The content of this evidence summary was up-to-date in February 2019. See summaries of product characteristics (SPCs), British national formulary (BNF), or the Medicines and Healthcare products Regulatory Agency (MHRA) or NICE websites for up-to-date information.
Buprenorphine prolonged-release injection (Buvidal, Camurus) is an opioid partial agonist/antagonist. It is administered as a weekly or monthly subcutaneous injection and must be given by a healthcare professional. It has a marketing authorisation for treating opioid dependence in adults and young people aged 16 years and over within a framework of medical, social and psychological treatment (summary of product characteristics).
Evidence was from 1 randomised controlled trial (Lofwall et al. 2018, see the evidence review for details) in 428 adults diagnosed with, and seeking treatment for, moderate to severe opioid use disorder. Overall, people using buprenorphine prolonged-release injection were no less likely to have opioid-negative urine samples or respond to treatment (defined as having no evidence of illicit opioid use at most assessments) compared with people using sublingual buprenorphine–naloxone.
Buprenorphine prolonged-release injection may be an option where there is a risk of diversion of opioid substitution medicines or concerns about the safety of medicines stored at home. It may also be an option for people who have difficulties adhering to daily supervised opioid substitution medication, such as for people who are working or in education.
Buprenorphine prolonged-release injection may have a place in treating opioid dependence in people in custodial settings, where the risk of diversion and time needed for supervised consumption currently leads to challenges in supplying supervised medicines safely.
However, the higher drug acquisition cost of buprenorphine prolonged-release injection compared with other treatments for opioid dependence will need to be taken into account.