Long-Acting Injectable Buprenorphine in Pregnancy.
- 1Department of Obstetrics and Gynecology and Department of Medicine, Section of Addiction Medicine, Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR.
Abstract
Objective
To describe real-world use of long-acting injectable buprenorphine among pregnant individuals with opioid use disorder (OUD), including monthly formulations and initiation among those not previously stable on sublingual buprenorphine.Methods
We conducted a retrospective chart review of inpatient and outpatient medical records of pregnant individuals with OUD who received at least one dose of long-acting injectable buprenorphine during pregnancy while admitted at a large academic medical center. Dosing patterns, supplemental sublingual buprenorphine use, treatment retention, and maternal outcomes were described.Results
Between January 1, 2024, and February 1, 2026, 12 pregnant individuals received long-acting injectable buprenorphine. Most received monthly formulations (11 of 12). Ten patients (83.3%) initiated treatment with long-acting injectable buprenorphine during pregnancy through low-dose buprenorphine initiation; two continued long-acting injectable buprenorphine that was started before pregnancy. Median gestational age for those who initiated long-acting injectable buprenorphine during pregnancy was 30 weeks (range 11-33 weeks). All patients newly initiated on long-acting injectable buprenorphine reported nonprescribed fentanyl use before treatment. Supplemental sublingual buprenorphine was prescribed for all participants initiating long-acting injectable buprenorphine (median 20 mg/d, range 12-32 mg/d). Four who initiated long-acting injectable buprenorphine transitioned to methadone during pregnancy because of persistent cravings or withdrawal. At delivery, retention on long-acting injectable buprenorphine was 66.7%, and 91.7% remained on any medication for OUD (MOUD).Conclusion
Among pregnant individuals who received long-acting injectable buprenorphine, including those with nonprescribed fentanyl use initiating treatment during pregnancy, retention on MOUD through delivery was high, and supplemental buprenorphine was commonly prescribed. Some patients transitioned to methadone, underscoring the importance of individualized treatment and counseling regarding formulation-specific considerations.
Related
- Retention and Other Efficacy Outcomes With Long-Acting Injectable Buprenorphine (Buvidal ® ) in France: A National Retrospective Cross-Sectional Study (OPALE 2)
- An Ultra-Long-Acting Buprenorphine Prodrug Ion-Pair for Opioid Use Disorder
- Total cost of care for long-acting injectable antipsychotics for schizophrenia: Pharmacy vs medical benefit
- Clinical Course and Discontinuation of Olanzapine Long-Acting Injectable: A Retrospective Case Series Including a Case of Post-Injection Delirium/Sedation Syndrome
- Efficacy and safety of long-acting injectable aripiprazole in bipolar disorder: a multinational real-world target trial emulation
BibTeX
@article{nacev2026longacting,
title = {{Long-Acting Injectable Buprenorphine in Pregnancy.}},
author = {Erin C Nacev and Kristin C Prewitt and Linda Peng and Eugene Song and Honora Englander and Patricia Liu},
journal = {O\&G open},
year = {2026},
month = oct,
doi = {10.1097/og9.0000000000000214},
url = {https://europepmc.org/article/MED/42910400},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Long-Acting Injectable Buprenorphine in Pregnancy.
AU - Erin C Nacev
AU - Kristin C Prewitt
AU - Linda Peng
AU - Eugene Song
AU - Honora Englander
AU - Patricia Liu
PY - 2026
DA - 2026/10/20
JO - O&G open
DO - 10.1097/og9.0000000000000214
UR - https://europepmc.org/article/MED/42910400
AB - Objective To describe real-world use of long-acting injectable buprenorphine among pregnant individuals with opioid use disorder (OUD), including monthly formulations and initiation among those not previously stable on sublingual buprenorphine.Methods We conducted a retrospective chart review of inpatient and outpatient medical records of pregnant individuals with OUD who received at least one dose of long-acting injectable buprenorphine during pregnancy while admitted at a large academic medical center. Dosing patterns, supplemental sublingual buprenorphine use, treatment retention, and maternal outcomes were described.Results Between January 1, 2024, and February 1, 2026, 12 pregnant individuals received long-acting injectable buprenorphine. Most received monthly formulations (11 of 12). Ten patients (83.3%) initiated treatment with long-acting injectable buprenorphine during pregnancy through low-dose buprenorphine initiation; two continued long-acting injectable buprenorphine that was started before pregnancy. Median gestational age for those who initiated long-acting injectable buprenorphine during pregnancy was 30 weeks (range 11-33 weeks). All patients newly initiated on long-acting injectable buprenorphine reported nonprescribed fentanyl use before treatment. Supplemental sublingual buprenorphine was prescribed for all participants initiating long-acting injectable buprenorphine (median 20 mg/d, range 12-32 mg/d). Four who initiated long-acting injectable buprenorphine transitioned to methadone during pregnancy because of persistent cravings or withdrawal. At delivery, retention on long-acting injectable buprenorphine was 66.7%, and 91.7% remained on any medication for OUD (MOUD).Conclusion Among pregnant individuals who received long-acting injectable buprenorphine, including those with nonprescribed fentanyl use initiating treatment during pregnancy, retention on MOUD through delivery was high, and supplemental buprenorphine was commonly prescribed. Some patients transitioned to methadone, underscoring the importance of individualized treatment and counseling regarding formulation-specific considerations.
SN - 2994-9726
ER -