The Medical Letter on Drugs and Therapeutics
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Lofexidine (Lucemyra) for Opioid Withdrawal

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      

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