Espranor

What is Espranor®?

Espranor® is a medication that can help you with withdrawal symptoms you might have when you stop using opioids like heroin.

Espranor® contains a medication called buprenorphine, which is a replacement for heroin or other opioids. It can help you to withdraw from opioids you’ve become dependent on by reducing cravings and limiting your withdrawal symptoms.

When you stop taking an opiate, you might have withdrawal symptoms as your body returns to normal. They can include: sweating; feeling hot and cold; runny eyes and nose; yawning; losing your appetite; stomach cramps; feeling sick or vomiting; diarrhoea; tremors; poor sleep; restlessness; general aches and pains; and just feeling awful.

Withdrawal symptoms usually get a bit better within 5 days, but you might still notice cravings for opioids, tiredness and restless sleep for a while afterwards.

How is Espranor® prescribed?

One of our recovery workers and someone from our clinical team will give you a full health and wellbeing assessment. If the assessment shows that Espranor® could be good for you, we’ll prescribe it. If you’ve ever injected drugs, we’ll help you to get a liver test, screening for any blood-borne viruses, and vaccinations that you might need.

Why choose Espranor®?

Espranor® is not the only opioid substitute that you can be prescribed. There is also a medication called methadone, but there are a few reasons that people sometimes pick instead:

• Parents usually choose Espranor® as it’s safer around children. You should keep both medications away from children.
• Some people feel more ‘clear-headed’ with Espranor® than with methadone.
• Some people have difficulties using methadone.
• Espranor® tends to be easier to detox from than methadone.
• Espranor® is less dangerous than methadone if you take an overdose.

Taking Espranor®

Espranor® comes as a small wafer which dissolves on your tongue. This usually takes about 15 seconds. The medication is absorbed straight into your bloodstream. Espranor® does not work if you swallow it. Once you’ve taken Espranor® , you should avoid swallowing for two minutes and avoid eating or drinking for five minutes.

Usually, you’ll take Espranor® once a day. At the start of treatment, the pharmacist who gives you your Espranor® will need to be there when you take it. This is to make sure you’re taking the right dose for Espranor® to be safe and effective.

When you first take Espranor®:

• If you use heroin you should wait at least 6 – 8 hours after your last heroin dose.
• If you are taking methadone: you take the first dose of Espranor® between 24 and 36 hours after your last dose of methadone.
• For Espranor® to work well you need to take it when your body has low levels of heroin or methadone. You should only take your first dose when you feel some withdrawal symptoms starting.
• Espranor® can cause withdrawal symptoms if taken too soon after your last dose of opioid.

You’ll start on a low dose of Espranor® and work your way up to your regular dose. It’s important not to take other opioids during this time, as this will give you withdrawal symptoms. Most people feel they are on the correct dose within the first week of treatment.

Coming off Espranor®

Once you’ve settled into your regular Espranor® prescription, your recovery worker will talk to you about what your goals are for your treatment. One of the things you’ll talk about is how to reduce your Espranor® dose and eventually come off it completely. This is called a detox. Your worker and prescriber will take a look at your dose every six weeks and see if they think it should be changed.

Other notes about taking Espranor®

• Extra support and counselling from groups such as NA can be really helpful when you’re trying to stay off opioids like heroin. Support from family, friends and other people close to you can also make a big difference.
• Every so often during your treatment, a member of our team will ask you to take a drug test to make sure your treatment remains appropriate and safe.
• You should refrain from drinking alcohol or using drugs during your treatment.
• If you drive and you are taking Espranor®, you should let the DVLA know.
• All drugs must be kept out of reach of children and animals. Please ask your worker for a lockable box to store your medication (free of charge). Children should never be given your medication. They have no tolerance and it could kill them. Always call 999 if you think a child has swallowed your medication. Talk to your Health Visitor or GP if your child has difficulty sleeping or being soothed.
• Speak to your recovery worker or doctor if you experience side effects or symptoms and wish to stop treatment.
• Read the information leaflet which will be given with your medication.