Summary

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• Lofexidine (Lucemyra) is indicated for the mitigation of opioid withdrawal symptoms to facilitate abrupt opioid discontinuation in adults. It has been found equally effective as clonidine, another α-2 adrenergic agonist used off-label for managing these symptoms, but with fewer adverse effects such as hypotension and feelings of unwellness.
• Five studies focused on various aspects of opioid withdrawal management and treatment options, including Lucemyra's safety and efficacy.
• Compared to adjunct medications like gabapentin and suvorexant, Lofexidine shows limited evidence in augmenting opioid agonist initiation. However, it does have a more favorable side-effect profile than methadone, buprenorphine, or clonidine despite similar efficacy levels.
• There is evidence suggesting Lofexidine could be promising in managing stress among individuals with Opioid Use Disorder (OUD). Additionally, it presents as a useful alternative for managing moderate to severe alcohol withdrawal symptoms where benzodiazepines are inappropriate or contraindicated.
• When compared with long-acting opioids like buprenorphine or naltrexone, which are preferred for transitioning into maintenance therapy due to their proven efficacy, Lucemyra’s role appears limited only to initial withdrawal management rather than long-term maintenance treatments.
• Lucemyra aids the detoxification phase by initiating a quicker transition towards evidence-based treatments, thus potentially reducing the use of illicit substances. This makes its utility especially noteworthy in the beginning stages when addressing OUD, preparing patients further towards long-term therapies.