Management of Opioid Use Disorder: See Practice Guideline 900.5034

Buprenorphine Patch (Butrans) is NON-formulary as of 2017

Subcutaneous buprenorphine extended‐release:

        WARNING: RISK OF SERIOUS HARM OR DEATH WITH INTRAVENOUS ADMINISTRATION; SUBLOCADE and BRIXADI RISK EVALUATION AND MITIGATION STRATEGY (REMS)

• Serious harm or death could result if administered intravenously. BRIXADI and SUBLOCADE form a gel or solid upon contact with body fluids and may cause occlusion, local tissue damage, and thrombo-embolic events, including life-threatening pulmonary emboli, if administered intravenously.
• Because of the risk of serious harm or death that could result from intravenous self-administration, BRIXADI and SUBLOCADE are only available through a restricted program called REMS. Healthcare settings and pharmacies that order and dispense BRIXADI and SUBLOCADE must be certified in this program and comply with the REMS requirements. 

• • SUBLOCADE® is Restricted as below:
    • Ambulatory:  For clinics (typically primary care, Pain Clinics and Project Nurture); due to REMS program, only to be filled through Legacy Apothecary. 
    • Inpatient: Non-formulary

• • BRIXADI® is Formulary Restricted as below:
    • Weekly Formulation is limited to outpatient clinics, PES (Psychiatric Emergency Services), and ESUDS (Emergency Substance Use Disorder Service).
    • Monthly formulation will be limited to clinic use. It won’t be available during hospital stay at this time.
    • Planned transition to sublingual buprenorphine during inpatient stays.
    • See the review, educational presentation, and flyer for more details
    • See Brixadi REMS Fact Sheet and Website

• Micromedex
• CareNotes
• UpToDate
• Facts & Comparisons
• MedLinePlus (Patient Information)