ISSUE 1551
- Lofexidine (Lucemyra) for Opioid Withdrawal
- Two New Drugs for Glaucoma
- Baricitinib (Olumiant) for Rheumatoid Arthritis
- Firvanq - Vancomycin Oral Solution
- Correction: Abuse-Deterrent Opioids
- Axicabtagene Ciloleucel (Yescarta) for B-Cell Lymphoma (online only)
- Apalutamide (Erleada) for Prostate Cancer (online only)
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The FDA has approved lofexidine (Lucemyra – US WorldMeds/Salix), a centrally acting alpha2 receptor agonist, to manage withdrawal symptoms in adults abruptly stopping opioid use. Available in the UK since 1992, lofexidine is the first nonopioid to be approved in the US for management of opioid withdrawal symptoms. Clonidine (Catapres, and generics), another central alpha2 receptor agonist, has been used off-label for this indication for many years.
STANDARD TREATMENT — The partial opioid agonist buprenorphine is the drug of choice for management of opioid withdrawal in most patients.1 It is comparable in efficacy to the full opioid agonist methadone, but it is safer and does not need to be obtained through a licensed outpatient treatment program. Clonidine is less effective than methadone or buprenorphine; it is most useful as an adjunct
... more- Management of opioid withdrawal symptoms. Med Lett Drugs Ther 2018; 60 (in press).
- Drugs for opioid use disorder. Med Lett Drugs Ther 2017; 59:89.
- CW Gorodetzky et al. A phase III, randomized, multi-center, double blind, placebo controlled study of safety and efficacy of lofexidine for relief of symptoms in individuals undergoing inpatient opioid withdrawal. Drug Alcohol Depend 2017; 176:79.
- L Gowing et al. Alpha2-adrenergic agonists for the management of opioid withdrawal. Cochrane Database Syst Rev 2016; 5:CD002024.
- RL Woosley and KA Romero. QT drugs list. Available at: www. crediblemeds.org. Accessed July 3, 2018.
- Inhibitors and inducers of CYP enzymes and P-glycoprotein. Med Lett Drugs Ther 2017 September 18 (epub). Available at: www.medicalletter.org/downloads/CYP_PGP_Tables.pdf.

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