Treating Opioid Withdrawal With Lucemyra (Lofexidine)
Medically reviewed byIsaac Alexis, M.D., AAMA, AMP-BC
February 5, 2019
Lucemyra (lofexidine) is the first and only non-opioid medication approved by the FDA for the treatment of opioid withdrawal in adults. Approved in May of 2018, this medication first became available for prescription in August of this year. Lucemyra may be used to treat withdrawal caused by a variety of opioid drugs, including heroin and prescription opioid pain relievers.
Lofexidine is not a standalone treatment for opioid addiction. Like other medications for the treatment of withdrawal, Lucemyra works to reduce the uncomfortable and often times painful symptoms of opioid withdrawal. It doesn’t treat the psychological elements of addiction.
Used within a comprehensive medical detox program, Lucemyra can help a person’s body to heal and stabilize in preparation for the next stage of treatment. While detoxing addresses the physical components of addiction, a drug rehabilitation program treats the mental, emotional, behavioral, and social harm caused by addiction.
Following a medically supervised detoxification program with a drug rehabilitation program typically gives a person the highest chance of recovery success.
What Is Lucemyra (Lofexidine)?
Lofexidine has been approved and used as a treatment for opioid withdrawal in the United Kingdom for over 25 years, however, it wasn’t until this summer that it became available in American as an approved medication for the treatment of opioid withdrawal syndrome.
Lucemyra is an alpha2-adrenergic agonist. This means that it creates its effect by binding to adrenergic neuron receptors to inhibit the release of the neurotransmitter norepinephrine. This helps balance the side effects of a person discontinuing opioids, which in turn reduces the discomfort associated with withdrawal.
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Used during peak withdrawal symptoms, typically five to seven days after the opioid drug is last used, this medication may be prescribed for up to 14 days. However, this drug has not been approved for treatment beyond two weeks. The exact dosage of a person’s medication will vary per their unique needs and should only be determined by a physician.
Typically, it’s recommended that a person take three 0.18 mg tablets by mouth four times a day during peak withdrawal, at five to six-hour intervals. Lucemyra may itself cause withdrawal symptoms, and because of this, it’s recommended that a person is gradually tapered off it over the course of two to four days. The medication’s labeling suggests reducing a person’s dose by one tablet every one to two days.
What Types Of Opioid Withdrawal Does Lucemyra (Lofexidine) Treat?
Lucemyra is designed to treat abrupt opioid discontinuation, or quitting “cold turkey,” in adults.
In addition to treating heroin dependence, Lucemyra may be prescribed to help a person withdrawal from the following commonly abused prescription opioid painkillers:
- fentanyl (Actiq, Duragesic)
- hydrocodone (Vicodin, Norco)
- hydromorphone (Dilaudid)
- meperidine (Demerol)
- methadone (Dolophine, Methadose)
- morphine (Duramorph, MS Contin)
- oxycodone (OxyContin, Percocet)
- oxymorphone (Opana)
Each person’s treatment plan, including the use of any medications, should be determined by their personal health and medical needs.
Is Lucemyra (Lofexidine) Addictive?
As a non-opioid drug, Lucemyra isn’t addictive. Due to this, this medication doesn’t hold the potential for drug diversion, misuse, and abuse that widely used opioid medications for withdrawal, Suboxone (buprenorphine) and methadone, do.
Because of this, certain individuals, their families, and treatment providers may feel more comfortable using this medication as a treatment option. However, when used under expert supervision, any of these medications are generally safe and effective treatments for opioid withdrawal.
Treating Opioid Withdrawal With Lucemyra (Lofexidine)
Despite its use at reducing withdrawal symptoms, Lucemyra will not necessarily prevent them from happening entirely. Further, lofexidine does not prevent psychological cravings.
According to prescribing information, a person may still experience the following symptoms of opioid withdrawal syndrome while taking this medication:
- aches and pains
- feeling of sickness
- muscle spasms or twitching
- muscles tension
- pounding heart
- runny eyes
- stomach cramping
Because of this, additional treatments may need to be administered. Psychosocial support is recommended, and other medications may be necessary to help treat withdrawal symptoms. Therapies may also be administered to fight any dehydration or malnourishment that has resulted from opioid abuse.
As symptoms arise, clinicians should adapt treatment to best manage withdrawal symptoms and ensure that a person is safe and comfortable. Therapists and counselors may be available to help address any emotional or mental strain caused by withdrawal.
Providing comfort, encouragement, and compassionate support during this time can help to increase treatment retention rates. It also better ensures that a person stays on track to continue with rehabilitative services for their addiction.
In regards to people with an opioid use disorder, Lucemyra’s manufacturers caution that withdrawal management without additional treatment is not recommended.
Following detox with a research-based treatment program targets both the physical and psychological impacts of addiction. This multi-dynamic approach helps a person to heal both in body and mind so that they can create the strongest foundation for a drug-free life.
Side Effects And Risks Of Lucemyra (Lofexidine) Use
Like all prescription medications, Lucemyra may cause side effects. The most common adverse reactions could include:
- dry mouth
- orthostatic hypotension (low blood pressure upon standing)
In addition to these, more serious complications could accompany Lucemyra use.
Warnings And Precautions Of Lucemyra (Lofexidine) Use
The following safety concerns have been linked to Lucemyra use:
Central Nervous System (CNS) Depression: When used with CNS depressants, such as alcohol, barbiturates, benzodiazepines, or other sedatives, Lucemyra may exacerbate the depressant effects of these substances, causing serious side effects.
Increased Risk Of Overdose: Once a person successfully detoxes, there’s a good chance their tolerance has decreased. This means that they may be sensitive to smaller doses of their drug of abuse. Because of this, doses they were accustomed to taking could be highly dangerous.
This can cause a heightened risk of overdose and death, should a person relapse and begin abusing opioids again. A drug rehab program can be a valuable resource to help protect a person from this risk. The best programs also aid a person in building long-lasting sober living principles that strengthen a drug-free life.
Withdrawal: Stopping Lucemyra without a gradual dose reduction, or taper, can cause discontinuation (withdrawal) symptoms. These symptoms may include:
- excessive sweating
- the pain of the extremities
- raised blood pressure
Other Complications: Lofexidine can cause lowered blood pressure, pulse, and fainting. Patients should be made aware of these risk and be taught how to self-monitor for these and other related concerns. This is especially true for those who are receiving this medication as part of an outpatient detox program for addiction.
As with any medication, Lucemyra should only be used when prescribed by a doctor, and only as they recommend. Detoxing without medical supervision, or a do-it-yourself detox, can be dangerous and increase the odds that a person experience these or other side effects. Additionally, detoxing without professional help can increase the risk of relapse, overdose, and an unsuccessful recovery from opioid addiction.
How Does Lucemyra (Lofexidine) Compare To Clonidine?
Lofexidine’s properties resemble those of the generic drug clonidine, a medication that is sometimes used off-label to treat withdrawal from opioids. According to Pharmacy Times, “Lofexidine is a structural analog of clonidine.”
This chemical makeup allows each drug to work on the body’s sympathetic nervous system, an action that reduces the body’s fight-or-flight response. This effect lessons certain physical withdrawal symptoms, in addition to mental ones, such as a sense of panic or depression.
Research has found that, when compared to clonidine, Lofexidine may have a better safety profile in addition to a smaller impact on a person’s blood pressure.
Despite any similarities, it’s reported that there’s a massive difference in cost between the two medications, leading some to question the benefit of using Lofexidine over clonidine. Business Insider reports that Lucemyra costs $1,738 a week, whereas clonidine is approximately a dollar.
For a person in need of treatment, the cost is typically one of the biggest concerns. Fortunately, insurance benefits may cover certain medications for opioid withdrawal, making treatment a more easily attainable goal.
Finding Outpatient And Inpatient Detox Programs That Use Lucemyra (Lofexidine)
While Lucemyra may be administered as part of an outpatient or inpatient detox program, moderate to severe opioid dependence and addiction are often better treated in an inpatient setting.
Inpatient drug rehab centers frequently offer both detox and rehab programs. Choosing a residential program that offers both services on site can ease the stress of transitioning from one program to the next.
Cravings and temptation can run high after detoxing. Progressing directly to rehab can help to protect a person from triggers and negative environments that could threaten their sobriety. Inpatient drug rehab centers provide greater support, accountability, and resources to help a person overcome the dysfunctional patterns of an addictive lifestyle.
Being that this is a new medication, it may take a bit of research to find a treatment program that offers this treatment. Trained addiction specialists can evaluate a person’s treatment needs, help them research treatment options, and build a customized treatment plan.
Reach out to RehabCenter.net for more info on Lucemyra and other opioid treatment options.Article Sources
Cochrane - Clonidine, lofexidine, and similar medications for the management of opioid withdrawal
MultiVu - US WorldMeds and Salix Announce U.S. Launch of LUCEMYRA™ (lofexidine) 0.18 Mg Tablets
U.S. Food & Drug Administration - HIGHLIGHTS OF PRESCRIBING INFORMATION
Lucemyra.com - Lucemyra
Pharmacy Times - How Lucemrya Reduces Opioid Withdrawal Symptoms
Business Insider - Doctors are calling out a new drug that helps people with addiction for costing more than $1,700 a week — while a generic costs just $1