How does this medication work? What will it do for me?
Buprenorphine belongs to the class of medications called opioid analgesics (pain relievers). Buprenorphine sustained release is only intended to treat persistent severe chronic (long-term) pain, where pain relief is needed around the clock. For acute pain or "breakthrough" pain, the doctor will prescribe another pain medication such as acetaminophen, ibuprofen, or a narcotic-containing medication.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each rectangular or square, beige coloured patch consisting of a protective liner, functional layers, and an active surface area of 6.25 cm2 delivers 5 µg/hour buprenorphine. Nonmedicinal ingredients: beige coloured backing layer of polyethylene terephthalate; an adhesive matrix rim without buprenorphine; a separating foil over the adhesive matrix; the buprenorphine-containing adhesive matrix with inactive ingredients including aluminum acetylacetonate, levulinic acid, oleyl oleate, polyacrylate (dry solids), and povidone; and a release liner (before use, the release liner covering the adhesive layer is removed and discarded).
Each rectangular or square, beige coloured patch consisting of a protective liner, functional layers, and an active surface area of 12.5 cm2 delivers 10 µg/hour buprenorphine. Nonmedicinal ingredients: beige coloured backing layer of polyethylene terephthalate; an adhesive matrix rim without buprenorphine; a separating foil over the adhesive matrix; the buprenorphine-containing adhesive matrix with inactive ingredients including aluminum acetylacetonate, levulinic acid, oleyl oleate, polyacrylate (dry solids), and povidone; and a release liner (before use, the release liner covering the adhesive layer is removed and discarded).
Each rectangular or square, beige coloured patch consisting of a protective liner, functional layers, and an active surface area of 25 cm2 delivers 20 µg/hour buprenorphine. Nonmedicinal ingredients: beige coloured backing layer of polyethylene terephthalate; an adhesive matrix rim without buprenorphine; a separating foil over the adhesive matrix; the buprenorphine-containing adhesive matrix with inactive ingredients including aluminum acetylacetonate, levulinic acid, oleyl oleate, polyacrylate (dry solids), and povidone; and a release liner (before use, the release liner covering the adhesive layer is removed and discarded).
How should I use this medication?
The usual dose of buprenorphine patch varies according to the needs of the individual. The most common starting dose of buprenorphine sustained release patch is 5 µg per hour and it may be slowly increased as required. The maximum daily dose of buprenorphine patch is 20 µg per hour. Each patch should be worn for 7 days.
The patch may be applied to any convenient skin area - recommended sites include the upper outer arm, upper chest, upper back, or the side of the chest. Change the skin site where you apply the patch each week, making sure that at least 3 weeks (21 days) pass before you reuse the same skin site. Apply this medication to a hairless or nearly hairless skin site. If the application site must be cleaned, clean the site with water only and avoid using soaps, alcohol, oils, lotions, or abrasive devices. Allow the skin to dry before applying the patch.
Do not apply the patch to broken skin or to areas where there may be irritation (rashes, swelling, redness, or other skin problems). When handling the patch do not touch the sticky side of the patch with your fingers, and instead use the protective liner as a handle. Press the entire patch firmly into place with the palm of your hand over the patch for about 30 seconds - do not rub the patch. Wash your hands thoroughly after the application. Following use, discard the patch in a manner that prevents accidental application or ingestion by curious pets or children.
This medication may be habit-forming if taken for long periods of time. You may experience withdrawal effects if you stop using this medication suddenly after extended use. If you plan on stopping the medication, your doctor may want you to reduce the dose gradually to reduce the severity of withdrawal effects.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If the patch falls off, do not reapply the patch. Discard the medication safely and apply a new patch to a different site. If the edges of the patch start to loosen, apply first aid tape or special see-through adhesive dressings only to the edges of the patch. If you leave the patch on for more than 7 days, remove the patch and apply a new patch. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you:
- are allergic to buprenorphine or any ingredients of this medication
- are dependent on opioids or experiencing narcotic withdrawal symptoms
- are pregnant, planning to become pregnant, in labor, or breast-feeding
- are under 18 years of age
- had a head injury
- have acute or severe asthma or another airway disease
- have ileus (narrowing of intestines or a blockage in intestines)
- have mild, irregular, or temporary pain
- have myasthenia gravis
- have severe drowsiness or severe breathing difficulties
- have severe liver disease
- have taken MAO inhibitors (e.g., phenelzine, tranylcypromine, moclobemide or selegiline) within 14 days
- may require abdominal surgery (e.g. people with inflamed pancreas or appendix)
- require pain relief before or after surgery
- suffer from alcohol addiction or dependence, or have convulsions
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- any pain or difficulty experienced while urinating or blood in urine
- eye swelling, itching, or red eye
- generalized swelling
- increased blood pressure
- loss of appetite
- shortness of breath, paleness or fatigue (anemia)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- blurred vision or vision changes
- chest pain or discomfort
- cold, clammy skin
- feeling faint, dizzy, confused, and having trouble talking, thinking or walking normally
- severe breathing problems, shortness of breath, slow breathing, or shallow breathing
- severe drowsiness
- slow heartbeat
- symptoms of an allergic reaction, e.g.:
- difficulty breathing or swallowing
- swelling of the face or throat
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Application of heat: Heat applied to or around the area of the patch can cause an unpredictable release and absorption of this medication. Avoid applying external heat such as heating pads or electric blankets, or soaking in hot tubs while wearing the buprenorphine patch.
Application site skin reactions: In rare cases, there have been severe skin reactions at the site of application. If you experience signs of inflammation, including a burning feeling, discharge, or raised bumps, stop using the medication and talk to your doctor as soon as possible.
Blood pressure: Buprenorphine can cause decreases in blood pressure, especially when a person rises from a lying or sitting position (orthostatic hypotension). To minimize the feeling of dizziness or lightheadedness upon standing, get up slowly from a lying or sitting position. If you have a condition that increases your risk of low blood pressure (hypotension) such as certain heart conditions, cerebrovascular disease (e.g., strokes), are prone to dehydration, or are being treated with blood pressure medications, discuss with your doctor how this medication may affect your medical condition or medications you are taking and whether any special monitoring is needed.
Central nervous system: The effects of buprenorphine on the brain are increased when taken with other medications with similar effects, such as opioids (codeine, morphine, oxycodone), anesthetic agents, haloperidol, promethazine, or phenobarbital. Taking any of these medications at the same time as using buprenorphine may cause an increase in drowsiness, dizziness, breathing difficulty, and awareness of surroundings. Tell your doctor if you are using any of these other medications.
Dependence and withdrawal: Physical dependence, psychological dependence, and abuse have occurred with the use of buprenorphine. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while using buprenorphine. Talk to your doctor about the risks and benefits of taking this medication. It is important to keep this medication in a safe place to prevent theft. It is against the law to sell or give this medication to other people.
Drowsiness/reduced alertness: Buprenorphine may impair the mental or physical abilities needed for certain potentially hazardous activities such as driving a car or operating machinery. Avoid driving or operating heavy machinery until you have determined how this medication affects you.
Heart conditions: Buprenorphine can cause an abnormal heart rhythm. If you have certain heart rhythm problems (especially long QT syndrome, congenital QT interval prolongation, and low heart rate), irregular heart rhythms caused by other medications in the past, low blood potassium or magnesium levels, or are taking certain medications used to treat irregular heart rhythms (e.g., quinidine, procainamide, amiodarone, sotalol), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience an irregular heartbeat, stop taking this medication and contact your doctor. Your doctor will monitor your heart rhythm regularly while you are taking this medication with a test called an electrocardiogram (ECG).
Medical conditions: If you have addiction problems, Addison's disease, blood pressure problems, enlarged prostate, problems urinating, mental health problems (e.g., depression or hallucinations), reduced pituitary function, reduced thyroid function, kidney disease or reduced kidney function, liver disease or reduced liver function, or a history of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Medication transfer to others: People using this medication should be careful while hugging or sharing a bed to ensure that the buprenorphine patch does not get transferred to others. If the patch comes loose and accidentally sticks to the skin of another person, take the patch off the person's skin immediately and call a doctor. This applies to both fresh and used patches (some drug remains in the patch even after it has been used).
Respiratory conditions: This medication affects breathing and may cause respiratory depression. If you experience difficulty breathing, including slow, shallow breathing, seek medical attention immediately. If you have breathing difficulties (e.g., asthma, chronic obstructive pulmonary disease [COPD], sleep apnea), are severely overweight, are taking medications that may affect breathing (e.g., codeine, morphine, oxycodone, anesthetic agents, haloperidol, phenobarbital), or are a senior, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Stopping the medication: Stopping this medication suddenly may lead to withdrawal symptoms such as anxiety, sweating, difficulty sleeping, rigors, pain, nausea, tremors, diarrhea, difficulty breathing, goose bumps, or, rarely, hallucinations. If you are thinking of stopping the medication, check with your doctor first. This medication should be stopped gradually as recommended by your doctor.
Use of buprenorphine patch: Buprenorphine should not be used on broken or damaged skin. This can lead to higher than normal levels of buprenorphine in the blood stream thus increasing the risk of side effects. In addition, you should not put the buprenorphine patch in your mouth, chew or swallow it, or use it in any way other than applying on skin. This may cause choking and lead to death.
Pregnancy: Taking this medication during pregnancy can harm the developing baby and cause a withdrawal syndrome in the baby after birth. Buprenorphine should not be used during pregnancy. If you become pregnant while using this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are using buprenorphine patches, it may affect your baby. Women taking this medication should not breast-feed.
Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.
Seniors: Seniors may be more sensitive to the effects of buprenorphine and may require a lower dose and monitoring by their doctor as a result.
What other drugs could interact with this medication?
There may be an interaction between buprenorphine sustained release patches and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/BuTrans