A while ago I wrote a blog about Lofexidine ( Lucemyra). I basically said that there’s not a ton of data but what seemed clear is that it’s crazy ridiculous expensive and really not any better than Clonidine. At a 1000X higher price. Well, I proved to be right.
Dr. David Juurlink MD Ph.D. from Sunnybrook Health Sciences in Toronto, Canda wrote a terrific summary of the most complete, robust up to date study on lofexidine. Just published in the May/June 2019 edition of the Journal of Addiction Medicine. ” Safety and Efficacy of Lofexidine for Medically Managed Opioid Withdrawal: A Randomized Controlled Clinical Trial” Fishman MD, Tirado MD, Alam MD.etc. al.
This was a multicenter Double-blind placebo-controlled study of 603 patients at 18 different US Centers. Keep in mind two of the authors are paid consultants to the manufacturer of Lofexidine. What did we learn?
- Lofexidine does slightly reduce withdrawal compared to placebo.
- As mentioned in my previous blog, Lofexidine and Clonidine are pharmacologically and structurally similar
- A review of all randomized trials comparing lofexidine with clonidine in patients suffering opioid withdrawal have shown the reduction of withdrawal symptoms are the same.
- The benefit of lofexidine on withdrawal is maximal by day 2. No difference from placebo is evident by day 7.
- Clonidine has slightly more side effects such as light-headed, dizzy and drowsy.
- 7 days of Lofexidine in the US is about $1700 compared to $1 for Clonidine
” In short, lofexidine can be viewed as a slightly safer version of clonidine that offers patients with opioid withdrawal marginal clinical benefit for perhaps a few days, at a cost of more than $3000o over a typical 2 week treatment period.”.
Drug company price gouging for a “me too” drug for the most desperate and vulnerable of patients.
Ken Starr MD
