Which medication is contraindicated for use during pregnancy for opioid use disorder?

Suboxone, which is a combination of buprenorphine and naloxone, is contraindicated for use during pregnancy for opioid use disorder primarily due to concerns about the effects of the naloxone component. Buprenorphine, the active ingredient in Suboxone, is often used in the treatment of opioid use disorder and has been found to be safer in pregnancy compared to full agonists. However, naloxone can precipitate withdrawal in opioid-dependent pregnant women, posing risks to both the mother and the fetus.

The use of other options can be more suitable in the management of opioid use disorder during pregnancy. For instance, methadone is often considered the standard of care for opioid-dependent pregnant women due to its long half-life and relatively stable release profile, which can help prevent withdrawal symptoms without the risks associated with opioid withdrawal. Bupropion and clonidine may not be contraindicated in the same way as Suboxone, as they do not carry the same risks related to precipitating withdrawal in opioid-dependent individuals.

Due to these considerations regarding fetal safety and the risks of withdrawal, use of Suboxone during pregnancy is generally avoided.