth retardation, this might be an advantage. Moreover the number of ambulatory visits for OST patients are drastically reduced. Due to the subcutaneus depot drug safety is increased both due to the inability to divert the substnce to the „black market“ an ddue to th eimposibillity of accidental ingestion by toddlers.

We report on our first experience in transitioning pregnant BUP-maintained patients from s.l. BUP to the s.c. depot formulation.