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Buprenorphine LAI

Brixadi is a long-acting buprenorphine injection available in weekly or monthly doses.

Brixadi

Crystalline Depot

How it works

Brixadi works by forming a crystalline gel when the yellowish liquid comes into contact with bodily fluid.

This gel depot slowly biodegrades to release buprenorphine over an extended peiod of time.

Moderate to Severe OUD

Indication and Usage

This new LAI is indicated for use in patients with moderate to severe opioid use disorder (OUD).

Patients must be currently using, or have had at least one dose of, oral buprenorphine to be elligible for this medication.

This medication is intended for use along with counseling and psychosocial support.

Healthcare Professional Injections

Dosage and Administration

Brixadi must be injected slowly into only subcutanous areas of the buttock, thigh, abdomen, or upper arm.

Injection sites should be rotated and not reused for 8 weeks.

*Upper arm should not be used until after 4 consecutive doses are received.

Weekly or Monthly

Frequency

Weekly and monthly doses do not have the same formulation, so one or the other must be used. Patients can initiate on either formulation.

Weekly doses are 50 mg/mL and are available in 8 mg, 16 mg, 24 mg, and 32 mg. Injections should be every 7 days up to 2 days before or after time point.

Monthly doses are 356 mg/mL and are available in 64 mg, 96 mg, and 128 mg. Injections should be every 28 days up to 7 days before or after time point.

Subcutaneous Use

Injection sites

Because of the gel forming reaction that occurs with injection, this medication can only be injected subcutaneously.

Intramuscular, intradermal, and especialy intravenous injection can lead to occlusion, necrosis, and ultimately death.

Patient Factors

Considerations

Latex allergies may exclude patient use.

Buprenorphine may pass through breast milk.

May cause respiratory depression in geriatric patients.

Not recommended in patients with severe hepatic impairment.

Should not be coadministered with other medications that may cause respiratory depression, regardless of age.

Adverse Reactions

Monitoring

Patients should be monitored for adverse reactions immediately following injections and for several days after.

Injection Site: signs of infection, pain, redness and itching, signs of tampering or attempts to remove depot.

Other; headache, constipation, nausea, insomnia, UTI, impairment of ability to drive or operate machinery.

Brixadi REMS

Pharmacy

Pharmacies will be required to register with this REMS program prior to administering Brixadi.

Policy and procedure documents must be developed to ensure Brixadi is administered only by the healthcare professional, and not dispensed to the patient.

Brixaid cannot be distributed, transferred, loaned or sold from the original pharmacy.

High risk of overdose

Narcan

Because buprenorphine is a partial opioid agonist, patients have the potential to relapse and are at a higher risk of overdose.

Patients and family members should be informed of the importance of opioid reversal agents and how to look for signs of respiratory depression.

Long Lasting Presence

Stopping Brixadi

Because Brixadi is a long-acting injectable, buprenorphine may be detectable in patients for an extended period of time after their last dose.

Weekly: up to 4 weeks after last dose.

Monthly: Up to 4 months after last dose.

It is important to inform patients of this when they initiate treatment. During this time, patients should continue to be monitored for adverse reactions and withdrawals.

Coming Soon!

Availability

Brixadi is expected to be available in September 2023.

According to a company representative, most patients will pay around $10 for one injection.

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