The Probuphine Implant provides patients with six months of slow-release, steady levels of buprenorphine.
The Probuphine Implant was created to increase convenience and treatment retention, and decrease opioid use and diversion in persons who are already stable on low-to-moderate dosages of oral buprenorphine.
In this Comprehensive Probuphine Implant Review article, I will cover the following:
- Probuphine Implant Overview
- Probuphine Implant Pharmacological Effects
- Probuphine Implant Benefits
- Probuphine Implant Side Effects
- Probuphine Implant Cost
- Probuphine Implant Prescribing Criteria
Table of Contents
The Opioid Epidemic & Buprenorphine
Before I provide detailed info on the Probuphine Implant, I believe it’s important to first inform you about certain events that led up to the creation and approval of Probuphine.
The U.S. opioid epidemic has been devastating our country for at least 20 years. In an effort to help mitigate the epidemic, in 2002, the medications Subutex and Suboxone were approved by the FDA for the treatment of opioid dependence.
Both medications contain an ingredient known as buprenorphine.
Buprenorphine is a partial opioid agonist.
When an individual with opioid dependence takes buprenorphine at the prescribed dosage their doctor provides, the medicine is able to prevent opioid withdrawal symptoms and cravings.
Buprenorphine accomplishes this by binding to the same opioid receptors in the body that drugs like oxycodone, hydrocodone, heroin, morphine, and other opioids bind to.
Over the years, a superabundance of individuals have used Subutex and Suboxone to quit their addictive patterns and establish lives free from illicit drug use.
However, since these buprenorphine formulations were only approved as a film or pill placed under the tongue or on the inside of a person’s cheek until it disolves – despite their effectiveness – the pill or film can be lost, stolen, forgotten, or even sold illegally on the black market.
Probuphine Implant Overview
In an effort to provide outpatient buprenorphine treatment that is more convenient and has less potential negative aspects associated with it, San Francisco-based Titan Pharmaceuticals and their partners Braeburn Pharmaceuticals based in Princeton, New Jersey – created Probuphine – which is now FDA-approved for the treatment of opioid dependence.
Probuphine consists of four, one-inch-long rods that are implanted under the skin on the inside of the upper arm.
The Probuphine Implant provides treatment for six months, thus making it more convenient for the patient than oral buprenorphine formulations – since they don’t need to visit the doctor’s office or pharmacy on a regular basis.
Administering the Probuphine Implant requires special training because it must be surgically inserted and removed.
The only invididulas that should insert and remove the Probuphine Implant are health care providers that have completed the training and are certified through a restricted program called the Probuphine Risk Evaluation and Mitigation Strategy (REMS) Program.
As I wrote earlier in the the article, Probuphine is a buprenorphine implant that provides six months of continuous, consistent levels of buprenorphine. This is achieved by ProNeura technology.
According to the Titan Pharmaceuticals website:
ProNeura offers continuous drug delivery and consists of a small, solid rod made from a mixture of ethylene-vinyl acetate (EVA) and a drug substance. The resulting product is a solid matrix that is placed subcutaneously, normally in the inner part of the upper arm in a simple office procedure, and is removed in a similar manner at the end of the treatment period.
The drug substance that is part of the ProNeura implant is released slowly into the patient’s body at continuous levels, through the process of dissolution. This results in a stable level of medication in the blood, similar to intravenous administration.”
With stable levels of medication in the blood, this prevents people from experiencing peak-and-trough level dosing. Many people that take oral formulations of buprenorphine experience slight withdrawal symptoms and cravings when the drug starts wearing off.
This can keep the addictive mind going, as patients are continuously having to take a drug everyday to feel normal and prevent withdrawal symptoms as well as cravings.
Using a buprenorphine implant with ProNeura technology prevents this negative aspect of buprenorphine treatment from occurring.
Due to the unique characteristics of Probuphine, there are five main benefits of using a buprenorphine implant rather than an oral formulation of the medicine.
Benefits of Probuphine:
- Lower risk of diversion
- Greater adherence
- Additional option for medication-assisted treatment
- Frequent travelers (no need for daily administration)
- Fewer office visits
Probuphine Side Effects
As with all medications, there is a possibility that you will experience some side effects. Probuphine has a list of minor and major side effects that people may experience.
Below I will provide you with a list of Probuphine side effects found on Drugs.com.
More common minor side effects:
- Back pain
- Cough or hoarseness
- Difficulty having a bowel movement (stool)
- Fever or chills
- Lower back or side pain
- Painful or difficult urination
- Runny nose
- Stomach pain
- Stuffy nose
- Trouble sleeping
Less common minor side effects:
- Feeling faint, dizzy, or lightheaded
- Feeling of warmth or heat
- Flushing or redness of the skin, especially on the face and neck
- Lack or loss of strength
Major side effects:
- Blurred vision
- Difficult or troubled breathing
- Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- Irregular, fast, slow, or shallow breathing
- Pale or blue lips, fingernails, or skin
- Pinpoint pupils
- Relaxed and calm feeling
- Unusual tiredness or weakness
At this point in the article, you may be wondering what is the cost of Probuphine. It is much more expensive than buprenorphine pills, which cost around $130 to $190 a month.
The total cost of Probuphine is $4,950 for the six-month treatment implant – which breaks down to about $825 a month.
Depending on the type of insurance you have, Probuphine may or may not be covered, as many insurers will opt for you to use the less-costly buprenorphine pills.
Who can get the Probuphine Implant?
Probuphine isn’t prescribed to patients which are not already taking buprenorphine oral formulations for opioid maintenance.
The following passage is taken from an online PDF provided by Braeburn Pharmaceuticals on Probuphine prescribing info:
Probuphine is indicated for the maintenance treatment of opioid dependence in patients who have achieved and sustained prolonged clinical stability on low-to-moderate doses of a transmucosal buprenorphine-containing product (i.e., doses of no more than 8 mg per day of Subutex or Suboxone sublingual tablet equivalent or generic equivalent).
Probuphine should be used as part of a complete treatment program to include counseling and psychosocial support.”
The Probuphine Implant provides an additional option for patients that are using medication-assisted treatment to prevent opioid withdrawal symptoms and cravings. Some proponents of Probuphine believe the buprenorphine implant will provide many benefits in treatment.
Others raise concerns that patients will “steer off course” if they aren’t coming into the doctor’s office for regular checkups – but rather get the implant then “disappear” for six months until it’s time for the implant to be removed.
I’m a firm believer in providing a plethora of different treatment options that cater to the individual needs and preferences of individuals who want to recover from opioid dependence.
Thus, the Probuphine Implant is, in my opinion, an excellent addition to the ever-increasing list of medications used to treat opioid dependence. However, medications and counseling are only pieces of the “Recovery Puzzle.”
Until more treatment providers start learning how to treat addiction in a holistic way – with a focus on restoring individual biochemistry to balance with supplements, nutrition, exercise, and other integrative modalities – I believe the relapse rates will continue to soar high like the Eagles in the sky.
If you have any questions or comments on my Probuphine Implant Review, please post them in the comment box below.