ArticleAmerican journal of obstetrics and gynecology2017
An evidence-based recommendation to increase the dosing frequency of buprenorphine during pregnancy.
Article in American journal of obstetrics and gynecology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03740243 (Comparison of Buprenorphine vs Buprenorphine/Naloxone on the Effects of Maternal Symptomatology), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Buprenorphine vs Buprenorphine/Naloxone on the Effects of Maternal Symptomatology
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.Anesthesia and analgesia · 2025Guideline
- Hospital Care for Pregnant Persons With OUD Review.American journal of medicine open · 2025Review
- Buprenorphine and norbuprenorphine concentrations associated with clinical withdrawal during pregnancy.Drug and alcohol dependence · 2025Article
- Association between buprenorphine dose and outcomes among pregnant persons with opioid use disorder.American journal of obstetrics and gynecology · 2025Article
- Pharmacokinetic Characterization of Labetalol in Pregnancy (The CLIP Study): A Prospective Observational Longitudinal Pharmacokinetic/Pharmacodynamic Cohort Study During Pregnancy and Postpartum.Journal of clinical medicine · 2025Article
- The Psychiatrist's Role in Treating Perinatal Opioid Use Disorder and Reducing Maternal Mortality.Focus (American Psychiatric Publishing) · 2024Review
- The effect of pregnancy-related hormones on hepatic transporters: studies with premenopausal human hepatocytes.Frontiers in pharmacology · 2024Article
- What to Expect With Pregnant or Postpartum Prescribing of Extended-Release Buprenorphine (CAM2038).Journal of clinical gynecology and obstetrics · 2023Article
- Article
- Pregnancy related hormones increase CYP3A mediated buprenorphine metabolism in human hepatocytes: a comparison to CYP3A substrates nifedipine and midazolam.Frontiers in pharmacology · 2023Article
- Association Between Buprenorphine Dose and the Urine "Norbuprenorphine" to "Creatinine" Ratio: Revised.Substance abuse : research and treatment · 2023Article
- Neonatal opioid withdrawal syndrome: a review of the science and a look toward the use of buprenorphine for affected infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- Early lessons from maternal mortality review committees on drug-related deaths-time for obstetrical providers to take the lead in addressing addiction.American journal of obstetrics & gynecology MFM · 2020Article
- Prediction of Maternal and Fetal Pharmacokinetics of Dolutegravir and Raltegravir Using Physiologically Based Pharmacokinetic Modeling.Clinical pharmacokinetics · 2020Article
- Buprenorphine dosing for the treatment of opioid use disorder through pregnancy and postpartum.Current treatment options in psychiatry · 2020Article
- Drug dosing during pregnancy-opportunities for physiologically based pharmacokinetic models.Journal of pharmacokinetics and pharmacodynamics · 2020Review
- Medication treatment for opioid use disorder in expectant mothers (MOMs): Design considerations for a pragmatic randomized trial comparing extended-release and daily buprenorphine formulations.Contemporary clinical trials · 2020Article
- Pregnancy Alters CYP- and UGT-Mediated Metabolism of Buprenorphine.Therapeutic drug monitoring · 2020Article
- Building a Group-Based Opioid Treatment (GBOT) blueprint: a qualitative study delineating GBOT implementation.Addiction science & clinical practice · 2019Article
- Opioid use disorder in pregnancy.The mental health clinician · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDose-adjusted plasma concentrations of buprenorphine are significantly decreased during pregnancy compared with the nonpregnant state. This observation suggests that pregnant women may need a higher dose of buprenorphine than nonpregnant individuals to maintain similar drug exposure (plasma concentrations over time after a dose). The current dosing recommendations for buprenorphine during pregnancy address the total daily dose of buprenorphine to be administered, but the frequency of dosing is not clearly addressed. Based on buprenorphine's long terminal half-life, once-daily or twice-daily dosing has generally been suggested.
objectiveThe objective of the study was to assess the impact of dosing frequency on buprenorphine plasma concentration time course during pregnancy. STUDY
designWe utilized 3 data sources to determine an optimal frequency for dosing of buprenorphine during pregnancy: data from a pharmacokinetic study of 14 pregnant and postpartum women on maintenance buprenorphine in a supervised clinical setting; data from pregnant women attending a buprenorphine clinic; and data from a physiologically based pharmacokinetic modeling of buprenorphine pharmacokinetics in nonpregnant subjects.
resultsAmong the 14 women participating in the pharmacokinetic study during and after pregnancy, plasma concentrations of buprenorphine were <1 ng/mL (the theoretical concentration required to prevent withdrawal symptoms) for 50-80% of the 12 hour dosing interval while at steady state. Among 62 women followed up in a opioid agonist treatment program, in which dosing frequency is determined in part by patient preference, 10 (16%) were on once-daily dosing, 10 (16%) were on twice-daily dosing, 28 (45%) were on thrice-daily dosing, and 14 (23%) were on four-times-daily dosing. A physiologically based pharmacokinetic model in nonpregnant subjects demonstrated that dosing frequency has an impact on the duration over which the plasma concentrations are below a specified plasma concentration threshold.
conclusionA more frequent dosing interval (ie, three-times-daily or four-times-daily dosing) may be required in pregnant women to sustain plasma concentrations above the threshold of 1 ng/mL to prevent withdrawal symptoms and to improve adherence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.