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Generic name: lofexidine (loe FEX i deen)
Brand name: Lucemyra®
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
Lofexidine is a non-opioid prescription medicine used in adults to help with the symptoms of opioid withdrawal that may happen when you stop taking an opioid suddenly. Lofexidine will not completely prevent the symptoms of opioid withdrawal.
Symptoms of opioid withdrawal include:
Lofexidine is not a treatment for opioid use disorder. If you have been diagnosed with opioid use disorder, your health care provider may prescribe lofexidine as part of a complete treatment program for your opioid use disorder.
Lofexidine may cause low blood pressure, slow heart rate, dizziness, and fainting. Notify your health care provider right away if you experience these symptoms. If you take lofexidine and have any of these symptoms, do not take your next dose until you have talked to your health care provider. You should stay well-hydrated and avoid becoming overheated during treatment with lofexidine because that can increase your risk of low blood pressure and fainting. You should also be careful to stand up slowly from lying down or sitting.
After the period of time of not using opioid medications, you will respond to lower doses of opioids for pain. Do not begin using opioids at the doses you tolerated prior to starting lofexidine. This may increase your risk of overdose and death.
Lofexidine can potentiate the central nervous system depressant effects of benzodiazepines, alcohol, barbiturates, and other sedating drugs.
Lofexidine should be used in conjunction with a comprehensive treatment program.
Lofexidine treatment should be discontinued by slowly decreasing the dose usually over 2 to 4 days to minimize withdrawal symptoms.
There is limited data on lofexidine use in pregnant women to inform about drug-associated risk. The safety of lofexidine in pregnant women has not been established. In animal studies, there was evidence of offspring having reduced body weights and developmental delays, but these results cannot be applied to humans.
There is no information regarding the presence of lofexidine or its metabolites in human milk, the effects on the breastfed infant, or the effects on milk production. Caution should be exercised when lofexidine is administered to a nursing woman.
Your health care provider and you should consider your clinical need for lofexidine and any other potential adverse effects on breastfed children from lofexidine or from the underlying maternal condition.
Lofexidine should be taken exactly as your health care provider tells you to take it. Do not change your dose or stop taking lofexidine without talking to your health care provider.
Lofexidine is usually dosed at 0.54 mg 4 times daily, with at least 5 to 6 hours between each dose. The dosing of lofexidine is adjusted based on your withdrawal symptoms and how well you are tolerating the drug. Lofexidine can be continued for up to 14 days if needed. Take lofexidine with or without food.
You should drink plenty of non-caffeine liquids, unless told otherwise by your doctor.
You should never take more than 16 tablets in 1 day and no single dose should exceed 4 tablets.
Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
If you miss a dose of lofexidine, take it as soon as you remember unless it is closer to the time of your next dose. Do not double your next dose or take more than what is prescribed. You should wait at least 5 to 6 hours between each dose.
Do not drive, operate heavy machinery, or perform any other dangerous activities until you know how lofexidine affects you.
Avoid drinking alcohol, using opioid pain medications (such as codeine, hydrocodone, oxycodone, or morphine), or using illegal drugs while you are taking lofexidine. They may increase adverse effects (e.g., sedation) of the medication.
Keep in mind that some cough syrups may contain opioid pain medication. Discuss all medications with your doctor and pharmacist prior to taking lofexidine.
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
Signs and symptoms of an overdose include:
Common side effects
Rare/serious side effects
Lofexidine is not indicated for long-term use. Lofexidine treatment usually last for 5 to 7 days following last opioid use. It may only be continued up to 14 days with dosing guided by symptoms. Lofexidine must be discontinued gradually over a 2 to 4-day period.
Lofexidine may increase the depressant effects of alcohol, benzodiazepines, barbiturates and other sedating drugs.
Paroxetine (Paxil®) may increase the absorption of lofexidine, which can increase the side effects of lofexidine (e.g., low blood pressure, slow heart rate).
Lofexidine may reduce the effectiveness of oral naltrexone (Revia®) when given within 2 hours of each other.
Taking lofexidine and methadone together may cause irregular heart rhythms. Concurrent use requires cardiac monitoring.
Your pharmacist or doctor will help you to determine if other medications you take can interfere with the effects of lofexidine.
Lofexidine will begin working shortly after taking one dose.
There are no FDA black box warnings for lofexidine.
Last Reviewed: January 2023
This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.
©2022 American Association of Psychiatric Pharmacists (AAPP). AAPP makes this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.