Abstract
Background Opioid use disorder (OUD) in pregnancy is managed by medication-assisted treatment. Sublingual buprenorphine is one option, but subcutaneous extended-release buprenorphine (Sublocade®) is an alternate form administered in monthly injections. Through an extensive literature search, we did not find any prior publication on the use of Sublocade in pregnancy. Case Two patients with OUD switched from sublingual buprenorphine to Sublocade. One patient received a total of eight injections and then discovered she was pregnant. Based on ultrasound dating, the last 5 administrations occurred during her pregnancy. The second patient received 6 injections with the last occurring at the time of her last menstrual period. Both declined further injections, as well as oral buprenorphine. Serial urine drug screens remained positive for buprenorphine through delivery in both cases. Neither the mothers nor the neonates experienced withdrawal symptoms or adverse outcomes. No birth anomalies were found. Discussion. Though further research is needed regarding the use of Sublocade in pregnancy, it is likely that other pregnancies will occur during this treatment modality. If this long-acting form of buprenorphine medication is found to be safe, it might play a role in managing some pregnant patients with OUD.
Highlights
Opioid use disorder (OUD) in pregnancy is managed by medication-assisted treatment
The mainstay of medical management is to place these patients on medications for opioid use disorder (MOUD) that use longer-acting opioid drugs such as methadone or buprenorphine [2,3,4,5,6]
Through a literature search of PubMed, Embase, Cochrane, Google Scholar, and Scopus, we did not find any prior publication on the use of Sublocade in pregnancy
Summary
Opioid use disorder (OUD) in pregnancy is a rising epidemic, especially in the United States. The Centers for Disease Control and Prevention reported that the prevalence of OUD more than quadrupled in the United States from 1999 to 2014 (from 1.5/1000 deliveries to 6.5/1000) [1]. The mainstay of medical management is to place these patients on medications for opioid use disorder (MOUD) that use longer-acting opioid drugs such as methadone or buprenorphine [2,3,4,5,6]. These two medications are administered in daily oral/sublingual dosages. The objective of this report is to describe the pregnancy and delivery outcome of two patients who were receiving monthly Sublocade injections and became pregnant
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