Drug updated on 3/28/2024
| Dosage Form | Tablet (oral; 0.18 mg) |
| Drug Class | Central alpha-2 adrenergic agonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for mitigation of opioid withdrawal symptoms to facilitate abrupt opioid discontinuation in adults.
Summary
- Lofexidine (Lucemyra) is indicated for the mitigation of opioid withdrawal symptoms to facilitate abrupt opioid discontinuation in adults.
- Three systematic reviews/meta-analyses were reviewed, providing insights into the effectiveness and safety profile of lofexidine compared to other treatments for managing moderate to severe alcohol withdrawal symptoms (AWS).
- One review found that while benzodiazepines remain the treatment of choice for AWS, gabapentin could be an alternative under certain circumstances with a 'moderate' level of evidence against standard benzodiazepine treatments; however, lofexidine had a 'very low' level of certainty.
- Another study comparing lofexidine with clonidine showed equivalent efficacy in reducing opioid withdrawal symptom severity but reported fewer adverse effects such as hypotension and feeling unwell associated with lofexidine use.
- The same study also noted significant side effects like hypotension, bradycardia, and pupillary constriction when using lofexidin compared to placebo which may affect its comparative efficacy against other agents depending on factors like cost and detoxification venue.
- A third review suggested psychopharmacological interventions targeting stress including clonidine or lofexidin might improve outcomes among individuals undergoing medication-assisted treatment (MAT) for Opioid Use Disorder (OUD), although results regarding associations between appraised stress levels and MAT retention rates were mixed across studies included in this analysis.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Lucemyra (lofexidine) Prescribing Information. | 2020 | US Worldmeds LLC, Louisville KY |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| The Effectiveness of Non-Benzodiazepine, Non-Barbiturate Medications for Alcohol Withdrawal Syndrome: A Rapid Systematic Review. | 2021 | Alcohol and Alcoholism |
| Lofexidine versus clonidine for mitigation of opioid withdrawal symptoms: a systematic review. | 2020 | Journal of the American Pharmacists Association |
| Stress and opioid use disorder: A systematic review. | 2019 | Addictive Behaviors |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| The ASAM national practice guideline for the treatment of opioid use disorder. | 2020 | American Society of Addiction Medicine |