To Helen Dynda Using Lofexidine to treat opiate symptoms

From: Kath Findlay (klfindlay@adhesions.org.uk)
Wed May 1 00:53:46 2002


Hi Helen,

I hope you are recovering well since your surgery, I heard some of the girls talking about coming of opiates and I came across this article on Lofexidine I am not sure if this is available in the US as some of our meds are different to yours. Their must be others available to. I will have some news for you soon about the new barrier that I told you about last year. It is in trials at the moment and UK-AS is assisting them in their PR by being quoted about the problems of adhesions.

In Friendship Kath Findlay

The UK Adhesion Society

http://www.adhesions.org.uk

Kath.Findlay@adhesions.org.uk

Using Lofexidine to treat opiate symptoms

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Lofexidine is an alpha-2 adrenergic agonist which can be used in the
management of the symptoms of opiate withdrawal. It is a similar drug to
clonidine, the use of which is limited due to the likeihood of postural
hypotension: this side-effect is less marked with lofexidine.

Lofexidine blocks the adrenaline/noradrenaline related withdrawal symptoms of opiate withdrawal. It does not affect other opiate withdrawal symptoms such as muscle aches, insomnia and craving.

Side effects

Drowsiness, dry mucous membranes, hypotension (usually postural) and bradycardia.

Assessment

Patient must have normal blood pressure. There are no contraindications. All suspect drug reactions should be reported. During withdrawal, blood pressure should be checked if symptoms of postural hypotension develop.

Dosage

1 tablet (200mcg) twice a day, increasing if necessary in steps of 1-2 tablets daily up to na maximum of 12 tablets (2.4mg) daily.

Compliance is most likely if withdrawal from opiates is not attempted until the maximum dose of lofexidine is achieved, at which stage either gradual or sudden withdrawal of opiates may be attempted. Opiates can be reduced gradually over a maximum of 2 weeks, allowing for a further 7-day period of lofexidine treatment and a maximum lofexidine treatment period of 4 weeks. Alternatively, if opiates are stopped abruptly, treatment with lofexidine is usually required for a further 7-10 days.

To prevent rebound hypertension, lofexidine medication should be reduced gradually over 2-4 days.

Lofexidine can be used to reduce withdrawal symptoms in patients

* who wish to detoxify from opiates. * who are reducing their opiates gradually. If withdrawal symptoms are a problem with each reduction of opiate dosage, use lofexidine 1-2 tabs as required up to a maximum of 6 per day. Prescribe 20 tablets and encourage the patient to take them as needed, no more than 2 at a time. Treatment can be stopped after 3-4 days as withdrawal symptoms rarely last longer than this. * who have missed one or more doses of their usual opiates. Use lofexidine 1-2 tabs as required up to a maximum of 6 per day.

There is no indication for long term treatment with lofexidine


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