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 2 Standard induction titration schedule

	Buprenorphine/naloxone^a
	Dosing
Day 1^b (0–24 h)	Start with 2–4 mg SL If 60–90 min have passed without the onset of withdrawal symptoms: additional dosing can be done in increments of 2–8 mg SL Suggested total dose target for day 1 is 8–12 mg SL
Day 2 (24–48 h)	Start with dose equal to the total amount of buprenorphine/naloxone administered on day 1 Titrate in increments or decrements of 2–8 mg to a level that holds the patient in treatment and suppresses opioid withdrawal, guided by reassessment of the clinical and psychological status of the patient Suggested total daily dose for day 2 is 8–16 mg SL Max total daily dose is 32 mg SL
Day 3 (48–72 h)	Consolidate day 2 total dose to once daily dosing Suggested total daily dose for day 3 is 8–16 mg SL Max total daily dose is 32 mg SL

SL sublingual, COWS Clinical Opiate Withdrawal Scale
^aExpressed as milligrams of buprenorphine in a buprenorphine/naloxone SL tablet
^bThe 1st dose of buprenorphine/naloxone is administered when the patient scores ≥ 11 on the COWS; and it has been at least 6–12 h after their last use of short-acting opioids or 24–72 h after their last use of long-acting opioids. Depending on the patient’s last use and the time taken to score ≥ 11 on the COWS, day 1 may take longer than 24 h

ISSN: 1940-0640