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Less QT Prolongation with Buprenorphine for Addiction

May be a safer alternative than levomethadyl and methadone

THURSDAY, Dec. 13 (HealthDay News) -- In contrast to levomethadyl and methadone, buprenorphine is much less likely to prolong the QT interval and may be a safer alternative to treat opioid addition, researchers report in the Dec. 10/24 issue of the Archives of Internal Medicine.

Erich F. Wedam, M.D., from the National Naval Medical Center in Bethesda, Md., and colleagues randomized 154 opioid-addicted patients with a normal baseline corrected QT (QTc) to levomethadyl acetate, methadone hydrochloride or buprenorphine hydrochloride for 17 weeks.

The researchers found that patients receiving levomethadyl or methadone were significantly more likely to have a QTc prolongation greater than 470 milliseconds for males, or 490 milliseconds for females (28 percent on levomethadyl, 23 percent on methadone, 0 percent on buprenorphine). Patients treated with levomethadyl or methadone were also significantly more likely to have a QTc increase of greater than 60 milliseconds from baseline (21 percent on levomethadyl, 12 percent on methadone, 2 percent on buprenorphine).

"Buprenorphine is associated with less QTc prolongation than levomethadyl or methadone and may be a safe alternative," Wedam and colleagues conclude.

One author is employed by Reckitt-Benckiser Pharmaceuticals Inc., manufacturer and distributor of buprenorphine, and another author reports past funding from Purdue Pharma LP, Biotek Inc. and Titan Pharmaceuticals Inc. for studies of other buprenorphine formulations.

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