Outcomes associated with once-daily versus multiple-daily dosing of buprenorphine/naloxone for opioid use disorder

Background and Objectives Clinical studies examining once-daily versus multiple-daily dosing of buprenorphine/naloxone in patients with opioid use disorder (OUD) in the absence of comorbid pain are lacking. Methods This retrospective chart review aimed to compare 100 patients prescribed single-daily buprenorphine/naloxone (n = 50) to those prescribed multiple-daily buprenorphine/naloxone (n = 50) to elucidate the impact that dosing frequency has on negative urine drug screens (UDS) and the number of relapses in OUD. Results The once-daily cohort produced 84% negative UDSs compared with 74% in the multiple-daily cohort which was statistically significant (p = .034). There were a total of 43 relapses reported in the once-daily cohort, compared with 141 relapses in the multiple-daily cohort (p < .001). The average number of relapses per patient in the single-daily cohort was 0.68 compared with the multiple-daily cohort average of 2.16 (p < .001). In the once-daily cohort, 14% of patients experienced at least one relapse throughout the study, compared with 31% in the multiple-daily cohort (p < .002). There were no significant differences between time to relapse, adherence to treatment, or treatment retention. Statistically significantly more patients in the multiple-daily cohort were using methamphetamines (p = .005); there were no significant differences between groups with the use of any other illicit or non-prescribed substances. Discussion and Conclusions Once-daily dosing was associated with more negative UDSs and fewer opioid relapses compared with multiple-daily dosing. Scientific Significance This was the first study to evaluate buprenorphine/naloxone dosing frequency for opioid use disorder, in the absence of chronic pain. Additional studies evaluating optimal dosing schedules for relapse prevention are warranted.

Automated summary

This retrospective chart review aimed to compare the impact of once-daily versus multiple-daily dosing of buprenorphine/naloxone on urine drug screens (UDS) and relapse rates in patients with opioid use disorder (OUD). The results showed that once-daily dosing was associated with a higher rate of negative UDS and fewer relapses compared to multiple-daily dosing. However, there were no significant differences between the two groups in terms of relapse time, treatment adherence, or treatment retention.