open-label, safety study of lofexidine

Conditions: Opioid Withdrawal

Summary: the purpose of this phase 3 open-label treatment study is to evaluate the safety and effectiveness of lofexidine at a clinically relevant dose to alleviate symptoms of acute withdrawal from any opioid, including methadone and buprenorphine. this study will take place in a variety of clinical scenarios, both in-clinic and outpatient settings.

eligible subjects (person seeking treatment for partial or total opioid withdrawal) enrolled in this study are required to take lofexidine for a minimum of 7 days.

Eligibility criteria:
inclusion criteria: * male or female at least 18 years of age * must be able to verbalize understanding of the consent form, able to provide written informed consent, and verbalize willingness to complete study procedures * must have current dependence, according to the mini international neuropsychiatric interview (m.i.n.i.), on any opioid (including methadone and buprenorphine maintenance treatment) * must be seeking treatment for partial or total withdrawal from current opioid and expected, as determined by the principal investigator, to benefit from lofexidine treatment for at least 7 days at clinically relevant doses. this can include a variety of clinical situations where opioid withdrawal illness is likely to occur including abrupt and total withdrawal (including from methadone and buprenorphine), agonist-assisted total withdrawal, dose reduction of maintenance treatment (e.g., methadone, buprenorphine) and transition from an opioid agonist to naltrexone or buprenorphine maintenance * must have urine toxicology screen result of positive for opioid(s) relevant to the subject's withdrawal treatment goal * if female and of childbearing potential, subject must agree to use of one of the following methods of birth control including oral contraceptives, patch, barrier (diaphragm, sponge or condom) plus spermicidal preparations, intrauterine contraceptive system, levonorgestrel implant, medroxyprogesterone acetate contraceptive injection, complete abstinence from sexual intercourse, hormonal vaginal contraceptive ring or surgical sterilization or partner sterile (with documented proof) exclusion criteria: * female subject who is pregnant or lactating * history of very serious medical illness not under control including, but not limited to, active self-reported acquired immune deficiency syndrome (aids) or self-reported human immunodeficiency virus (hiv) positive status and taking retroviral medications currently or within the past 4 weeks and/or having an unstable psychiatric condition. these conditions will be determined at screening by medical history, physical examination, 12 lead electrocardiogram (duplicate), clinical laboratory tests for infectious diseases, and a tuberculin test * current dependence (based on the m.i.n.i.) on any psychoactive substance (excluding caffeine, nicotine, and the subject's current opioid-dependence agent, which can include methadone and buprenorphine, for example, in agonist-maintained subjects) that requires detoxification or dose reduction as part of the pre-defined individual subject withdrawal treatment goal * have participated in an investigational drug study within the past 30 days * have a history of lofexidine exposure in a prior clinical trial or otherwise * have an abnormal cardiovascular exam at screening * any subject that requires tricyclic antidepressants, which may reduce the efficacy of imidazoline derivatives and/or beta-receptor blockers, to avoid the risk of excessive bradycardia

Keywords: detoxification agonist taper methadone step down buprenorphine step down opioid withdrawal syndrome