Buprenorphine/naloxone moves from Type 1 to Type 2 TPP drug

July 24, 2019

Change will be effective July 15, 2019.

Effective July 15, 2019, buprenorphine/naloxone products moved from Type 1 to Type 2 TPP status in Alberta. As a result, these products will no longer require use of a secure TPP prescription form. Buprenorphine/naloxone products will continue to be monitored through TPP Alberta as a Type 2 drug.

Single entity buprenorphine (e.g., Butrans patches) and all buprenorphine products for veterinary use will remain a Type 1 TPP drug which means a secure TPP form is still required.

The change for buprenorphine/naloxone was made to facilitate prescribing of these products for Albertans with Opioid Use Disorder (OUD). While much work has been done to address the opioid crisis, Albertans continue to overdose and lose their lives to opioids. The co-chairs of the federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses recently issued a statement on the release of new data on the opioid crisis.

Buprenorphine/naloxone is as effective as methadone for treatment of OUD but with an improved safety profile. The agonist/antagonist action of buprenorphine/naloxone results in a “ceiling effect” which lowers the risk of respiratory depression and overdose, side effects and diversion/non-medical use (CRISM Guideline for the Clinical Management of Opioid Use Disorder).

When assessing prescriptions for buprenorphine/naloxone products, please remember the following points:

  • Prescriptions must be signed and dated. 
  • Only written or faxed prescriptions are acceptable. Verbal prescriptions are not permitted.
  • No refills are permitted. All “re-orders” must be new written prescriptions.
  • Part-fills are allowed. For part-fills, the prescriber must indicate the total amount of medication, the quantity for each part-fill, and the interval between fills.
  • Prescribers must provide clear directions for use.  This should include instructions:
    • for witnessed ingestion and the frequency with which this is to occur;
    • identifying the days in which a patient is permitted to receive carry doses (as applicable); and
    • the end-date or effective timeframe for the prescription. 

Click here to view a sample prescription.

For more information on TPP Alberta, please visit cpsa.ca/tpp.

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