Elimination buprenorphine

Buprenorphine is metabolized by the liver mediated by cytochrome P450 3A4, and its clearance is related to hepatic blood flow. Plasma protein binding is about 96%. The mean elimination half-life from plasma is 37 hours. 

The overall success rate for correct use of the pupillometer by participants (n = 37) was 92.9% that is, nearly every time participants attempted a trial they were eventually successful. The success rate (percentage obtaining a successful sequence on the first try of each study day) in participants after minimal experience (2 weeks or about 6 exposures) was 72%, and if the four participants who had trouble obtaining stability were eliminated, the overall success rate further increased to 81%. Thus, even minimally trained patients maintained on methadone4 or buprenorphine,16 drugs known to produce miosis, obtained reliable pupillary measures. 

Several epidemiological studies have shown that buprenorphine has the potential for diversion and misuse. A combination formulation, buprenorphinenaloxone, was developed to reduce this potential In a survey of intravenous drug users in Malaysia, both buprenorphine and buprenorphine + naloxone were diverted and misused however, the introduction of buprenorphine + naloxone contributed towards reducing the problem but did not eliminate it [13 ]. 

Buprenorphine is metabolized in the liver by CYP3A4 and N-dealkylated to form norbuprenorphine. It is also conjugated with glucuronic acid to form buprenorphine-3P-0-glucuronide and norbuprenor-phine-3P-0-glucuronide. Approximately 2/3 of buprenorphine is eliminated unchanged in feces [1-3]. 

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