The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

IX.d

Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

Children may be a greater risk compared to adults as there may be no ceiling effect in the former (PMID 30740990)

Publications

von Fabeck K, Boulamery A, Glaizal M, de Haro L, Simon N

Buprenorphine poisoning in children: a 10-year-experience of Marseille Poison Center.

Fundamental & clinical pharmacology. 2020;34(2):265-269

Lo Re M, Chaplin M, Aronow B, Modesto-Lowe V

Buprenorphine Overdose in Young Children: An Underappreciated Risk.

Clinical pediatrics. 2019;58(6):613-617

Toce MS, Burns MM, O'Donnell KA

Clinical effects of unintentional pediatric buprenorphine exposures: experience at a single tertiary care center.

Clinical toxicology (Philadelphia, Pa.). 2017;55(1):12-17

Lee SC, Klein-Schwartz W, Doyon S, Welsh C

Comparison of toxicity associated with nonmedical use of benzodiazepines with buprenorphine or methadone.

Drug and alcohol dependence. 2014;138:118-23

Guo AY, Ma JD, Best BM, Atayee RS

Urine specimen detection of concurrent nonprescribed medicinal and illicit drug use in patients prescribed buprenorphine.

Journal of analytical toxicology. 2013;37(9):636-41

Kim HK, Smiddy M, Hoffman RS, Nelson LS

Buprenorphine may not be as safe as you think: a pediatric fatality from unintentional exposure.

Pediatrics. 2012;130(6):e1700-3

Boom M, Niesters M, Sarton E, Aarts L, Smith TW, Dahan A

Non-analgesic effects of opioids: opioid-induced respiratory depression.

Current pharmaceutical design. 2012;18(37):5994-6004

Pedapati EV, Bateman ST

Toddlers requiring pediatric intensive care unit admission following at-home exposure to buprenorphine/naloxone.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2011;12(2):e102-7

Ferrant O, Papin F, Clin B, Lacroix C, Saussereau E, Remoué JE, Goullé JP

Fatal poisoning due to snorting buprenorphine and alcohol consumption.

Forensic science international. 2011;204(1-3):e8-11

Yassen A, Olofsen E, van Dorp E, Sarton E, Teppema L, Danhof M, Dahan A

Mechanism-based pharmacokinetic-pharmacodynamic modelling of the reversal of buprenorphine-induced respiratory depression by naloxone : a study in healthy volunteers.

Clinical pharmacokinetics. 2007;46(11):965-80

Moro C, Taino R, Mandalà M, Labianca R

Buprenorphine-induced acute respiratory depression during ifosfamide-based chemotherapy.

Annals of oncology : official journal of the European Society for Medical Oncology. 2006;17(9):1466-7