Medications for opioid use disorder (MOUD) are a critical tool for individuals struggling with opioids. Research has repeatedly shown the efficacy of this pharmacological component in treatment. To date, there are three medications that are recommended by the World Health Organization (WHO) and approved by the US Food and Drug Administration (FDA) to treat opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. All brand name MOUD prescriptions include one, or a combination, of these three medications. Common brand names include Bunavail, Belbuca, Subutex, Suboxone, Naltrexone (Vivitrol), Sublocade, and ZubSolv. MOUDs like buprenorphine/naloxone (Suboxone) can be used temporarily or as long-term maintenance medications. The option to taper off of a MOUD is always available. However, indefinite, long-term treatment is strongly recommended to patients with OUD. Patients on long-term MOUD treatment plans have significantly lower rates of relapse. The long-term use of MOUDs is safe, effective, and evidence-based.
In addition to the FDA-approved MOUDs mentioned above, several other medications can be particularly helpful in the recovery process. The brand medication Lucemyra is among these useful supplemental medications. This article discusses what Lucemyra is and how it works in the context of OUD treatment plans. The FDA approved the use of Lucemyra in May 2018. Its indicated use is to mitigate the symptoms of opioid withdrawal to facilitate abrupt discontinuation of opioids in adults.
Lucemyra is the brand name for lofexidine oral tablets. Unlike most FDA-approved MOUDs, lofexidine (Lucemyra) is neither an opioid agonist nor an opioid antagonist. Many MOUDs contain the opioid antagonist naltrexone. It is important that naltrexone-containing medications are started only after opioids are out of a patient’s system. MOUDs containing an opioid antagonist, such as naltrexone (Vivitrol) and buprenorphine/naltrexone (Suboxone), typically require patients to wait 7-14 days from the last opioid use. If naltrexone treatment is started too soon, patients are at risk of abrupt opioid withdrawal syndrome.
The symptoms experienced during this 7-14 day period can be extremely uncomfortable, scary, and overwhelming for patients. Non-opioid medications such as lofexidine (Lucemyra) can help to relieve these symptoms without compromising the start date of an opioid antagonist-containing MOUD treatment plan. Lofexidine (Lucemyra) is only a short-term medication that is prescribed for a maximum of 14 days. While lofexidine (Lucemyra) treats opioid withdrawal symptoms, it does not treat opioid use disorder. This is a crucial distinction between lofexidine (Lucemyra) and FDA-approved MOUDs. To better understand this difference, it is important to understand how lofexidine (Lucemyra) works.
Lofexidine (Lucemyra) is a non-opioid, oral, central alpha 2-adrenergic receptor agonist. Despite this intimidatingly scientific description, the way lofexidine (Lucemyra) works in the body is relatively simple. Essentially, lofexidine (Lucemyra) reduces the over-production of the hormone norepinephrine, responsible for many of the uncomfortable symptoms of opioid withdrawal. Norepinephrine is a naturally occurring hormone. Opioids typically reduce the release of norepinephrine. When opioids are used on a regular basis, the brain works overtime to regulate the chemical imbalance by releasing extra norepinephrine. When an individual whose brain is used to steady, regular levels of opioids suddenly stops taking opioids, their brain becomes flooded with norepinephrine. This high level of norepinephrine in the brain can often cause painful withdrawal symptoms, including aches and pains, stomach cramps, nausea, vomiting, diarrhea, muscle spasms and twitching, insomnia and problems sleeping, chills, muscular tension, heart pounding, runny eyes, and yawning. Lofexidine (Lucemyra) relieves these symptoms by slowing the release of norepinephrine and restoring the brain’s chemical balance. Lofexidine (Lucemyra) does not completely treat the symptoms of withdrawal, but it does help to alleviate the pain and discomfort of many of these symptoms.
Typically, withdrawal symptoms are most severe in the first 5 to 7 days following the last use of opioids. It is during this time period that patients begin lofexidine (Lucemyra). Because the symptoms of withdrawal do not typically last longer than 14 days, lofexidine (Lucemyra) should only be taken up to 14 days. Dosage amounts vary depending on the patient, the intensity of the withdrawal symptoms, and the type of opioid a patient was previously taking. As previously mentioned, lofexidine (Lucemyra) does not treat OUD; it only treats the uncomfortable symptoms of opioid withdrawal. It is recommended that lofexidine (Lucemyra) be prescribed as part of a long-term treatment plan involving a maintenance medication such as buprenorphine/naltrexone (Suboxone).
Bicycle Health is dedicated to helping people get off and stay off opioids. To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.
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