Lofexidine ($ Lucemyra)
norepinephrine alpha-2 agonist
- Opioid withdrawal
- Similar to clonidine
Features
Dosing
Take three 0.18 mg tablets 4 times daily q5-6-hour during peak withdrawal symptoms, generally first 5 to 7 days following last use of opioid. Can take PRN. Daily max 2.88 mg (16 tablets) and no single dose should exceed 0.72 mg (4 tablets)
Discontinue with a gradual dose reduction over 2 to 4 day
INTERACTIONS: Lower 50% to adjust for higher levels with strong CYP2D6 inhibitors (asenapine, bupropion, cannabidiol, duloxetine, and non-pram SSRIs: fluoxetine, paroxetine, sertraline ≥ 150 mg/day)
Management
FDA approved for opioid use disorder, but not clear if works better than generic (clonidine) which is also an alpha-antagonist.
EMR Text
Opioid
Lofexidine (Lucemyra) use based on FDA approval in opioid use disorder.
Lofexidine side effects, including hypotension, reviewed with patient.