Comparing rapid micro-induction and standard induction of buprenorphine/naloxone for treatment of opioid use disorder: protocol for an open-label, parallel-group, superiority, randomized controlled trial

Table 1 Rapid micro-induction titration schedule

	Buprenorphine/naloxone^a		Hydromorphone^b
	Dosing	Total daily dose	Dosing
Day 1 (0–24 h)	0.5 mg SL Q3H	4 mg SL	1–16 mg PO/SC/IV/IM Q1-3H PRN and titrate to effect (start at the lower end of dosing range) For 1st dose—Max 8 mg PO, or 4 mg SC/IV/IM
Day 2 (24–48 h)	1 mg SL Q3H	8 mg SL	1–16 mg PO/SC/IV/IM Q1-3H PRN and titrate to effect (start at the lower end of dosing range)
Day 3 (48–72 h)	8–16 mg SL once daily and 1–4 mg SL Q3H PRN	8–16 mg SL; Max 32 mg SL including PRN	Discontinued
Day 4 (72–96 h)	Consolidate day 3 total dose to once daily dosing	Max 32 mg SL	Discontinued

SL sublingual, Q_H every_hour, PRN as needed, PO by mouth, SC subcutaneous, IV intravenous, IM intramuscular
^aExpressed as milligrams of buprenorphine in a buprenorphine/naloxone SL tablet
^bThe opioids the patients are using are rotated to hydromorphone. Hydromorphone is administered as needed to meet the patient’s opioid requirements. Hold if sedated, RR < 10, or O₂ saturation < 92%

ISSN: 1940-0640